Published in:
Open Access
01-12-2018 | Research article
What can organisational theory offer knowledge translation in healthcare? A thematic and lexical analysis
Authors:
Ann Dadich, Navin Doloswala
Published in:
BMC Health Services Research
|
Issue 1/2018
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Abstract
Background
Despite the relative abundance of frameworks and models to guide implementation science, the explicit use of theory is limited. Bringing together two seemingly disparate fields of research, this article asks, what can organisational theory offer implementation science? This is examined by applying a theoretical lens that incorporates agency, institutional, and situated change theories to understand the implementation of healthcare knowledge into practice.
Methods
Interviews were conducted with 20 general practitioners (GPs) before and after using a resource to facilitate evidence-based sexual healthcare. Research material was analysed using two approaches – researcher-driven thematic coding and lexical analysis, which was relatively less researcher-driven.
Results
The theoretical lens elucidated the complex pathways of knowledge translation. More specifically, agency theory revealed tensions between the GP as agent and their organisations and patients as principals. Institutional theory highlighted the importance of GP-embeddedness within their chosen specialty of general practice; their medical profession; and the practice in which they worked. Situated change theory exposed the role of localised adaptations over time – a metamorphosis.
Conclusions
This study has theoretical, methodological, and practical implications. Theoretically, it is the first to examine knowledge translation using a lens premised on agency, institutional, and situated change theories. Methodologically, the study highlights the complementary value of researcher-driven and researcher-guided analysis of qualitative research material. Practically, this study signposts opportunities to facilitate knowledge translation – more specifically, it suggests that efforts to shape clinician practices should accommodate the interrelated influence of the agent and the institution, and recognise that change can be ever so subtle.