Universität zu Köln

Schippel, Nicolas ORCID: 0000-0001-5612-8482, Hower, Kira Isabel, Zank, Susanne, Pfaff, Holger ORCID: 0000-0001-9154-6575 and Rietz, Christian (2022). Considering the role of context when implementing government policies in hospitals: introduction of a prospective payment system for psychiatry. J. Health Organ. Manag., 36 (3). pp. 279-292. BINGLEY: EMERALD GROUP PUBLISHING LTD. ISSN 1758-7247 ; 1477-7266

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Abstract

Purpose The context in which an innovation is implemented is an important and often neglected mediator of change. A prospective payment system (PPS) for psychiatric and psychosomatic facilities with major implications for inpatient psychiatric care in Germany was implemented from 2013 to 2017. This study aims to examine the determinants of implementation of this government policy using the Diffusion of Innovations theory and consider the role of context. Design/methodology/approach An exploratory case study was conducted in two wards of a psychiatric hospital in Germany: geriatric psychiatry (GerP) and general psychiatry (GenP). Fifteen interviews were conducted with different occupational groups and analyzed in-depths. Routine hospital data were analyzed for delimiting the two contexts. Findings Routine hospital data show a higher day-mix index (1.08 vs. 0.94) in the GerP context and a very different structure regarding PPS groups, indicating a higher patient complexity. Two types of factors influencing implementation were identified: Context-independent factors included social separation between nurses and doctors, poor communication behavior between the groups and a lack of conveying information about the underlying principles of the PPS. Context-dependent factors included compatibility of the new requirements with existing routines and the relative advantage of the PPS, which were both perceived to be lower in the GerP context. Practical implications Depending on the patient characteristics in the specific context, compatibility with existing routines should be ensured when implementing. Clear communication of the underlying principles and reduction of organizational and communicative barriers between professional groups are crucial success factors for implementing such innovations. Originality/value This study shows how a diffusion process takes place in an organization even after the organization adopts an innovation. The authors could show how contextual differences in terms of patient characteristics result in different determinants of implementation from the views of the employees affected by the innovation.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Schippel, Nicolas UNSPECIFIED orcid.org/0000-0001-5612-8482 UNSPECIFIED Hower, Kira Isabel UNSPECIFIED UNSPECIFIED UNSPECIFIED Zank, Susanne UNSPECIFIED UNSPECIFIED UNSPECIFIED Pfaff, Holger UNSPECIFIED orcid.org/0000-0001-9154-6575 UNSPECIFIED Rietz, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-569858
DOI:	10.1108/JHOM-01-2021-0021
Journal or Publication Title:	J. Health Organ. Manag.
Volume:	36
Number:	3
Page Range:	pp. 279-292
Date:	2022
Publisher:	EMERALD GROUP PUBLISHING LTD
Place of Publication:	BINGLEY
ISSN:	1758-7247 ; 1477-7266
Language:	English
Faculty:	Faculty of Human Sciences
Divisions:	Faculty of Human Sciences > Department Heilpädagogik und Rehabilitation > Zentrum für Heilpädagogische Gerontologie
Subjects:	Social sciences Education Medical sciences Medicine
Uncontrolled Keywords:	Keywords Language HEALTH-CARE; INNOVATIONS; DIFFUSION; ORGANIZATIONS; GERMANY; DEPRESSION; ADULTS Multiple languages Health Policy & Services Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/56985