Dynamics of Innovation Implementation and Organizational Performance in Mental Health Services1

摘要

While organizational variables play an important role in the adoption and implementation of evidence based practices in mental health, most researchers have assumed that successful implementation leads to improving organizational performance. Yet existing organizational theory suggests that implementation differs by organizational characteristics, and certain configurations can lower organizational performance. This study shows how implementation of evidence based practice impacts organizational performance. Specifically, we present a system dynamics simulation model of implementation and organizational performance based on existing theory, system dynamics research, and key informant interviews. By varying organizational characteristics we learn how implementation affects organizational performance, and then explain these effects through subsequent behavioral analysis. These analyses led to a simplification of the theory and model for understanding performance following the implementation of evidence based practice. The theory implies that benefits from evidence-based practice depend on how fast managers can implement the innovation relative to the quality improvement process.