Replication or Innovation? Structuration in Policy Implementation

2020 ◽  
Vol 3 (2) ◽  
pp. 141-154
Author(s):  
Jodi R Sandfort ◽  
Stephanie Moulton
Keyword(s):  
Large Body ◽  
Implementation Process ◽  
Public Affairs ◽  
Management Approach ◽  
Successful Implementation ◽  
Structural Elements ◽  
Endogenous Factors ◽  
Program Policy ◽  
Institutional System ◽  
Or Organization

Abstract Why does a program, policy, or management approach implemented with success in one jurisdiction or organization fail to achieve similar results in another context? There is a large body of literature in public affairs and related fields that wrestle with this question. Scholars place varying emphasis on the constraints of the institutional system relative to humans’ agency in bringing about successful outcomes, and there is a tendency to generate lists of factors that enable or impede successful implementation. In this article, we present an alternative theoretical approach grounded in structuration processes. We turn to recent empirical scholarship and theory to re-examine what is known about structural elements that influence the implementation process: rules, routines, culture, and resources. This literature emphasizes that the work of these mechanisms is fundamentally shaped by endogenous factors within a system, fueled by the agency of actors within the setting. This is a more robust way to understand how microdynamics shape meso conditions in organizations and networks. Rather than understanding the implementation puzzle as how to replicate effective ideas, this frame suggests more attention to how to support innovation and learning is warranted.

scholarly journals The Views of Health Workforce Managers on the Implementation of Workload Indicators of Staffing Need (WISN) Method in Primary Healthcare Settings in South Africa

2017 ◽  
Vol 3 (1) ◽  
pp. 132
Author(s):  
Ntshengedzeni M. Ravhengani ◽  
Ntombifikile G. Mtshali
Keyword(s):  
South Africa ◽  
Health Workforce ◽  
Primary Healthcare ◽  
Workforce Planning ◽  
Implementation Process ◽  
Health Systems Strengthening ◽  
Management Approach ◽  
Successful Implementation ◽  
Implementation Barriers ◽  
African Countries

Background: Several African countries, including South Africa, are using the Workload Indicators of Staffing Need (WISN) method, as the preferred health workforce planning and management approach. Ineffective implementation of this method can however mean that health outcomes are not improved.Objectives: This study explored the views of health workforce managers regarding potential barriers and enablers to implementation of the WISN method in South African primary healthcare (PHC) settings.Method: This study adopted a qualitative approach and Grounded Theory research design. Following ethics clearance, a total of fourteen participants, PHC nurse managers and WISN coordinators were purposefully selected to participate in the study. Data were collected through focus group interviews and document analysis. Open, axial and selective coding was conducted to analyse data, including the use of Nvivo data analysis software to assist with the analysis.Findings: Participants in this study highlighted a number of conditions necessary for the successful implementation of the WISN method. These included political will and leadership, provision of necessary support to enable implementation process, collaborative and consultative approach by stakeholders, clear, efficient and consistent communication, resources availability, continued support in implementing WISN and stability in leadership and staff in PHC settings.Conclusions: The study concludes that successful WISN implementation requires addressing implementation barriers, such as unavailability of financial and human resources, and enhancing enablers, such as normative guides implementation guideline, technical capacity and availability of continuous support to implementers. This study’s results can be used to enhance WISN implementation and health systems strengthening.

Evidence-based eHealth interventions for caregivers of people with dementia (Myinlife and Partner in Balance): Evaluation of implementations in municipality contexts (Preprint)

2020 ◽  
Author(s):  
Hannah Liane Christie ◽  
Lizzy Mitzy Maria Boots ◽  
Huibert Johannes Tange ◽  
Frans Rochus Josef Verhey ◽  
Marjolein Elizabeth de Vugt
Keyword(s):  
Self Efficacy ◽  
Measurement Instrument ◽  
Implementation Process ◽  
Successful Implementation ◽  
Evidence Based ◽  
Multiple Sources ◽  
Target Groups ◽  
Face To Face ◽  
People With Dementia ◽  
Implementation Context

