Organizational theory for dissemination and implementation research
Organizational theory for dissemination and implementation research
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DOI：
10.1186/s13012-017-0592-x
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发表时间：
2017-05-12
影响因子：
7.2
通讯作者：
Weiner, Bryan J.
中科院分区：
文献类型：
--
作者：
Birken, Sarah A.;Bunger, Alicia C.;Weiner, Bryan J.
背景：即使在最佳的内部组织条件下，组织外部环境的变化也可能会破坏实施，例如资金波动、合同实践的调整、新技术、新立法、临床实践指南和建议的变化或其他环境变化。内部组织条件越来越多地反映在实施框架中，但实施研究缺乏对组织外部环境如何影响实施成功的细致解释。组织理论为实施研究人员提供了许多现有的、高度相关的、迄今为止尚未开发的关于组织与其环境之间复杂相互作用的解释。在本文中，我们展示了组织理论在实施研究中的实用性。讨论：我们应用了四种著名的组织理论（制度理论、交易成本经济学、权变理论和资源依赖理论）来发表对实施 SafeCare 的努力的描述，SafeCare 是一种防止虐待和忽视儿童的循证实践。交易成本经济学理论解释了频繁且不确定的 SafeCare 签约流程可能会导致效率低下，从而影响私营儿童福利组织的实施。制度理论解释了儿童福利系统如何被激励实施 SafeCare，因为这样做符合儿童福利系统专业社区内主要利益相关者的期望。应急理论解释了机构间协作团队等工作如何通过促进适应儿童福利机构的内部和外部环境来促进 SafeCare 的实施。资源依赖理论 (RDT) 解释了由合同、谅解备忘录和谈判支持的机构间关系如何通过平衡自主权和对资助机构和 SafeCare 开发人员的依赖来促进 SafeCare 的实施。总结：除了上述组织理论的回顾性应用之外，我们主张主动使用组织理论来设计实施研究。例如，应选择实施策略以最大限度地减少交易成本，随着时间的推移促进和保持组织动态的内部和外部环境之间的一致性，并在满足组织的财务需求的同时保留其自主权。我们描述了在实施研究中应用组织理论对实施策略、实施工作评估、测量、研究设计、理论和实践的影响。我们还为实施研究人员提供应用组织理论的指导。
Background: Even under optimal internal organizational conditions, implementation can be undermined by changes in organizations' external environments, such as fluctuations in funding, adjustments in contracting practices, new technology, new legislation, changes in clinical practice guidelines and recommendations, or other environmental shifts. Internal organizational conditions are increasingly reflected in implementation frameworks, but nuanced explanations of how organizations' external environments influence implementation success are lacking in implementation research. Organizational theories offer implementation researchers a host of existing, highly relevant, and heretofore largely untapped explanations of the complex interaction between organizations and their environment. In this paper, we demonstrate the utility of organizational theories for implementation research.Discussion: We applied four well-known organizational theories (institutional theory, transaction cost economics, contingency theories, and resource dependency theory) to published descriptions of efforts to implement SafeCare, an evidence-based practice for preventing child abuse and neglect. Transaction cost economics theory explained how frequent, uncertain processes for contracting for SafeCare may have generated inefficiencies and thus compromised implementation among private child welfare organizations. Institutional theory explained how child welfare systems may have been motivated to implement SafeCare because doing so aligned with expectations of key stakeholders within child welfare systems' professional communities. Contingency theories explained how efforts such as interagency collaborative teams promoted SafeCare implementation by facilitating adaptation to child welfare agencies' internal and external contexts. Resource dependency theory (RDT) explained how interagency relationships, supported by contracts, memoranda of understanding, and negotiations, facilitated SafeCare implementation by balancing autonomy and dependence on funding agencies and SafeCare developers.Summary: In addition to the retrospective application of organizational theories demonstrated above, we advocate for the proactive use of organizational theories to design implementation research. For example, implementation strategies should be selected to minimize transaction costs, promote and maintain congruence between organizations' dynamic internal and external contexts over time, and simultaneously attend to organizations' financial needs while preserving their autonomy. We describe implications of applying organizational theory in implementation research for implementation strategies, the evaluation of implementation efforts, measurement, research design, theory, and practice. We also offer guidance to implementation researchers for applying organizational theory.