I left off last time.....
Sarah Fraser is a consultant to health care organizations in the U.K. She points out "that innovators are not normal people, and look for and enjoy change, while most people are wary of change. " For this reason innovators are poor messengers for spread change. The majority of the people are those that hold the organizaton together, go to work at 7AM and not to a conference. They care for patients from day-to-day. If innovators cast aspersions on this group, then spread change is dead. Spreading innovation must also reduce costs, and there must be a return on investment for the organization that is making change. The organization (or stakeholder) must see financial gain for adopting the "new thing".
The article (which I highly recommend to IT people, vendors, RHIO developers and the like) goes on to discuss
Pilotitis
Low Hanging Fruit Syndrome
Unworkable Universal Solutions
The fallacy of the "tipping point"
Accepting Roger's categorizations of people, ie early, late, laggards
Spreading improvement requires continuous measurement
Without leaders....there is nothing
Implement good ideas is better than spreading good practices
I highly recommend this monograph which can be found at:
http://www.chcf.org/documents/chronicdisease/TheScienceOfSpread.pdf