Barriers to innovation transfer in a remote and rural health, social care & housing setting
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Introduction: The transfer of good practice into a new area is seldom straightforward. This study investigates the process leading up to transfer in a project which aimed to transfer best practice into health, social care and housing in a remote and rural area. The specific practice was the use of electronic tablets for single shared assessment. The study aimed to answer the Research Question ‘What factors enable or hinder successful practice transfer within a remote and rural setting?’ This was addressed by asking three main sub-questions: - how and why did the key people select electronic single shared assessment for transfer? - what were the attitudes of staff to the electronic tablets for single shared assessment? - what key issues influenced the process leading up to practice transfer? Methodology: A case study design and qualitative research methods were used. Rogers’ theory of diffusion of innovations was used to design a framework for assessment of evidence against the broad areas of the diffusion process. It provided a checklist of elements characterising the active process of diffusion of new practice or innovation. Semi-structured interviews were held with key stakeholders in the implementation and management of the transfer of electronic single shared assessment. Documents including progress reports, minutes of meetings and emails were reviewed. Data was coded and categorised using the qualitative data package QSR N6, a software tool which assists the user to manage data and ideas. Grounded theory was used to analyse and code data. Emerging themes were established against organisational change theory. Themes were then categorised and interpreted against the framework. Results: The lack of time for the project lead to drive the project and insufficient slack resources arising from the rural setting were key reasons for the delay in practice transfer. The project focus shifted from the transfer of electronic single shared assessment to the transfer of improvements to single shared assessment itself. Key aspects of the results reflected theory around the factors influencing organisational change and knowledge transfer. The framework was successful in providing a structure against which the stages of practice transfer could be checked in relation to organisational change. Three gaps were identified: the framework did not allow for technological change in the arrival of laptops instead of electronic computer tablets; the measurement of time corresponding to the slow progress of the project, and the inability of high level management to resolve the issue of IT incompatibility. None of the gaps significantly affected analysis of the study findings. Conclusion: Transfer of good practice requires leadership, resources, and ownership from frontline users. Slack resources, including time, will be key in whether practice transfer will be completed successfully and the new practice sustained across all geographical project areas. More research is needed on transfer of practice in health, social care and housing settings in remote and rural areas.