Table 1 Definitions of components of Greenhalgh et al.’s diffusion of innovations model
Component | Definition | |
|---|---|---|
Attributes of the innovation | How the potential adopter views the pros and cons of the innovation | |
Relative advantage | A clear, unambiguous advantage in terms of either effectiveness or cost effectiveness. | |
Compatibility | Compatible with the values, norms and perceived needs or intended adopters. | |
Low complexity | Composed of simple, easy to implement steps; able to be broken down and learned on an incremental basis. | |
Trialability | Can be experimented with. | |
Observability | Benefits are (or quickly become) visible to intended adopters. | |
Potential for reinvention | Possibility to adapt, refine or otherwise modify the innovation to suit adopter needs. | |
Fuzzy boundaries | If innovations have ‘hard cores’ (irreducible elements of the innovation) and ‘soft peripheries’ (structures and systems required for full implementation), adaptation of the soft periphery can facilitate adoption. | |
Risk | Risks of the innovation (as perceived by the intended adopter) are outweighed by its perceived benefits. | |
Task issues | Extent to which the innovation is relevant, feasible, workable and easy to use for the adopter. | |
Nature of knowledge | Knowledge required to enact the innovation can be transferred, either by codification (explicit knowledge) or more informally, e.g., by shadowing (tacit knowledge). | |
Technical support | If the innovation is technical, help desk support is available, especially in the early stages of implementation. | |
System antecedents for innovation (including structure and/or absorptive capacity and/or receptive context) | Extent to which the organisation is ready for innovations in general | |
Structure | Size and/or maturity | Practice size is related to innovation adoption, with larger practices faring better regarding implementation; a proxy for other features, e.g., slack resources and functional differentiation. |
Formalisation | The extent to which there are rules and protocols regarding organisational activities which are upheld. | |
Differentiation | The extent to which roles and activities are divided. | |
Decentralisation | Decision-making power is appropriately dispersed across organisations. | |
Slack resources | The resources an organisation has beyond what it minimally requires to maintain operations. | |
Absorptive capacity for new knowledge | A dynamic capability pertaining to knowledge creation and use that enhances an organisation’s ability to gain and sustain a competitive advantage. | |
Pre-existing knowledge and/or skill set | Existing knowledge and skills within the organisation; particularly facilitatory if somehow related to the innovation. | |
| Â | Ability to find, interpret, recodify and integrate new knowledge | The ability to take on, understand, integrate into existing systems and put into productive use new information. |
Enablement of knowledge sharing via internal and external networks | Individuals are able to share knowledge regarding the innovation internally and externally through established networks. | |
Receptive context for change | A combination of factors from both the inner and the outer contexts that together determine an organisation’s ability to respond effectively and purposefully to change. | |
Leadership and vision | Top management support, advocacy of the implementation process and continued commitment to it enhance the success of implementation and routinisation. | |
| Â | Good managerial relations | Staff have positive relationships with managers. |
Risk-taking climate | A supportive working culture where practice staff feel able to experiment with new innovations without fear of being reprimanded. | |
Clear goals and priorities | Objectives are clear to the organisation and the staff. | |
High-quality data capture | Organisational systems are in place to obtain high-quality data related to the innovation diffusion. | |
System readiness for innovation | The extent to which the organisation is ready for the specific innovation. | |
| Â | Tension for change | Degree to which adopters see the current situation as inadequate or intolerable. |
Innovation system fit | The innovation fits with existing values, norms, strategies, goals, skill mix, supporting technologies and ways of working within the organisation. | |
Power balances | Â | |
Assessment of implications | The implications of adoption are known and assessed. | |
Dedicate time and/or resources | Degree to which budget and resources available are adequate and recurrent. | |
Monitoring and feedback | Systems and skills are in place to monitor and evaluate the impact of the innovation and feedback to adopters. | |
Adopter | Those meant to adopt and enact innovations. | |
| Â | Needs | What the adopter needs to be able to adopt the innovation. |
Motivation | Whether the adopter is motivated to adopt the innovation. | |
Values and goals | Does the innovation gel with the adopter’s values and goals? | |
Skills | The skills required to adopt the innovation and whether adopters possess these. | |
Learning style | The ways that adopters learn are considered and catered to in the innovation training. | |
Social networks | The patterns of friendship, advice, communication and support that exist among members of a social system. | |
Implementation process | The process by which a new innovation is diffused across an organisation. | |
| Â | Decision making devolved to front-line teams | Do lead users of the innovation have control over aspects of the implementation process? |
Hands-on approach by leaders and managers | Leaders and managers are involved in the implementation process, supporting and assisting problem solving as required. | |
Human resources issues, especially training | Have all human resources issues linked to the introduction of the innovation (training, workload, supervision, performance management) been addressed adequately? | |
Dedicated resources | Specific resources of time, budget and other relevant resource are dedicated to support implementation. | |
Internal communication | Involved bodies communicate effectively with each other regarding the innovation and the implementation process. | |
External collaboration | Effective knowledge-sharing links to other organisations who are implementing the same innovation. | |
Reinvention and/or development | Was it possible to adapt the innovation or the tasks and processes associated with it to suit local contingencies? | |
Feedback on progress | Are there evaluative and feedback mechanisms in place and enacted? | |