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.

Agency
National Institute of Health (NIH)
Institute
Agency for Healthcare Research and Quality (AHRQ)
Type
Dissertation Award (R36)
Project #
1R36HS019107-01
Application #
7982763
Study Section
Health Systems Research (HSR)
Program Officer
Harding, Brenda
Project Start
2010-06-01
Project End
2011-05-31
Budget Start
2010-06-01
Budget End
2011-05-31
Support Year
1
Fiscal Year
2010
Total Cost
Indirect Cost
Name
University of North Carolina Chapel Hill
Department
Administration
Type
Schools of Public Health
DUNS #
608195277
City
Chapel Hill
State
NC
Country
United States
Zip Code
27599
Birken, Sarah A; Lee, Shoou-Yih Daniel; Weiner, Bryan J et al. (2015) From strategy to action: how top managers' support increases middle managers' commitment to innovation implementation in health care organizations. Health Care Manage Rev 40:159-68
Birken, Sarah A; Lee, Shoou-Yih Daniel; Weiner, Bryan J et al. (2013) Improving the effectiveness of health care innovation implementation: middle managers as change agents. Med Care Res Rev 70:29-45
Birken, Sarah A; Lee, Shoou-Yih Daniel; Weiner, Bryan J (2012) Uncovering middle managers' role in healthcare innovation implementation. Implement Sci 7:28