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Article
Publication date: 30 August 2011

Rohan Sooklal, Thanos Papadopoulos and Udechukwu Ojiako

This paper utilises a case study to discuss the applicability of normalisation process theory (NPT) as an alternative lens in understanding how social processes impact on the…

1426

Abstract

Purpose

This paper utilises a case study to discuss the applicability of normalisation process theory (NPT) as an alternative lens in understanding how social processes impact on the information systems development (ISD) process.

Design/methodology/approach

The research was undertaken at an educational setting utilising a qualitative case approach.

Findings

The research suggests a framework based on NPT. This framework aims to provide better insights of the normalisation process, based on the views of the development team. The research results strongly support the utilisation of NPT in a non‐healthcare setting. NPT serves as a means to explain the factors and actions that promote the work of routine embedding of new technologies in the practice.

Practical implications

The theory has its foundations in the relative paucity of the extant ISD literature. It also provides a holistic approach for explaining the dynamics entailed in IS project endeavours. This is undertaken by considering the multiplicity and heterogeneity of stakeholders. The usefulness of NPT as a theory for exploring the challenges in embedding a new practice in current ISD endeavours is shown.

Originality/value

The paper discusses how NPT can assist in exploring the social production and organisation of new practices.

Details

Industrial Management & Data Systems, vol. 111 no. 8
Type: Research Article
ISSN: 0263-5577

Keywords

Article
Publication date: 12 February 2018

Cynthia Mejia and Edwin N. Torres

Asynchronous video interviews (AVIs) enable recruiters and job candidates to conduct and review employment interviews at different points in time, promising improved cost and time…

2281

Abstract

Purpose

Asynchronous video interviews (AVIs) enable recruiters and job candidates to conduct and review employment interviews at different points in time, promising improved cost and time efficiencies for all users. This research aims to investigate the implementation and normalization process of AVI in the hospitality industry with the unified theory of acceptance and use of technology (UTAUT) and the normalization process theory (NPT) providing theoretical support.

Design/methodology/approach

Semi-structured interviews have been conducted with hiring managers from three different hospitality companies, which were in different stages of the implementation process. The data have been recorded, transcribed and coded according to the UTAUT and NPT constructs, revealing emergent themes.

Findings

Five overarching themes emerged: AVI effort and efficiency expectation; augmentation to the interview process; challenges for the applicant; challenges for the recruiter; and issues with applicant interviewing aesthetics. Additional coding and analysis with NPT identified the following in terms of evaluation of the implementation process: participants’ implementation activities showed a tendency to emanate from cognitive participation (relationship work), leading to coherence (sense-making work), followed by collective action (enactment of work/operational work) and finally reflexive monitoring (appraisal work).

Practical implications

Findings from this research include recommendations for the best practices integrating AVI into the hospitality employee selection process.

Originality/value

Given the increased demands on the recruitment and selection of talent in the hospitality industry, several organizations have turned to mechanized HR software platforms. The impact of interview modalities and particularly AVI has received limited research attention, thus this study expanded this new stream of literature. Furthermore, this research is among a nascent stream using NPT to evaluate the implementation and normalization of this new technology.

Details

International Journal of Contemporary Hospitality Management, vol. 30 no. 2
Type: Research Article
ISSN: 0959-6119

Keywords

Article
Publication date: 29 March 2021

Pia Vedel Ankersen, Rikke Grynderup Steffensen, Emely Ek Blæhr and Kirsten Beedholm

Life expectancy is 15–20 years shorter for individuals with than for people without mental illness. Assuming that undiagnosed and undertreated somatic conditions are significant…

Abstract

Purpose

Life expectancy is 15–20 years shorter for individuals with than for people without mental illness. Assuming that undiagnosed and undertreated somatic conditions are significant causes, the Central Denmark Region set out to implement joint psychiatric and somatic emergency departments (EDs) to support integrated psychiatric/somatic care as an effort to prolong the lifetime of individuals with mental illness. Through the lens of Normalization Process Theory, the authors examine healthcare frontline staff’s perceptions of and work with the implementation of integrated psychiatric/somatic care in the first joint-specialty ED in Denmark.

Design/methodology/approach

A single-case mixed-methods study using Normalization Process Theory (NPT) as an analytic framework to evaluate implementation of psychiatric/somatic integrated care (IC) in a joint-specialty emergency department. Data were generated from observations, qualitative interviews and questionnaires distributed to the frontline staff.

Findings

Implementation was characterized by a diffuse normalization leading to an adaption of the IC in a fuzzy alignment with existing practice. Especially, confusion among the staff regarding how somatic examination in the ED would ensure prolonged lifetime for people with mental illness was a barrier to sense-making and development of coherence among the staff. The staff questioned the accuracy of IC in the ED even though they recognized the need for better somatic care for individuals with mental illness.

