3 resultados para Healthcare innovation adoption

em Digital Commons at Florida International University


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Research on the adoption of innovations by individuals has been criticized for focusing on various factors that lead to the adoption or rejection of an innovation while ignoring important aspects of the dynamic process that takes place. Theoretical process-based models hypothesize that individuals go through consecutive stages of information gathering and decision making but do not clearly explain the mechanisms that cause an individual to leave one stage and enter the next one. Research on the dynamics of the adoption process have lacked a structurally formal and quantitative description of the process. ^ This dissertation addresses the adoption process of technological innovations from a Systems Theory perspective and assumes that individuals roam through different, not necessarily consecutive, states, determined by the levels of quantifiable state variables. It is proposed that different levels of these state variables determine the state in which potential adopters are. Various events that alter the levels of these variables can cause individuals to migrate into different states. ^ It was believed that Systems Theory could provide the required infrastructure to model the innovation adoption process, particularly applied to information technologies, in a formal, structured fashion. This dissertation assumed that an individual progressing through an adoption process could be considered a system, where the occurrence of different events affect the system's overall behavior and ultimately the adoption outcome. The research effort aimed at identifying the various states of such system and the significant events that could lead the system from one state to another. By mapping these attributes onto an “innovation adoption state space” the adoption process could be fully modeled and used to assess the status, history, and possible outcomes of a specific adoption process. ^ A group of Executive MBA students were observed as they adopted Internet-based technological innovations. The data collected were used to identify clusters in the values of the state variables and consequently define significant system states. Additionally, events were identified across the student sample that systematically moved the system from one state to another. The compilation of identified states and change-related events enabled the definition of an innovation adoption state-space model. ^

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This is an empirical study whose purpose was to examine the process of innovation adoption as an adaptive response by a public organization and its subunits existing under varying degrees of environmental uncertainty. Meshing organization innovation research and contingency theory to form a theoretical framework, an exploratory case study design was undertaken in a large, metropolitan government located in an area with the fourth highest prevalence rate of HIV/AIDS in the country. A number of environmental and organizational factors were examined for their influence upon decision making in the adoption/non-adoption as well as implementation of any number of AIDS-related policies, practices, and programs.^ The major findings of the study are as follows. For the county government itself (macro level), no AIDS-specific workplace policies have been adopted. AIDS activities (AIDS education, AIDS Task Force, AIDS Coordinator, etc.), adopted county-wide early in the epidemic, have all been abandoned. Worker infection rates, in the aggregate and throughout the epidemic have been small. As a result, absent co-worker conflict (isolated and negligible), no increase in employee health care costs, no litigation regarding discrimination, and no major impact on workforce productivity, AIDS has basically become a non-issue at the strategic core of the organization. At the departmental level, policy adoption decisions varied widely. Here the predominant issue is occupational risk, i.e., both objective as well as perceived. As expected, more AIDS-related activities (policies, practices, and programs) were found in departments with workers known to have significant risk for exposure to the AIDS virus (fire rescue, medical examiner, police, etc.). AIDS specific policies, in the form of OSHA's Bloodborn Pathogen Standard, took place primarily because they were legislatively mandated. Union participation varied widely, although not necessarily based upon worker risk. In several departments, the union was a primary factor bringing about adoption decisions. Additional factors were identified and included organizational presence of AIDS expertise, availability of slack resources, and the existence of a policy champion. Other variables, such as subunit size, centralization of decision making, and formalization were not consistent factors explaining adoption decisions. ^

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Government call centers (311) were first created to reduce the volume of non-emergency calls that were being placed to emergency 911 call centers. The number of 311 call centers increased from 57 in 2008 to about 300 in 2013. Considering that there are over 2,700 municipal government units across the United States, the adoption rate of the 311 centers is arguably low in the country. This dissertation is an examination of the adoption of 311 call centers by municipal governments. My focus is specifically on why municipal governments adopt 311 and identifying which barriers result in the non-adoption of 311 call centers. This dissertation is possibly the first study to examine the adoption of 311 call centers in the United States. The dissertation study has identified several significant factors in the adoption and non-adoption of 311 government call centers. The following factors were significant in the adoption of 311 government call centers: managerial support, financial constraints, organizational responsiveness, strategic plan placement, and technology champion. The following factors were significant barriers that resulted in the non-adoption of a 311 government call center; no demand from citizens, start up costs, annual operating costs, unavailability of funding, and no obvious need for one.If local government entities that do not have a 311 government call center decide to adopt one, this study will help them identify the conditions that need to be in place for successful adoption to occur. Local government officials would first need to address the barriers in setting up the 311 call centers.