BACKGROUND Very few evidence-based eHealth interventions for caregivers of people with dementia are implemented into practice. Municipalities are one promising context to implement these interventions, due to their available policy and innovation incentives regarding (dementia) caregiving and prevention. In this study, two evidence-based eHealth interventions for caregivers of people with dementia (Partner in Balance and Myinlife) were implemented in eight municipalities in the Euregion Meuse-Rhine. OBJECTIVE This study’s objectives were to (1.) evaluate this implementation and (2.) investigate determinants of successful implementation. METHODS This study collected eHealth usage data, Partner in Balance coach evaluation questionnaires, and information on implementation determinants. This was done by conducting interviews with the municipality officials, based on the Measurement Instrument for Determinants of Implementation (MIDI). This data from multiple sources and perspectives was integrated and analysed to form a total picture of the municipality implementation process. RESULTS The municipality implementation of Partner in Balance and Myinlife showed varying levels of success. In the end, three municipalities planned to continue the implementation of Partner in Balance, while none planned to continue the implementation of Myinlife. The two Partner in Balance municipalities that did not consider the implementation to be successful, viewed the implementation as an external project. For Myinlife, it was clear that more face-to-face contact was needed to engage the implementing municipality and the target groups. Successful implementations were linked to implementer self-efficacy CONCLUSIONS The experiences of implementing these interventions suggested that this implementation context was feasible regarding the required budget and infrastructure. The need to foster sense of ownership and self-efficacy in implementers will be integrated into future implementation protocols, as part of standard implementation materials for municipalities and organisations implementing Myinlife and Partner in Balance.

scholarly journals Integrating Ecosystem Services and Human Demand for a New Ecosystem Management Approach: A Case Study from the Giant Panda World Heritage Site

2019 ◽  
Vol 12 (1) ◽  
pp. 295 ◽  
Author(s):  
Bin Fu ◽  
Pei Xu ◽  
Yukuan Wang ◽  
Yingman Guo
Keyword(s):  
Ecosystem Services ◽  
Ecosystem Management ◽  
Giant Panda ◽  
Supply And Demand ◽  
World Heritage ◽  
World Heritage Site ◽  
Management Approach ◽  
Successful Implementation ◽  
Heritage Site ◽  
Trade Offs

Ecological management based on the ecosystem approach promotes ecological protection and the sustainable use of natural resources. We developed a quantitative approach to identify the ecological function zones at the country-scale, through integrating supply and demand of ecosystem services. We selected the biologically diverse hotspot of Baoxing County, which forms a part of the Sichuan Giant Panda World Heritage Site, to explore the integration of ecosystem services supply and demand for ecosystem management. Specifically, we assessed the various support, provision, regulating, and cultural services as classified by the Millennium Ecosystem Assessment. We applied the InVEST (Integrated Valuation of Ecosystem Services and Trade-offs) model to spatially map habitat quality, water retention, and carbon sinks, and used statistical data to evaluate food products, animal husbandry, and product supply services. We then quantified the demands for these services in terms of population, protected species, hydropower, water, and land use. The relationship between areas of supply and areas of demand was discussed for each township, and the spatial variability in the supply–demand relationship was also considered. As a result, we spatially divided the county into six ecological functional areas, and the linkages between each region were comprehensively discussed. This study thus provides a detailed methodology for the successful implementation of an ecosystem management framework on a county-scale based on the spatial partitioning of supply and demand.

scholarly journals Implementation and effectiveness of drive-through medication pick-up and home delivery services. A patient safety initiative during COVID-19 pandemic

2021 ◽  
pp. 251604352110090
Author(s):  
Haneen K AlAbbasi ◽  
Shabeer A Thorakkattil ◽  
Syed I Mohiuddin ◽  
Habib S Nemr ◽  
Rita Jabbour ◽  
...  
Keyword(s):  
Patient Safety ◽  
Implementation Process ◽  
Home Delivery ◽  
Successful Implementation ◽  
Social Distancing ◽  
Pharmacy Department ◽  
Ensure Patient Safety ◽  
Number Of Patients ◽  
Delivery Services ◽  
Safety Initiative

Introduction With the emergence of the first COVID-19 case in Saudi Arabia, Johns Hopkins Aramco Healthcare has immediately executed the appropriate protocols in response to this severe global crisis. The pharmacy department at Johns Hopkins Aramco Healthcare continues to play an essential role in providing the safest, efficient, and effective service to its eligible patients. In response to the COVID-19 pandemic, the pharmacy department acted by implementing a drive-through pharmacy and home delivery services as new person-centered services to ensure patient safety. These two new services were initiated to protect both the pharmacist and the patient from COVID-19 infections as they ensure social distancing and reduce patients’ visits to the walk-in pharmacies, hence providing valuable and convenient services during this pandemic. Objective This article aims to describe the implementation processes and effectiveness of drive-through medication pick-up and home-delivery services as a patient safety initiative during the COVID-19 pandemic. Method The implementation process of the drive-through and home delivery services are explained in detail. The utilization of these two services is evaluated by measuring the number of patients and prescriptions between April 2020 and August 2020. Result The increased utilization of drive-through medication pick-up and home delivery services in terms of the number of patients and prescriptions ensures patient safety by minimizing infection risk. Conclusion The increase in the utilization of drive-through medication pick-up and home delivery services reflects its successful implementation during the COVID-19 pandemic. Both services meet the pandemic’s social-distancing requirements and minimize risks of infections, which will ensure patient safety during the COVID-19 pandemic.

