TY - JOUR
T1 - Pathways for best practice diffusion
T2 - The structure of informal relationships in Canada's long-term care sector
AU - Dearing, James W.
AU - Beacom, Amanda M.
AU - Chamberlain, Stephanie A.
AU - Meng, Jingbo
AU - Berta, Whitney B.
AU - Keefe, Janice M.
AU - Squires, Janet E.
AU - Doupe, Malcolm B.
AU - Taylor, Deanne
AU - Reid, Robert Colin
AU - Cook, Heather
AU - Cummings, Greta G.
AU - Baumbusch, Jennifer L.
AU - Knopp-Sihota, Jennifer
AU - Norton, Peter G.
AU - Estabrooks, Carole A.
N1 - Publisher Copyright:
© 2017 The Author(s).
PY - 2017/2/3
Y1 - 2017/2/3
N2 - Background: Initiatives to accelerate the adoption and implementation of evidence-based practices benefit from an association with influential individuals and organizations. When opinion leaders advocate or adopt a best practice, others adopt too, resulting in diffusion. We sought to identify existing influence throughout Canada's long-term care sector and the extent to which informal advice-seeking relationships tie the sector together as a network. Methods: We conducted a sociometric survey of senior leaders in 958 long-term care facilities operating in 11 of Canada's 13 provinces and territories. We used an integrated knowledge translation approach to involve knowledge users in planning and administering the survey and in analyzing and interpreting the results. Responses from 482 senior leaders generated the names of 794 individuals and 587 organizations as sources of advice for improving resident care in long-term care facilities. Results: A single advice-seeking network appears to span the nation. Proximity exhibits a strong effect on network structure, with provincial inter-organizational networks having more connections and thus a denser structure than interpersonal networks. We found credible individuals and organizations within groups (opinion leaders and opinion-leading organizations) and individuals and organizations that function as weak ties across groups (boundary spanners and bridges) for all studied provinces and territories. A good deal of influence in the Canadian long-term care sector rests with professionals such as provincial health administrators not employed in long-term care facilities. Conclusions: The Canadian long-term care sector is tied together through informal advice-seeking relationships that have given rise to an emergent network structure. Knowledge of this structure and engagement with its opinion leaders and boundary spanners may provide a route for stimulating the adoption and effective implementation of best practices, improving resident care and strengthening the long-term care advice network. We conclude that informal relational pathways hold promise for helping to transform the Canadian long-term care sector.
AB - Background: Initiatives to accelerate the adoption and implementation of evidence-based practices benefit from an association with influential individuals and organizations. When opinion leaders advocate or adopt a best practice, others adopt too, resulting in diffusion. We sought to identify existing influence throughout Canada's long-term care sector and the extent to which informal advice-seeking relationships tie the sector together as a network. Methods: We conducted a sociometric survey of senior leaders in 958 long-term care facilities operating in 11 of Canada's 13 provinces and territories. We used an integrated knowledge translation approach to involve knowledge users in planning and administering the survey and in analyzing and interpreting the results. Responses from 482 senior leaders generated the names of 794 individuals and 587 organizations as sources of advice for improving resident care in long-term care facilities. Results: A single advice-seeking network appears to span the nation. Proximity exhibits a strong effect on network structure, with provincial inter-organizational networks having more connections and thus a denser structure than interpersonal networks. We found credible individuals and organizations within groups (opinion leaders and opinion-leading organizations) and individuals and organizations that function as weak ties across groups (boundary spanners and bridges) for all studied provinces and territories. A good deal of influence in the Canadian long-term care sector rests with professionals such as provincial health administrators not employed in long-term care facilities. Conclusions: The Canadian long-term care sector is tied together through informal advice-seeking relationships that have given rise to an emergent network structure. Knowledge of this structure and engagement with its opinion leaders and boundary spanners may provide a route for stimulating the adoption and effective implementation of best practices, improving resident care and strengthening the long-term care advice network. We conclude that informal relational pathways hold promise for helping to transform the Canadian long-term care sector.
KW - Advice seeking
KW - Canada
KW - Diffusion of innovations
KW - Integrated knowledge translation
KW - Long-term care
KW - Long-term care sector
KW - Opinion leadership
KW - Social network analysis
UR - http://www.scopus.com/inward/record.url?scp=85011357479&partnerID=8YFLogxK
U2 - 10.1186/s13012-017-0542-7
DO - 10.1186/s13012-017-0542-7
M3 - Journal Article
C2 - 28159009
AN - SCOPUS:85011357479
VL - 12
JO - Implementation Science
JF - Implementation Science
IS - 1
M1 - 11
ER -