Despite mounting evidence regarding efficacious clinical and managerial practices in health care organizations, a large gap exists between evidence and practice. Recent empirical studies estimate that the implementation rate of innovations identified in quality improvement research is less than 50 percent. An extensive body of literature on implementation effectiveness in health care has largely focused on the role of top management teams and physicians. Middle managers have a critical yet poorly understood role in innovation implementation. The purpose of this study is to assess middle managers'role in innovation implementation in health care organizations. Theory suggests that middle managers in organizations that provide job resources may reciprocate with increased commitment to innovation implementation. The first aim of the proposed study is to employ secondary data from a self-administered survey to assess the relationship between (1) middle managers'commitment to innovation implementation and implementation effectiveness and (2) job resources and middle managers'commitment to innovation implementation. The second study aim is to employ semi- structured interviews to broadly explore the mechanisms through which (1) middle managers'commitment to innovation implementation increases implementation effectiveness and (2) job resources increase middle managers'commitment to innovation implementation. Study results will identify high-leverage ways for health care organizations to facilitate the translation of evidence into practice and contribute to a growing body of literature on implementation effectiveness. PUBLIC HEALTH RELEVANCE: The proposed research is relevant to public health because it will identify high-leverage ways for health care organizations to facilitate the translation of evidence into practice. Implementing innovations has the potential to improve health care quality, access, and costs.

R36HS019107

2010-06-01

2011-05-31