The Diffusion of an Organisational Innovation: Adopting 'Patient-Focused Care' in an N.H.S. Hospital Trust

Chris Howorth, Frank Mueller, Charles Harvey

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This paper deals with the diffusion and adoption of an organisational innovation, ‘Patient-Focused Care’, at a British Hospital Trust. We will be discussing how PFC emerged in the U.S. context, was propagated by policy makers, and judged worth adopting by organisational decision-makers. In providing an analysis of the case, we are attempting to bridge the gap between the policy context on the one hand [and], the organisational context on the other hand. The paper shows the importance of the ‘local’ context in shaping the adoption of a ‘global’ organisational innovation. The ‘appropriation process’ will play out in context-specific ways in terms of conflicts between managers and expert professionals; the way the ‘foreignness’ of the innovation plays out; and the way public policy-makers can influence the appropriation process. Most importantly, the paper intends to show how the cognitive boundaries of the N.H.S. as an ‘organisational field’ are beginning to move beyond national borders.
Original languageEnglish
Pages (from-to)213-232
JournalCompetition and Change
Issue number2
Publication statusPublished - Jun 2002


  • new institutionalism
  • organisational innovation
  • international diffusion of innovation
  • organisational field
  • isomorphism
  • National Health Service

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