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Organizational Change

Everett M. Rogers in his book Diffusion of Innovations describes the elements of diffusion as "1) an innovation that is 2) communicated through channels 3) over time 4) among members of a social system." (Rogers, 1995)  Diffusion occurs when an organizational change (the group medical visit) is fully integrated into the organization (outpatient medical practice). He describes the different stages of integrating change into a social system, which is described in the attached presentation outline.  This is helpful, when considering that group medical visits are an entirely new way for providing health care. It takes time and is dependent on many other factors, such as other stresses and strains on the department, the system's history of innovation, personnel, and time.

Rogers also describes different categories of adopters, which is useful when thinking about conducting group medical visits, which is really about changing patients, providers and a system's way of looking at how medical care is provided.  There are usually one or two innovators, who can then recruit and inspire the early adaptors.  Once the group medical visit "experiment" has met with success, the late adopters may join in and be convinced that this will be a usual, customary service provided by your organization.  During this critical phase, it is helpful to bring in an outside "expert" who can work with all layers of the system to inspire, and provide the knowledge and skills to all layers of the system to fully integrate group medical visits into the system of care. The attached powerpoint presentation is a visual model describing the percentage of the different categories of adopters that are found in a "typical" organization.
 

Rogers, EM. Diffusion of Innovations (4th edition). New York, New York. Free Press. 1995. 

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