Individual factors influencing the diffusion of process innovations from manufacturing to health services settings

![CDATA[This paper presents an organisational behaviour perspective of individual level factors influencing diffusion of innovation (DoI) in a public hospital. The innovation consists of applying Lean principles coupled with computer simulation of process changes in the imaging department of a medium-sized tertiary public hospital. Greenhalgh and colleagues (2004) have identified eleven factors that influence the spread and sustainability of innovation in health settings: (1) relative advantage, (2) compatibility, (3) low complexity, (4) trialability, (5) observability, (6) potential for reinvention, (7) fuzzy boundaries, (8) minimal risk, (9) relevance, (10) the nature of knowledge required and (11) support. Aim: To determine if these factors help to understand DoI from manufacturing to health settings. Methodology: Semi-structured interviews were conducted with eight hospital personnel who helped identify and implement strategies to improve patient-flow within the imaging department. The interview schedule reflected the 11 factors identified by Greenhalgh and colleagues (2004). Interviews were examined for thematic similarities and differences. Findings: This paper reports on attributes of innovation-individual interactions that helped and hindered DoI, in a public hospital adopting process innovations originating in manufacturing settings. Computer simulation eased the implementation of process changes because it: (1) helped to assess relative advantage; (2) presented information in a manner that corresponded with individual preferences; (3) was simple and user-friendly; (4) allowed for experimentation; (5) was visual; (6) could be adapted to the department; (7) could accommodate the dynamic nature of departmental processes; (8) offered minimal risk; (9) was relevant to the research participants; (10) offered information that could be transferred from one context to another. Conclusions and Implications: This study has significant implications for practice and research. For practitioners, it suggests that the DoI can be guided by the 11 lessons identified by Greenhalgh et al. (2004), but that the combination of innovation and context may add other factors. For researchers, this study highlights the need for additional research to test the value of computer simulation when implementing other reforms.]]