Practical implications

This study highlights that a focus on outcomes (prolonging lifetime for people with mental illness and reducing stigmatization) can be counterproductive. Replacing the outcome focus with an output focus, in terms of how to develop and implement psychiatric/somatic IC with the patient perspective at the center, would probably be more productive.

Originality/value

In 2020, the Danish Health Authorities published new whole-system recommendations for emergency medicine (EM) highlighting the need for intensifying integrated intra and interorganizational care including psychiatric/somatic IC (ref). Even though this study is not conclusive, it points to subjects that can help to identify resources needed to implement psychiatric/somatic IC and to pitfalls. The authors argue that the outcome focus, prolonging the lifetime for individuals with mental illness by identifying somatic illness, was counterproductive. In accordance with the recommendations of contemporary implementation studies, the authors recommend a shift in focus from outcome to output focus; how to develop and implement psychiatric/somatic IC.

Details

Journal of Integrated Care, vol. 30 no. 1
Type: Research Article
ISSN: 1476-9018

Keywords

Article
Publication date: 26 August 2020

Michael Clark, David Jolley, Susan Mary Benbow, Nicola Greaves and Ian Greaves

The scaling up of promising, innovative integration projects presents challenges to social and health care systems. Evidence that a new service provides (cost) effective care in a…

Abstract

Purpose

The scaling up of promising, innovative integration projects presents challenges to social and health care systems. Evidence that a new service provides (cost) effective care in a (pilot) locality can often leave us some way from understanding how the innovation worked and what was crucial about the context to achieve the goals evidenced when applied to other localities. Even unpacking the “black box” of the innovation can still leave gaps in understanding with regard to scaling it up. Theory-led approaches are increasingly proposed as a means of helping to address this knowledge gap in understanding implementation. Our particular interest here is exploring the potential use of theory to help with understanding scaling up integration models across sites. The theory under consideration is Normalisation Process Theory (NPT).

Design/methodology/approach

The article draws on a natural experiment providing a range of data from two sites working to scale up a well-thought-of, innovative integrated, primary care-based dementia service to other primary care sites. This provided an opportunity to use NPT as a means of framing understanding to explore what the theory adds to considering issues contributing to the success or failure of such a scaling up project.

Findings

NPT offers a framework to potentially develop greater consistency in understanding the roll out of models of integrated care. The knowledge gained here and through further application of NPT could be applied to inform evaluation and planning of scaling-up programmes in the future.

Research limitations/implications

The research was limited in the data collected from the case study; nevertheless, in the context of an exploration of the use of the theory, the observations provided a practical context in which to begin to examine the usefulness of NPT prior to embarking on its use in more expensive, larger-scale studies.

Practical implications

NPT provides a promising framework to better understand the detail of integrated service models from the point of view of what may contribute to their successful scaling up.

Social implications

NPT potentially provides a helpful framework to understand and manage efforts to have new integrated service models more widely adopted in practice and to help ensure that models which are effective in the small scale develop effectively when scaled up.

Originality/value

This paper examines the use of NPT as a theory to guide understanding of scaling up promising innovative integration service models.

Details

Journal of Integrated Care, vol. 29 no. 1
Type: Research Article
ISSN: 1476-9018

Keywords

Article
Publication date: 22 April 2020

Daiane Scaraboto, Stefânia Ordovás de Almeida and João Pedro dos Santos Fleck

The purpose of this study is to explain how online brand communities work to support the denormalization of controversial (i.e. illegal yet normalized) gaming practices.

Abstract

Purpose

The purpose of this study is to explain how online brand communities work to support the denormalization of controversial (i.e. illegal yet normalized) gaming practices.

Design/methodology/approach

This qualitative study was characterized by long-term immersion in an online brand community for Brazilian Xbox gamers. The dataset includes online and offline interactions with community members, interviews, and online archival data.

Findings

This study shows how online brand community members promoted legal gaming in a market where piracy was prevalent. It demonstrates how community members worked to establish coherence; engaged in cognitive participation; developed collective action that extended beyond the community; and reflected on their own work.

Research limitations/implications

This study identifies online brand communities as a potential ally in combating controversial practices in online gaming; complements individual and behavioral approaches in explaining why consumers adopt controversial practices in online environments; and adds a normalization framework to the toolkit of Internet researchers.

Practical implications

This study identifies ways in which the potential of online brand communities can be leveraged to reduce consumer adherence to controversial gaming practices through denormalizing these and normalizing alternative practices that may be more desirable to companies and other stakeholders.

Originality/value

This long-term, qualitative study inspired by normalization process theory offers an innovative perspective on the online practices of consumers who engage with a brand in ways that create value for themselves and for the brand.