Institutional contradiction and BSC implementation: comparative organizational analysis

2019 ◽  
Vol 27 (3) ◽  
pp. 414-440 ◽  
Author(s):  
Nizar Mohammad Alsharari ◽  
Riyad Eid ◽  
Ali Assiri
Keyword(s):  
Balanced Scorecard ◽  
Relevant Literature ◽  
Implementation Process ◽  
Successful Implementation ◽  
Organizational Analysis ◽  
Accounting Systems ◽  
Content Type ◽  
The Balanced Scorecard ◽  
Exploratory Investigation ◽  
Dialectical Perspective

Purpose This paper aims to explain institutional contradictions in the balanced scorecard (BSC) implementation process between organizations, which successfully implemented BSC. The purpose of this paper is to identify a comprehensive set of potential determinants influencing the successful implementation of BSC. Design/methodology/approach This study is an exploratory investigation into the BSC implementation based on a dialectical perspective. It uses the triangulation of data collection including interviews, documents and surveys. This also includes a comprehensive scrutiny of the relevant literature; a comprehensive analysis of case studies of BSC implementations in four organizations; and interviews and documents evidences that have already implemented or are in the process of implementing BSC. Findings The BSC was successfully implemented in the organizations, when the accounting systems introduced in these organization had already been institutionalized, that is, accepted and used on day-to-day basis. The dialectical perspective postulates that for change to become institutionalized in the organization, it needs to overcome the problem of embedded agency. This process of change is possible due to the accumulation of institutional contradiction that enables human praxis to introduce change (Seo and Creed, 2002). Research limitations/implications There is a need to empirically test and refine the proposed factors and explore relationships among the various variables by collecting data from organizations that have already implemented BSC. Practical implications The findings of this study are important and relevant to all the different-sized organizations in the different sectors and industries. This study also makes a significant contribution to society in general. Originality/value This paper contributes to the literature on organizational and accounting change that emphasis the crucial role that institutional contradiction plays in the process of BSC implementation. The findings of this study will help management in making crucial decisions and in resource allocations that are required to make the BSC implementation a success.

scholarly journals Integrative Model of Nussp Program Policy Implementation in the Poor Community Empowerment Based on Tridaya

2017 ◽  
Vol 9 (3) ◽  
pp. 187
Author(s):  
Muhammad Tahir ◽  
Yulianto Kadji ◽  
Zuchri Abdussamad ◽  
Yanti Aneta
Keyword(s):  
Policy Implementation ◽  
Urban Slum ◽  
Community Empowerment ◽  
Integrative Model ◽  
Religious Values ◽  
Successful Implementation ◽  
The Poor ◽  
Program Policy ◽  
Social Empowerment ◽  
Poor Communities

The implementation of NUSSP (Neighborhood Upgrading Shelter Sector Project) program policy is a residential upgrading and settlement sector project in the context of urban slum settlement management for the empowerment of the poor communities based on tridaya in Makassar City which was implemented since 2005-2009 (phase I). This study used a qualitative approach by using case study at five urban villages of NUSSP’s program locations as the key areas, namely: Buloa, Cambaya, Lette, Rappocini, and Balang Beru sub-districts within Makassar. The data collection used in-depth interview, Focus Group Discussion (FGD), direct and participatory observation supported by document study, case history, and triangulation. The results of this study indicated that the integrative model achievement of NUSSP’s program policy implementation in handling of urban slum settlement by using the tridaya’s empowerment approach as an effort to empower the poor society, in the form of output and outcome of policy implementation that had provided benefits for the government and the poor communities from the empowerment development aspect, such as the physical environment, economic empowerment, and social empowerment. Although from the economic aspect and social empowerment were not relatively optimal conducted by government and private parties, neither were not yet relatively optimal conducted by NUSSP executing actors in the utilization of local cultural values and religious values to support the successful implementation of NUSSP program policies in the field. The findings of this study were in the form of the development of “Tridaya” empowerment concept into “Pancadaya” (environmental, social, economic, cultural and religious development). This finding revealed that the importance of the use of cultural and religious values transformed in the poor community empowerment concept, so it was assumed that they will give a significant contribution in supporting the integrative model of NUSSP’s program policy implementation in the handling of slums in order to empower the poor communities in urban slum areas.

scholarly journals Lean management in health care: a review of reviews of socio-technical components for effective impact

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Marta Marsilio ◽  
Martina Pisarra
Keyword(s):  
Health Care ◽  
Implementation Process ◽  
Management Approach ◽  
Lean Management ◽  
Impact Measurement ◽  
Content Type ◽  
Four Dimensions ◽  
Support Organization ◽  
Review Of Reviews

