The Power of People
How Diffusion of Innovation Works
Martin Alexander MBA
Director of Information Services
South Tyneside NHS Foundation Trust

A Typical Year
Over 61,000 A&E
Attendances
Over 46,000 In
Patient FCEs,
349 Acute
Beds
Over 240,000
Outpatient attendances
73 Community
Services providing over 1.3 million contacts, serving a population of
645,000

The Menu
• A quick bit about me
• About Innovation
• What does it all mean
• Can Technology Save the
NHS?

“The world as we have created it is a process of our thinking. It cannot be changed without changing our thinking.”
― Albert Einstein

A bit about me
Left school in 1981 with 5 G.C.E. O Levels to become a computer operator

The ICT Geek
I shall simply apply my self evident brilliance and the problem shall be solved

Internal Image
Help!!!

Why did NPfIT fail to deliver a universal hospital EPR in England despite having a budget of over
£6 billion?

“Adherence of HCWs to recommended hand hygiene procedures has been reported with very variable figures, in some cases unacceptably poor, with mean baseline rates ranging from 5% to
89%, representing an overall average of
38.7%”
Source : WHO Guidelines on Hand Hygiene in Health
Care, 2009

The study of change
Development
Studies
Ecology
Rural Studies
Economics
Sociology
Medicine
Political
Studies
Psychology
Cultural
Studies
Organisational
Studies
Business
Studies
Anthropology
Organisation
Structure
Marketing
Organisation
Change
Theory
Management and
Leadership
Epidemiology
Evidence
Based
Medicine
Health
Promotion

Attributes Affecting the Adoption of Innovation Within a Population
Source : Rogers. E.M. (2003) Diffusion of Innovation. 5 th ed. New York : Simon and Schuster
Observability
Relative
Advantage
Complexity
Compatibility Trialability

“Rogers viewed innovative change processes from the perspective of a social network of adopted change, which happened over time”

My Research
Research Core Questions
• Can Diffusion of Innovation move from theory to practical applications?
• Can tactics be developed within an IT project , targeting
DoI characteristics, that alter the rate of adoption and therefore improve the outcome of an innovative IT project?
• What can be learnt by developing and implementing these project tactics, and do they differ substantially from established project methodologies, such as Prince 2?

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An Innovative Project
The Patient Flow System
Electronic White Boards
Bed Management
Infection Tracking
E Discharge
Internal Referrals
Care Planning
Doctor / Nurse Hand Over

Entering information into computers gets in the way of caring for patients
14
12
6
1 1
Strongly Agree Agree Neither agree or disagree Disagree Strongly Disagree
Strategy : PIN and IN, Large Touch Sensitive Screens

I know about the NHS IT strategy
15
7 7
5
1
Strongly Agree Agree Neither agree or disagree Disagree Strongly Disagree
Strategy : Communication, news letters, ward visits

I think nurses and doctors should use computers more to improve patient care
13
11
7
2
1
Strongly Agree Agree Neither agree or disagree Disagree Strongly Disagree
Strategy : Mentor Trainers, Early Adopters, Maintain Momentum

Entering data into a computer is not part of my job
15
11
1
Strongly Agree
6
Agree Neither agree or disagree Disagree
Strategy : Find the win
2
Strongly Disagree

I have been fully involved in the design of computer systems I use at work
18
12
4
1
0
Strongly Agree Agree Neither agree or disagree Disagree Strongly Disagree
Strategy : Prototyping, Surveys, Sandpit System

Applied Learning
• Communication strategy
• Pre go live consultation
• Prototype and play
• Mentor Training
• Ward visits
• Drop in sessions
• News Letters

“With the clinical whiteboard I can see where the patients are in the hospital, plan their care and improve their experience”

So What?
Characteristics of Strategic Thinking

Characteristics of Traditional Strategic
Thinking
• Segment the problem
• Draw up a list
• Make a plan
• Count things
• Measure things
• Apply structure
• Create a framework
• Manage resources, people, money, technology
• Lead by example, be a good boss, or be a bossy boss
Dominated by functionalism, structuralism and linear thinking

Dominant World View
“If we do this thing and put this structure in place, good things will happen as a consequence”

New Strategic Thinking
• It offers a view of what we want to be
• It is more about emotions
• It contains abstract ideas
• It sets a framework of thinking
“If we all think this way, this is the potential of what can be achieved”

No