Details

Internet Research, vol. 30 no. 4
Type: Research Article
ISSN: 1066-2243

Keywords

Article
Publication date: 21 July 2021

Mitchell Sarkies, Suzanne Robinson, Teralynn Ludwick, Jeffrey Braithwaite, Per Nilsen, Gregory Aarons, Bryan J. Weiner and Joanna Moullin

As a discipline, health organisation and management is focused on health-specific, collective behaviours and activities, whose empirical and theoretical scholarship remains…

1130

Abstract

Purpose

As a discipline, health organisation and management is focused on health-specific, collective behaviours and activities, whose empirical and theoretical scholarship remains under-utilised in the field of implementation science. This under-engagement between fields potentially constrains the understanding of mechanisms influencing the implementation of evidence-based innovations in health care. The aim of this viewpoint article is to examine how a selection of theories, models and frameworks (theoretical approaches) have been applied to better understand phenomena at the micro, meso and macro systems levels for the implementation of health care innovations. The purpose of which is to illustrate the potential applicability and complementarity of embedding health organisation and management scholarship within the study of implementation science.

Design/methodology/approach

The authors begin by introducing the two fields, before exploring how exemplary theories, models and frameworks have been applied to study the implementation of innovations in the health organisation and management literature. In this viewpoint article, the authors briefly reviewed a targeted collection of articles published in the Journal of Health Organization and Management (as a proxy for the broader literature) and identified the theories, models and frameworks they applied in implementation studies. The authors then present a more detailed exploration of three interdisciplinary theories and how they were applied across three different levels of health systems: normalization process theory (NPT) at the micro individual and interpersonal level; institutional logics at the meso organisational level; and complexity theory at the macro policy level. These examples are used to illustrate practical considerations when implementing change in health care organisations that can and have been used across various levels of the health system beyond these presented examples.

Findings

Within the Journal of Health Organization and Management, the authors identified 31 implementation articles, utilising 34 theories, models or frameworks published in the last five years. As an example of how theories, models and frameworks can be applied at the micro individual and interpersonal levels, behavioural theories originating from psychology and sociology (e.g. NPT) were used to guide the selection of appropriate implementation strategies or explain implementation outcomes based on identified barriers and enablers to implementing innovations of interest. Projects aiming to implement change at the meso organisational level can learn from the application of theories such as institutional logics, which help elucidate how relationships at the macro and micro-level have a powerful influence on successful or unsuccessful organisational action. At the macro policy level, complexity theory represented a promising direction for implementation science by considering health care organisations as complex adaptive systems.

Originality/value

This paper illustrates the utility of a range of theories, models and frameworks for implementation science, from a health organisation and management standpoint. The authors’ viewpoint article suggests that increased crossovers could contribute to strengthening both disciplines and our understanding of how to support the implementation of evidence-based innovations in health care.

Article
Publication date: 11 October 2022

Irene Mateos Rodriguez, Saba Syed, Paul Wilkinson and Charlotte Tulinius

During the COVID-19 outbreak, clinical schools across the UK were forced to switch their learning from face-to-face to online platforms. This paper aims to describe the…

Abstract

Purpose

During the COVID-19 outbreak, clinical schools across the UK were forced to switch their learning from face-to-face to online platforms. This paper aims to describe the experiences of psychiatry teachers and medical students at Cambridge University of the online psychiatry case-based tutorials during the COVID-19 outbreak and the lessons learned from this implementation.

Design/methodology/approach

The authors conducted qualitative focus groups with students followed by in-depth individual interviews with students and teachers.

Findings

In a data-led systematic text condensation analysis, this study found seven themes: the COVID-19 context, the structure of the course, teachers’ educational ethos, beyond the (teaching) script, possibilities for learning or teaching reflective practice, attitudes to online learning and suggestions for future development. The authors then applied the normalisation process theory (NPT) as the theoretical frame of reference. This model has previously been applied to the implementation of telemedicine in psychiatry, to understand how new technology can become embedded in clinical care.

Originality/value

This study’s results show how the NPT model can be modified to support the delivery of medical education online, including reflective learning and practice as an iterative process at every stage of the implementation and delivery of the teaching.

Details

The Journal of Mental Health Training, Education and Practice, vol. 18 no. 2
Type: Research Article
ISSN: 1755-6228

Keywords

Open Access
Article
Publication date: 21 April 2023

Muhammad Fayyaz Nazir, Ellen Wayenberg and Shahzadah Fahed Qureshi

At the outbreak of the COVID-19 pandemic, the absence of pharmaceutical agents meant that policy institutions had to intervene by providing nonpharmaceutical interventions (NPIs)…

Abstract

Purpose

At the outbreak of the COVID-19 pandemic, the absence of pharmaceutical agents meant that policy institutions had to intervene by providing nonpharmaceutical interventions (NPIs). To satisfy this need, the World Health Organization (WHO) issued policy guidelines, such as NPIs, and the government of Pakistan released its own policy document that included social distancing (SD) as a containment measure. This study explores the policy actors and their role in implementing SD as an NPI in the context of the COVID-19 pandemic.