PurposeThe aims of the implementation of lean management in health care are to improve quality of care, to eliminate waste and to increase efficiency. The purpose of this study is to contribute to the advancement of knowledge by investigating which main socio-technical factors are considered to be effective for the implementation and management of lean initiatives.Design/methodology/approachA systematic review of literature reviews on lean management in health care was conducted. The components of the socio-technical system are identified by moving from the socio-technical drivers that support organization-wide quality improvement practices and the lean implementation process in health care. The impacts of lean management are classified using the internal processes, patient, learning and financial dimensions.FindingsThe 28 reviews retrieved confirm the current and increasing interest in lean management. While more than 60% of them call for a system-wide approach, system-wide implementations have rarely been observed, and, instead, adoption in isolated units or departments, or the use of single techniques and tools, prevails. The most commonly investigated socio-technical components are organizational structure, techniques and tools and organizational culture and strategic management. Significant impacts are reported for all the four dimensions. Nonetheless, the review reveals that there is still a lack of evidence on the sustainability of lean results and a need for a standardized impact measurement system.Originality/valueThis work stands out as the first review of reviews of how the socio-technical components of the lean management approach obtain positive impacts within the patient, internal processes, learning and financial dimensions.

scholarly journals Implementering av PICC-line – en kvalitativ studie av anestesisykepleieres erfaringer

2019 ◽  
Vol 14 (2) ◽  
Author(s):  
Stine Thorvaldsen Smith ◽  
Kristin Haraldstad
Keyword(s):  
Central Venous Catheter ◽  
Focus Groups ◽  
Implementation Process ◽  
Venous Catheter ◽  
Nurse Anesthetists ◽  
Successful Implementation ◽  
Central Venous ◽  
Hermeneutic Approach ◽  
Picc Line ◽  
Good Organization

PICC-line, a peripherally inserted central venous catheter has been implemented by several Norwegian hospitals in recent years. Nurse Anesthetists play an important role in this process, and have been given new tasks as a result of PICC-line implementation. This study aimed to describe Nurse Anesthetists’ experiences with implementation of PICC-line in hospital. A qualitative design, the data are based on three focus groups interviews with fifteen nurse anesthetists. The interviews were analyzed using a hermeneutic approach. Being a PICC-line nurse led to a feeling of competence, independence, motivation and meaningfulness. The implementation required good structure and organization, as well as enthusiasm. Collaboration and support influenced the implementation process. Good organization and enough available personnel, as well as good collaboration and support from the Anesthesiologists and the management are essential for a successful implementation.

Factors That Enable or Hinder the Implementation of Game Development Activity in Learning Environments

2020 ◽  
pp. 267-288
Author(s):  
Kevser Hava ◽  
Tolga Guyer ◽  
Hasan Cakir
Keyword(s):  
Computer Games ◽  
Gifted Students ◽  
Implementation Process ◽  
Educational Game ◽  
Successful Implementation ◽  
Game Engine ◽  
Development Activity ◽  
Negative Attitudes ◽  
Game Development ◽  
Instructional Process

This study aims to investigate the factors that enable or hinder the implementation of game development activity in the instructional process. One instructor and 15 gifted students between the ages of 11 and 15 took part in the study. The students developed computer games related to science topics using MS Kodu game engine within the implementation process. According to the findings, it is seen that instructional practices have great importance, and the instructor plays a key role in the activity. Making and playing games have been the greatest motivation resource for students. In addition, the social environment can be an important tool in sustaining students' motivation levels. The students' negative attitudes toward educational game topics and non-computer activities hinder the successful implementation of the activity. The MS Kodu game engine might be appropriate for novice designers but not be enough for teaching programming concepts. Team-based game development activity is believed to be useful for developing advanced games and increasing the level of interaction between students.

Factors That Enable or Hinder the Implementation of Game Development Activity in Learning Environments

2022 ◽  
pp. 344-364
Author(s):  
Kevser Hava ◽  
Tolga Guyer ◽  
Hasan Cakir
Keyword(s):  
Computer Games ◽  
Gifted Students ◽  
Implementation Process ◽  
Educational Game ◽  
Successful Implementation ◽  
Game Engine ◽  
Development Activity ◽  
Negative Attitudes ◽  
Game Development ◽  
Instructional Process

This study aims to investigate the factors that enable or hinder the implementation of game development activity in the instructional process. One instructor and 15 gifted students between the ages of 11 and 15 took part in the study. The students developed computer games related to science topics using MS Kodu game engine within the implementation process. According to the findings, it is seen that instructional practices have great importance, and the instructor plays a key role in the activity. Making and playing games have been the greatest motivation resource for students. In addition, the social environment can be an important tool in sustaining students' motivation levels. The students' negative attitudes toward educational game topics and non-computer activities hinder the successful implementation of the activity. The MS Kodu game engine might be appropriate for novice designers but not be enough for teaching programming concepts. Team-based game development activity is believed to be useful for developing advanced games and increasing the level of interaction between students.

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