“It can be very frustrating. I have given them (potential adopters and organizations) the tools and the protocols. I am even available to answer questions, but inevitably the go back and don’t make any changes.” - Linda Wick, Essential Health Heart Failure Program
Alignment of critical features of adopting organizations such as capacity, culture, resources, and leadership consistently determine the success or failure of an innovation’s implementation. In addition, adopting organizations need to understand and anticipate the disruptions that will result from the innovation. This includes thoughtful consideration of the impact of the innovation and the burden of implementation on staff. The adopter is infrequently one person. More often, adoption involves multiple layers of adopters within an organization – from the C-suite to the frontline provider – all of which will be uniquely affected by the innovation within their own professional spheres.
Echoing themes from previous sections, the resources needed to adopt innovations must be in place, including physical space, equipment, and funding, as well as human resources. Staff must invest not only their time, but also their energy and passion into adopting these innovations. Depending on other ongoing activities at the adopting organization, “innovation fatigue” may be a genuine issue, as staff members struggle to balance multiple, concurrent initiatives into their daily work. This fatigue and perceived burden can influence the initial adoption of the innovation as well as its sustainability.
The readiness of the adopting organization is partially dictated by the nature of the innovation. Different innovations may have different and very specific readiness requirements, which further underscore the need to outline the details of such requirements for adopting organizations, perhaps through an innovation-specific readiness assessment or checklist. This is especially true in the case of innovations that rely heavily on HIT capabilities. David Dorr provided the example of primary care practices that have a robust HIT infrastructure already in existence because of efforts to reach “meaningful use” requirements. These practices are better positioned to undertake HIT-related innovations, compared to practices that are just beginning to develop their HIT systems.