Systems Theory and Diffusion of Innovation in Nursing Practice

Introduction

The ability to acquire accurate and timely information enhances nursing practice and patient outcomes. Search engines and healthcare nursing databases operate in different ways, and it is necessary for healthcare professionals to understand how to access and efficiently use both public and professional resources. Because the public today has greater access to electronic health information, healthcare professionals must be aware of the information their patients are accessing and must be proficient at identifying credible sources.

It is important for healthcare professionals to know how to use professional databases. Nursing practice needs to be based on evidence, and access to healthcare databases assists nurses in identifying best practices. The use of theories from other disciplines also expands the breadth and depth of knowledge available to guide healthcare delivery and nursing practice. This paper discusses the relationship between systems theory and healthcare delivery in the United States, as well as the relationship between diffusion of innovation theory and the change process within healthcare delivery. It additionally addresses the relationship between systems theory and current nursing practice, and summarizes the search strategies used to acquire information on the specified theories.

The work of Laszlo and Krippner (1998), entitled "Systems Theories: Their Origins, Foundations, and Development," reports that a system "may be described as a complex of interacting components together with the relationships among them that permit the identification of a boundary-maintaining entity or process. Since social and psychological phenomena tend to resist quantitative modeling by posing basic difficulties already on the plane of boundary identification, alternative approaches must be relied upon. One such approach draws on the body of knowledge derived from General System Theory and its application in the domain of human activity systems." (p. 2)

Systems Theory and Healthcare Delivery

Laszlo and Krippner (1998) further note that the history of systems theories includes "contributions from such seminal thinkers as Alfred North Whitehead, Ludwig von Bertalanffy, Anatol Rapoport, Kenneth Boulding, Paul A. Weiss, Ralph Gerard, Kurt Lewin, Roy R. Grinker, William Gray, Nicolas Rizzo, Karl Menninger, Silvano Arieti, and, in more recent years, the dynamical systems theorists, the family systems theorists, and those who deal with dissipative structures and holistic paradigms." (p. 2) Evidence-based practice is described as "an essential principle in nursing education and practice," with leading nursing organizations recommending it "in all aspects of education and patient care services." (Laszlo and Krippner, 1998, p. 1)

Systems theory is reported to have developed from historical ideas. In the early 1900s, Ludwig von Bertalanffy — a renowned philosopher and theoretical biologist — modernized the significance of general systems theory. The phenomenon is reported to "unlock conceptual thinking" based on the idea that all levels of an organism, whether living or environmental, "comprise a logical homology that should be studied as an organized whole." (Laszlo and Krippner, 1998, p. 1) In the field of healthcare delivery, systems theory is reported to affect the "patterns of care, policies, and practices to influence a change in the whole organization." (Laszlo and Krippner, 1998, p. 1)

Hatcher and Heetebry (2004) utilized systems theory to provide better conceptualization of the factors and barriers associated with technology in the delivery of healthcare. Systems theory was used "to draw attention to best practices in health care delivery." When a narrow view is adopted, it is reported to place limitations on the technological impact and may create "additional gaps and errors unintentionally." (Martin, 2011) Inevitable flaws may result, and the technology as a whole system will be compromised.

A second important theorist is Everett M. Rogers, sociologist and the individual who introduced diffusion of innovation theory. This theory is used to "create change in health care delivery system." (Martin, 2011) The framework of this theory rests on the idea that adoption of innovation must be complete if it is to be effective and if meaningful changes are to occur. Rogers identifies five specific elements in effective change:

(Martin, 2011)

Diffusion of Innovation Theory

Diffusion theory is described as "powerful in addition to offering guidelines for leading and entrenching change; the theory has the capacity to frame evidence and employ findings." (Martin, 2011) Rogers' diffusion of innovation theory is also applied to advanced technology in the delivery of healthcare, which improves healthcare access and reduces costs (Martin, 2011).

The work of Cain and Mittman (2009), entitled "Diffusion of Innovation in Health Care," identifies ten critical dynamics of innovation diffusion:

(Cain and Mittman, 2009)

Gale and Schaffer (2009) further report that, drawing on Rogers' Diffusion of Innovations, "the easier it is to see the benefits to the patient of the practice change, the more likely it is to be adopted."