Theory | Proposition | Potential implications for MLMs’ use and selection of implementation strategies | Related MLM role |
---|---|---|---|
Contingency theory | The optimal structure of work is contingent on the uncertainty of the task and task environment: When uncertainty is higher, unprogrammed means of coordination will be the more effective way to structure a task; when uncertainty is low, programmed means of coordination will be more effective. | • Evaluate levels of uncertainty associated with implementation and its context. When uncertainty is high, avoid over-prescribing implementation strategies. • Evaluate levels of uncertainty associated with the implementation context. When uncertainty is high, limit efforts to tailor the context. | • Adapting information, the EBP, and implementation strategies |
Higher levels of interdependence (both within and between departments) will require greater investment in coordination (integration). | • Evaluate levels of interdependence required for implementation. For high levels of interdependence, invest resources in facilitating collaboration. | • Mediating between strategy and day-to-day activities | |
The greater the differentiation among departments, the more difficult it will be to coordinate. | • Identify differences among departments and plan for their implications for implementation efforts. | • Mediating between strategy and day-to-day activities | |
Resource dependency theory | To acquire power, organizations exchange resources for dependence on other organizations within their field. That is, organizations want autonomy and/or control, but they need resources to survive and/or produce in a way that satisfies stakeholders’ demands. | • Contribute to the adoption decision considering its potential as a form of control—a source of legitimacy in the field, from the perspective of key stakeholders, and boon to the organization’s competitive edgea. • Compromise autonomy for all of the resources needed for implementation. | • Selling EBP implementation |
Competition increases uncertainty perceived by decision makers and decreases willingness to consider, adopt, or implement EBPs. | • Acknowledging abovea, rigorously evaluate, appreciate, account, and plan for stakeholders’ resistance to EBP adoption and implementation. | • Selling EBP implementation | |
Decreased munificence requires organizations to reduce their dependence on some resources and/or find alternative resources. | • In relatively under resourced organizations, acquire resources for implementation substitute resources with interorganizational partnerships (e.g., collaboratives). | • Obtaining and diffusing information and other resources | |
Complexity theory | Interdependencies contribute to sense making and self-organization. | • Create opportunities for and facilitate collaborative work among implementers. | • Mediating between strategy and day-to-day activities |
Interdependencies among people with diverse perspectives contribute to more effective sense making. | • Engage implementers who have diverse (clinical, cultural, etc.) perspectives. • Facilitate collaboration among implementers that elicits diverse perspectives. | • Mediating between strategy and day-to-day activities | |
Feedback loops may amplify some effects and reduce others. At times, small changes will lead to large scale differences in outcomes (i.e., the butterfly effect) and vice versa. | • Monitor influences of changes over time. • Incorporate findings regarding changes’ influence into subsequent changes. • Monitor subsequent changes and repeat. | • Obtaining and diffusing information | |
Change that is guided by minimum specifications allows individuals to self-organize most effectively. | • Build autonomy into implementers’ positions. | • Adapting information and the EBP | |
The whole system is greater than the sum of its parts. | • Monitor processes and outcomes at organization and system levels. | • Obtaining and diffusing information |