Agency and implementation: Understanding the embedding of healthcare innovations in practice
An innovation is almost never a thing-in-itself. To be sure, there is often what looks like a thing – a newly invented or modified way of thinking or acting, or an artifact, or a system – that is identified in everyday talk as something new. In healthcare, as in almost every other area of human organization, innovations often involve highly organized, institutionally sanctioned, and systematically regulated changes in the structure and delivery of services. This paper presents a theory of implementation and embedding of innovations – Normalization Process Theory – and explores its application to a highly complex ensemble of socio-technical practices, clinical shared decision making. The theoretical analysis presented here shows how implementation as a process and embedding as a state can be conceptualized in terms of social mechanisms that effect changes in the ways that agents' contribute to normative restructuring, the reworking of relational conventions and group processes, the enacting of practices, and their projection into the future.
If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.
Volume (Year): 78 (2013)
Issue (Month): C ()
|Contact details of provider:|| Web page: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description|
|Order Information:|| Postal: http://www.elsevier.com/wps/find/supportfaq.cws_home/regional|
References listed on IDEAS
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Rapley, Tim & May, Carl & Heaven, Ben & Murtagh, Madeline & Graham, Ruth & Kaner, Eileen F.S. & Thomson, Richard, 2006. "Doctor-patient interaction in a randomised controlled trial of decision-support tools," Social Science & Medicine, Elsevier, vol. 62(9), pages 2267-2278, May.
- Charles, Cathy & Gafni, Amiram & Whelan, Tim, 1997. "Shared decision-making in the medical encounter: What does it mean? (or it takes at least two to tango)," Social Science & Medicine, Elsevier, vol. 44(5), pages 681-692, March.
- Sinding, Christina & Hudak, Pamela & Wiernikowski, Jennifer & Aronson, Jane & Miller, Pat & Gould, Judy & Fitzpatrick-Lewis, Donna, 2010. ""I like to be an informed person but..." negotiating responsibility for treatment decisions in cancer care," Social Science & Medicine, Elsevier, vol. 71(6), pages 1094-1101, September.
- May, Carl & Rapley, Tim & Moreira, Tiago & Finch, Tracy & Heaven, Ben, 2006. "Technogovernance: Evidence, subjectivity, and the clinical encounter in primary care medicine," Social Science & Medicine, Elsevier, vol. 62(4), pages 1022-1030, February.
- Charles, Cathy & Gafni, Amiram & Whelan, Tim, 1999. "Decision-making in the physician-patient encounter: revisiting the shared treatment decision-making model," Social Science & Medicine, Elsevier, vol. 49(5), pages 651-661, September.
- Nicolini, Davide, 2006. "The work to make telemedicine work: A social and articulative view," Social Science & Medicine, Elsevier, vol. 62(11), pages 2754-2767, June.
- Greenhalgh, Trisha & Stones, Rob, 2010. "Theorising big IT programmes in healthcare: Strong structuration theory meets actor-network theory," Social Science & Medicine, Elsevier, vol. 70(9), pages 1285-1294, May.
When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:78:y:2013:i:c:p:26-33. See general information about how to correct material in RePEc.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Shamier, Wendy)
If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.
If references are entirely missing, you can add them using this form.
If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.
If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.
Please note that corrections may take a couple of weeks to filter through the various RePEc services.