Robin Urquhart1, Lois Jackson2, Joan Sargeant3, Geoffrey A Porter4, Eva Grunfeld5. 1. Assistant Professor, Department of Surgery, Dalhousie University, Halifax, NS. 2. Professor, School of Health and Human Performance, Dalhousie University, Halifax, NS. 3. Acting Head and Professor, Division of Medical Education Dalhousie University, Halifax, NS. 4. Professor, Department of Surgery, Dalhousie University, Halifax, NS. 5. Giblon Professor and Vice Chair, Research, Department of Family and Community Medicine, University of Toronto Toronto, ON.
Abstract
BACKGROUND: The movement of new knowledge and tools into healthcare settings continues to be a slow, complex and poorly understood process. In this paper, we present the system-level factors important to the implementation of synoptic reporting tools in two initiatives (or cases) in Nova Scotia, Canada. METHODS: This study used case study methodology. Data were collected through interviews with key informants, document analysis, non-participant observation and tool use/examination. Analysis involved production of case histories, analysis of each case and a cross-case analysis. RESULTS: The healthcare system's delivery and support structure, information technology infrastructure, policy environment and history of collaboration and inter-organizational relationships influenced tool implementation in the two cases. CONCLUSIONS: The findings provide an in-depth, nuanced understanding of how healthcare system components can influence the implementation of a new tool in clinical practice.
BACKGROUND: The movement of new knowledge and tools into healthcare settings continues to be a slow, complex and poorly understood process. In this paper, we present the system-level factors important to the implementation of synoptic reporting tools in two initiatives (or cases) in Nova Scotia, Canada. METHODS: This study used case study methodology. Data were collected through interviews with key informants, document analysis, non-participant observation and tool use/examination. Analysis involved production of case histories, analysis of each case and a cross-case analysis. RESULTS: The healthcare system's delivery and support structure, information technology infrastructure, policy environment and history of collaboration and inter-organizational relationships influenced tool implementation in the two cases. CONCLUSIONS: The findings provide an in-depth, nuanced understanding of how healthcare system components can influence the implementation of a new tool in clinical practice.
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