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Special Communication |

Disseminating Innovations in Health Care

Donald M. Berwick, MD, MPP
JAMA. 2003;289(15):1969-1975. doi:10.1001/jama.289.15.1969.
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Published online

Health care is rich in evidence-based innovations, yet even when such innovations are implemented successfully in one location, they often disseminate slowly—if at all. Diffusion of innovations is a major challenge in all industries including health care. This article examines the theory and research on the dissemination of innovations and suggests applications of that theory to health care. It explores in detail 3 clusters of influence on the rate of diffusion of innovations within an organization: the perceptions of the innovation, the characteristics of the individuals who may adopt the change, and contextual and managerial factors within the organization. This theory makes plausible at least 7 recommendations for health care executives who want to accelerate the rate of diffusion of innovations within their organizations: find sound innovations, find and support "innovators," invest in "early adopters," make early adopter activity observable, trust and enable reinvention, create slack for change, and lead by example.

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Figure 1. Cumulative Number of Adopters of Hybrid Seed Corn in 2 Iowa Communities
Graphic Jump Location
Reprinted with permission from Rogers.21
Figure 2. Adopter Categorization on the Basis of Innovativeness
Graphic Jump Location
Reprinted with permission from Rogers.21

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