The Nonspread of Innovations: the Mediating Role of Professionals

    Two qualitative studies in the U.K. health care sector trace eight purposefully selected innovations. Complex, contested, and nonlinear innovation careers emerged. Developing the nonlinear perspective on innovation spread further, we theorize that multi-professionalization shapes “nonspread.” Social and cognitive boundaries between different professions retard spread, as individual professionals operate within unidisciplinary communities of practice. This new theory helps explain barriers to the spread of innovation in multiprofessional organizations in both health care and other settings.


    • Abbott A. 1988. The system of professions. London: University of Chicago Press. Google Scholar
    • Barley S. R. 1996. Technicians in the workplace: Ethnographic evidence for bringing work into organization studies. Administrative Science Quarterly, 41: 401–444. Google Scholar
    • Beck U. 1992. The risk society. London: Sage. Google Scholar
    • Bowker G. C., Leigh Star S. 2002. Sorting things out: Classification and its consequences. London: MIT Press. Google Scholar
    • Brown J. S., Duguid P. 1991. Organizational learning and communities of practice: Towards a unified view of working, learning and innovation. Organization Science, 2: 40–55. Google Scholar
    • Brown J. S., Duguid P. 2001. Knowledge and organization: A social-practice perspective. Organization Science, 12: 198–213. Google Scholar
    • Burrell G., Morgan G. 1979. Sociological paradigms and organisational analysis. London: Heinemann Educational Books. Google Scholar
    • Callon M., Paredo P, Rabeharisoa V., Gonadr T., Leray T. 1992. The management and evaluation of technological programmes and the dynamics of techno economic networks: The case of AFME. Research Policy, 21: 215–236. Google Scholar
    • Carlile P. 2002. A pragmatic view of knowledge and boundaries: Boundary objects in new product development. Organization Science, 13: 442–455. Google Scholar
    • Coleman J., Katz E., Menzel H. 1966. Medical innovation: A diffusion study. New York: Bobbs Merrill. Google Scholar
    • Denis J.-L., Langley A., Cazale L. 1996. Leadership and strategic change under ambiguity. Organization Studies, 17: 673–699. Google Scholar
    • Denis J.-L., Hebert Y., Langley A., Lozeau D., Trottier L. 2002. Explaining different patterns for complex health care innovations. Health Care Management Review, 27(3): 60–73. Google Scholar
    • Department of Health. 1993. Changing childbirth, part 1: Report of the expert maternity group. London: Her Majesty's Stationery Office. Google Scholar
    • Eisenhardt K. 1989a. Building theories from case study research. Academy of Management Review, 14: 532–550.LinkGoogle Scholar
    • Eisenhardt K. 1989b. Making fast strategic decisions in high-velocity environments. Academy of Management Journal, 32: 543–576.LinkGoogle Scholar
    • Ferlie E., Wood M., FitzGerald L. 1999. Some limits to evidence based medicine—A case study from elective orthopaedics. Quality in Health Care, 8: 99–107. Google Scholar
    • Ferlie E., FitzGerald L., Wood M. 2000. Getting evidence into clinical practice—An organizational behaviour perspective. Journal of Health Services Research and Policy, 5: 96–102. Google Scholar
    • FitzGerald L., Ferlie E., Wood M., Hawkins C. 1999. Evidence into practice? An exploratory analysis of the interpretation of evidence. In Mark A.Dopson S. (Eds.), Organisational behaviour in health care: 189–206. London: Macmillan. Google Scholar
    • FitzGerald L., Ferlie E., Wood M., Hawkins C. 2002. Interlocking interactions: The diffusion of innovations in health care. Human Relations, 55: 1429–1449. Google Scholar
    • FitzGerald L., Ferlie E., Hawkins C. 2003. Innovation in healthcare: How does credible evidence influence professionals? Health and Social Care in the Community, 11(3): 219–228. Google Scholar
    • Golden-Biddell K., Locke K. 1997. Composing qualitative research. Thousand Oaks, CA: Sage. Google Scholar
    • Kuhn T. S. 1970. The structure of scientific revolutions (2nd ed.). London: University of Chicago Press. Google Scholar
    • Langley A. 1999. Strategies for theorizing from process data Academy of Management Review, 24: 691–710.LinkGoogle Scholar
    • Langley A. 2001. The corruption of managerial techniques by organisations. Working paper, HEC, Montreal. Google Scholar
    • Latour B. 1987. Science in action. Cambridge, MA: Harvard University Press. Google Scholar
    • Lee T. W. 1999. Using qualitative methods in organizational research. Thousand Oaks, CA: Sage. Google Scholar
    • Leigh Star S. 1991. Power, technology and the phenomenology of conventions: On being allergic to onions. In Law J. (Ed.), A sociology of monsters: 26–56. London: Routledge. Google Scholar
    • Lomas J. 1993. Retailing research: Increasing the role of evidence in clinical services for childbirth. Milbank Quarterly, 71: 439–475. Google Scholar
    • McNulty T., Ferlie E. 2002. Reengineering health care: The complexities of organizational transformation. Oxford, England: Oxford University Press. Google Scholar
    • Merton R. K. 1973 The sociology of science. Chicago: University of Chicago Press. Google Scholar
    • Montgomery K., Oliver A. 1996. Responses by professional organizations to multiple and ambiguous institutional environments: The case of AIDS. Organization Studies, 17: 649–672. Google Scholar
    • Pettigrew A. 1997. What is processual analysis? Scandinavian Journal of Management, 13: 337–348. Google Scholar
    • Pettigrew A. M., Ferlie E., McKee L. 1992. Shaping strategic change—Making change in large organizations: The case of the NHS. London: Sage. Google Scholar
    • Robertson M., Swan J., Newell S. 1996. The role of networks in the diffusion of technological innovation. Journal of Management Studies, 33: 333–359. Google Scholar
    • Rogers E. 1995. The diffusion of innovations (4th ed.). New York: Free Press. Google Scholar
    • Schoenberger E. 1997. The cultural crisis of the firm. Oxford, England: Basil Blackwell. Google Scholar
    • Scott Poole M., Van de Ven A., Dooley K., Holmes M. E. 2000. Organisational change and innovation processes: Theory and methods for research. Oxford, England: Oxford University Press. Google Scholar
    • Swan J., Scarborough H., Robertson M. 2002. The construction of “communities of practice” in the management of innovation. Management Learning, 33: 477–496. Google Scholar
    • Van de Ven A., Polley D., Garud R., Venkataraman S. 1999. The innovation journey. Oxford, England: Oxford University Press. Google Scholar
    • Weick K. 1979. The social psychology of organizing. Reading, MA: Addison- Wesley. Google Scholar
    • Wenger E. 1998. Communities of practice. Cambridge, England: Cambridge University Press. Google Scholar
    • Williams F., Gibson D. V. 1990. Technology transfer—A communications perspective London: Sage. Google Scholar
    • Yin R. K. 1994. Case study research—Design and methods (2nd ed.). Newbury Park, CA: Sage. Google Scholar
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