Design/methodology/approach

The study adopted the constructs of Normalization Process Theory (NPT) to explore the implementation of SD as a complex and novel healthcare intervention under a qualitative study design. Data were collected through document analysis and interviews, and analysed under framework analysis protocols.

Findings

The intervention actors (IAs), including healthcare providers, district management agents, and staff from other departments, were active in implementation in the local context. It was observed that healthcare providers integrated SD into their professional lives through a higher level of collective action and reflexive monitoring. However, the results suggest that more coherence and cognitive participation are required for integration.

Originality/value

This novel research offers original and exclusive scenario narratives that satisfy the recent calls of the neo-implementation paradigm, and provides suggestions for managing the implementation impediments during the pandemic. The paper fills the implementation literature gap by exploring the normalisation process and designing a contextual framework for developing countries to implement guidelines for pandemics and healthcare crises.

Details

Public Administration and Policy, vol. 26 no. 1
Type: Research Article
ISSN: 1727-2645

Keywords

Article
Publication date: 11 September 2017

Shulamit Ramon, Helen Brooks, Sarah Rae and Mary-Jane O’Sullivan

This review paper will look at internationally existing publications in the English language on mental health shared decision making (SDM) implementation of a variety of…

Abstract

Purpose

This review paper will look at internationally existing publications in the English language on mental health shared decision making (SDM) implementation of a variety of interventions, including different methodologies and research methods, age groups and countries. The purpose of this paper is to provide an overview of: process, degree and outcomes of implementation; barriers and facilitators; perspectives on implementation by different stakeholders; analysis of the process of implementation in mental health services through the lenses of the normalisation process theory (NPT).

Design/methodology/approach

Following a targeted literature search the data were analysed in order to provide an overview of methodologies and methods applied in the articles, as well as of the variables listed above. Three different types of information were included: a content analysis of key issues, reflective understanding coming out of participating in implementation of an SDM project in the form of two narratives written by two key participants in an SDM pilot project and an NPT analysis of the process of implementation.

Findings

Only a minority of mental health SDM research focuses on implementation in everyday practice. It is possible and often desirable to achieve SDM in mental health services; it requires a low level of technology, it can save time once routinized, and it is based on enhancing therapeutic alliance, as well as service users’ motivation. Implementation requires an explicit policy decision, a clear procedure, and regular adherence to the aims and methods of implementation by all participants. These necessary and sufficient conditions are rarely met, due to the different levels of commitment to SDM and its process by the different key stakeholders, as well as due to competing providers’ objectives and the time allocated to achieving them.

Originality/value

The review indicates both the need to take into account the complexity of SDM, as well as future strategies for enhancing its implementation in everyday mental health practice. Perhaps because applying SDM reflects a major cultural change in mental health practice, current value attached to SDM among clinicians and service managers would need to be more positive, prominent and enduring to enable a greater degree of implementation.

Details

Mental Health Review Journal, vol. 22 no. 3
Type: Research Article
ISSN: 1361-9322

Keywords

Open Access
Article
Publication date: 27 October 2020

Michelle Myall, Carl May, Alison Richardson, Sarah Bogle, Natasha Campling, Sally Dace and Susi Lund

The purpose of this paper is to explore what happens when changes to clinical practice are proposed and introduced in healthcare organisations. The authors use the implementation…

1904

Abstract

Purpose

The purpose of this paper is to explore what happens when changes to clinical practice are proposed and introduced in healthcare organisations. The authors use the implementation of Treatment Escalation Plans to explore the dynamics shaping the translational journey of a complex intervention from research into the everyday context of real-world healthcare settings.

Design/methodology/approach

A qualitative instrumental collective case study design was used. Data were gathered using qualitative interviews (n = 36) and observations (n = 46) in three English acute hospital trusts. Normalisation process theory provided the theoretical lens and informed data collection and analysis.

Findings

While each organisation faced the same translational problem, there was variation between settings regarding adoption and implementation. Successful change was dependent on participants' ability to manage and shape contexts and the work this involved was reliant on individual capacity to create a new, receptive context for change. Managing contexts to facilitate the move from research into clinical practice was a complex interactive and iterative process.

Practical implications

The paper advocates a move away from contextual factors influencing change and adoption, to contextual patterns and processes that accommodate different elements of whole systems and the work required to manage and shape them.

Originality/value

The paper addresses important and timely issues of change in healthcare, particularly for new regulatory and service-oriented processes and practices. Insights and explanations of variations in implementation are revealed which could contribute to conceptual generalisation of context and implementation.

Details

Journal of Health Organization and Management, vol. 35 no. 9
Type: Research Article
ISSN: 1477-7266

Keywords

1 – 10 of over 5000