ArticleHealth services management research2012
Innovation sustainability in challenging health-care contexts: embedding clinically led change in routine practice.
Article in Health services management research, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
41 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Revolutionising health and social care: innovative solutions for a brighter tomorrow - a systematic review of the literature.BMC health services research · 2024Pooled it
- Navigating the sustainability landscape: a systematic review of sustainability approaches in healthcare.Implementation science : IS · 2018Pooled it
- An integrated, multidisciplinary management team intervention to improve patient-centeredness, HIV, and maternal-child outcomes in Lesotho: formative research on participatory implementation strategies.BMC health services research · 2024Trial
- Uptake of self-management education programmes for people with type 2 diabetes in primary care through the embedding package: a cluster randomised control trial and ethnographic study.BMC primary care · 2024Trial
- Knowledge Translation Interventions for Youth Health Care Transitions: Protocol for a Realist Review.JMIR research protocols · 2026Article
- Organizational Climate and Decision Aid Sustainability in Lupus Care: Mixed Methods Study.JMIR formative research · 2025Article
- Exploring the sustainability of virtual care interventions: A scoping review.PLOS digital health · 2025Article
- Building capability for clinician-led genomic change: insights from use and non-use of a theory-informed model for change.Frontiers in genetics · 2025Article
- Ensuring best practice in genomics education: A theory- and empirically informed evaluation framework.American journal of human genetics · 2024Review
- Ensuring best practice in genomics education: A scoping review of genomics education needs assessments and evaluations.American journal of human genetics · 2024Article
- Improving Children's Rehabilitation Service Quality and Experience Through Innovative Programming: A Developmental Evaluation of the Bright Ideas Program.Health services insights · 2024Article
- Hurdles of innovation-insights from a new healthcare delivery innovation program.Learning health systems · 2023Article
- Unpacking the 'process of sustaining'-identifying threats to sustainability and the strategies used to address them: a longitudinal multiple case study.Implementation science communications · 2023Article
- TRIPLE C reporting principles for case study evaluations of the role of context in complex interventions.BMC medical research methodology · 2023Review
- TheFrontiers in health services · 2023Article
- Responsible innovation in health and health system sustainability: Insights from health innovators' views and practices.Health services management research · 2022Article
- Sustainability of healthcare improvements for patients admitted with community-acquired pneumonia: follow-up data from a quality improvement project.BMJ open quality · 2022Article
- Sustainability of healthcare professionals' adherence to clinical practice guidelines in primary care.BMC primary care · 2022Article
- Care Home and Home Care Staff's Learning during the COVID-19 Pandemic and Beliefs about Subsequent Changes in the Future: A Survey Study in Sweden, Italy, Germany and the United Kingdom.Healthcare (Basel, Switzerland) · 2022Article
- Conceptualising interventions to enhance spread in complex systems: a multisite comprehensive medication review case study.BMJ quality & safety · 2022Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
The need for organizational innovation as a means of improving health-care quality and containing costs is widely recognized, but while a growing body of research has improved knowledge of implementation, very little has considered the challenges involved in sustaining change - especially organizational change led 'bottom-up' by frontline clinicians. This study addresses this lacuna, taking a longitudinal, qualitative case-study approach to understanding the paths to sustainability of four organizational innovations. It highlights the importance of the interaction between organizational context, nature of the innovation and strategies deployed in achieving sustainability. It discusses how positional influence of service leads, complexity of innovation, networks of support, embedding in existing systems, and proactive responses to changing circumstances can interact to sustain change. In the absence of cast-iron evidence of effectiveness, wider notions of value may be successfully invoked to sustain innovation. Sustainability requires continuing effort through time, rather than representing a final state to be achieved. Our study offers new insights into the process of sustainability of organizational change, and elucidates the complement of strategies needed to make bottom-up change last in challenging contexts replete with competing priorities.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.