ZP03316

Summary - Organizational theory for dissemination and implementation research

Organizations’ external environments influence implementation success are generally lacking

in implementation research. Four organizational theories (transaction cost economics, resource
dependency theory, institutional theory, and contingency theories) that found to be particularly
apt for retrospectively explaining how and why interactions between organizations and their
external environments influenced the implementation of SafeCare, a program for preventing
child maltreatment. Using a structured, behavioral approach, trained SafeCare providers
deliver in-home parent training in three core content areas: home safety, child health, and
parent-child interactions. SafeCare challenges associated with three stages of SafeCare life
cycle (adoption, implementation, and sustainment). TCE suggests that implementation
strategies should seek to minimize transaction costs. Institutional theory suggests that an
organization will implement an innovation when it is in congruence with the values, norms,
and expectations espoused by institutions in an organization’s environment. Contingency
theories suggest that implementation optimally involves adaptation to organizations’ internal
contexts (e.g., organizational capacity, mission and values, culture) and external contexts (e.g.,
patient needs, political environment, geographic locations) and to changes in those contexts
over time. RDT suggests that organizations will weigh the resources to be gained against the
autonomy to be lost from innovation implementation. Limitation of this paper, Perrow critiqued
TCE’s neglect of power relations. Indeed, in some cases, organizational theories’ propositions
sometimes contradict each other. This paper, have presented four organizational theories that
may be useful in implementation research because they were particularly apt for explaining
SafeCare’s adoption, implementation, and sustainment. Other organizational theories that may
be useful in implementation research include population ecology of organizations, agency
theory, and exchange theory. From the research, they have suggested implications for theory.
Implementation may be a determinant of organizational survival; to the extent that
implementing an innovation does not promote survival, implementation is unlikely to occur.
They also suggests that key organizational theories should be incorporated into
implementation frameworks. This paper demonstrate the utility of organizational theories for
implementation research. Also demonstrates the utility of organizational theory for explaining
the influence of the complex interaction between organizations and their environment on
implementation.