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Diffusion of innovations, defined as the adoption and implementation of new ideas, processes, products, or services in health care, is both particularly important and especially challenging. One known problem with adoption and implementation of new technologies is that, while organizations often make innovations immediately available, organizational actors are more wary about adopting new technologies because these may impact not only patients and practices but also reimbursement. As a result, innovations may remain underutilized, and organizations may miss opportunities to improve and advance. As innovation adoption is vital to achieving success and remaining competitive, it is important to measure and understand factors that impact innovation diffusion. Building on a survey of a national sample of 654 clinicians, our study measures the extent of diffusion of value-enhancing care delivery innovations (i.e., technologies that not only improve quality of care but has potential to reduce care cost by diminishing waste, Faems et al., 2010) for 13 clinical specialties and identifies healthcare-specific individual characteristics such as: professional purview, supervisory responsibility, financial incentive, and clinical tenure associated with innovation diffusion. We also examine the association of innovation diffusion with perceived value of one type of care delivery innovation – artificial intelligence (AI) – for assisting clinicians in their clinical work. Responses indicate that less than two-thirds of clinicians were knowledgeable about and aware of relevant value-enhancing care delivery innovations. Clinicians with broader professional purview, more supervisory responsibility, and stronger financial incentives had higher innovation diffusion scores, indicating greater knowledge and awareness of value-enhancing, care delivery innovations. Higher levels of knowledge of the innovations and awareness of their implementation were associated with higher perceptions of the value of AI-based technology. Our study contributes to our knowledge of diffusion of innovation in healthcare delivery and highlights potential mechanisms for speeding innovation diffusion.

In the early 2010s, the University of Wisconsin-Madison (UW-Madison) became increasingly concerned about incidents of academic workplace “bullying” on the campus, and in 2014–2016 created policies designed to address such behavior at the University. The new policies and accompanying initiatives were implemented in 2017, defining a new term to describe these behaviors as “hostile and intimidating behavior” (HIB). We use data from three sources to explore the outcomes of the new HIB policies and initiatives to date. Evaluation data from training sessions show the importance of educating the campus community about HIB, providing evidence that the training sessions increase HIB knowledge. Data from two campus-wide surveys measure incidence of HIB for different groups on campus (e.g., analysis by gender, race/ethnicity, sexual orientation, disability status, rank, job duty, and/or the intersection of these characteristics), as well as changes in the knowledge about HIB as reported by faculty and staff. These data show that UW-Madison faculty and staff are increasing their knowledge of HIB as a problem and also increasing their knowledge about what to do about it. Underrepresented groups who more commonly experience HIB agree that this culture is improving. At the same time, we are seeing slow and uneven progress in reduction of actual incidence of HIB at UW-Madison. We close with some “lessons learned” about instituting such a sweeping, campus-wide effort to reduce HIB, in the hopes that other campuses can learn from our experience.

This chapter examines the translation of generic global goals into local action. It first discusses the translation of global goals into national agendas and the challenges of localizing the goals. Localizing the goals is essential for ensuring that the SDGs reflect local needs, norms, and values, thus ensuring that local actors find them relevant and meaningful. The chapter argues that cocreation is a key vehicle for the localization of the SDGs and identifies the key benefits that arise from using cocreation as a localization strategy. Cocreation can foster the will and capacity for local governments and communities to advance the cause of sustainability. Cocreation can help communities integrate the sustainable development goals, identify hidden resources, build support networks, create social accountability, etc.

Collegiality is often discussed and analyzed as a challenged form of governance, a form of working that used to function well in universities prior to the emergence of contemporary and modern forms of governance. This seems to suggest that collegiality used to dominate, while other forms of governance are now taking over. The papers in volume 86 of this special issue support the notion of challenged collegiality, but also show that for the most part, nostalgic notions of “the good old days” are neither true nor helpful if we are to revitalize academic collegiality. After examining whether a golden age of collegiality ever existed, we discuss why collegiality matters. Exploring what are often described as limitations or “dark sides” of collegiality, we address four such “dark sides” related to slow decision-making, conflicts, parochialism, and diversity. This is followed by a discussion of how these limitations may be handled and what measures must be taken to maintain and develop collegiality. With a brief summary of the remaining papers under two headings, “Maintaining collegiality” and “Revitalizing collegiality,” we preview the rest of this volume.