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Dissemination of quality improvement innovations by multisector health care alliances

Larry Hearld (Department of Health Services Administration, University of Alabama, Birmingham, Alabama, USA)
Jeffrey A. Alexander (Department of Health Services Administration, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA)
Laura J. Wolf (Center for Health Care and Policy Research, Pennsylvania State University, University Park, Pennsylvania, USA)
Yunfeng Shi (Center for Health Care and Policy Research, Pennsylvania State University, University Park, Pennsylvania, USA)

Journal of Health Organization and Management

ISSN: 1477-7266

Article publication date: 12 June 2019

Issue publication date: 8 July 2019




Multisector health care alliances (alliances) are increasingly viewed as playing an important role in improving the health and health care of local populations, in part by disseminating innovative practices, yet alliances face a number of challenges to disseminating these practices beyond a limited set of initial participants. The purpose of this paper is to examine how alliances attempt to disseminate innovative practices and the facilitating and inhibiting factors that alliances confront when trying to do so.


The authors adopted multiple holistic case study design of eight alliances with a maximum variation case selection strategy to reflect a range of structural and geographic characteristics. Semi-structured interviews with staff, leaders and board members were used.


The findings show that dissemination is a multidirectional process that is closely if not inextricably intertwined with capacity- and context-related factors (of the alliance, partnering organizations and target organizations). Thus, standardized approaches to dissemination are likely the exception and not the rule, and highlight the value of existing frameworks as a starting point for conceptualizing the important aspects of dissemination, but they are incomplete in their description of the “on-the-ground” dissemination processes that occur in the context of collaborative organizational forms such as alliances.


Despite a rapidly expanding evidence base to guide clinical and managerial decision making, this knowledge often fails to make its way into routine practice. Consequently, the search for effective strategies to reduce this gap has accelerated in the past decade. This study sheds light on those strategies and the challenges to implementing them.



Hearld, L., Alexander, J.A., Wolf, L.J. and Shi, Y. (2019), "Dissemination of quality improvement innovations by multisector health care alliances", Journal of Health Organization and Management, Vol. 33 No. 4, pp. 511-528.



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