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Pay for Performance Initiative Implementation Model

Kimberly Boynton

Grand Canyon University

HCA699- Evidence-Based Research Project

Edward Paluch

11/10/2021

Part D – Change Model

Roger’s diffusion of innovation theory

Implementing pay for performance for nurses on improving care management and reducing re-hospitalization rates among the aging population can be done using Roger’s diffusion of innovation theory. Diffusion of Innovation (DOI) is used to explain how an idea gains momentum and spreads through a particular population over time. According to DOI theory, the spread’s result is that people adopt innovative ideas or behavior. Adoption means that there will be a meaningful change in the way people do things. In my organization, the implementation of pay for performance initiative will motivate nurses (García‐Avilés, 2020). It is also associated with low re-hospitalization rates among people with acute conditions, ensuring proper care management. The use of the DOI model to implement this initiative implies that after a short while, nurses and physicians who are the main stakeholders in the implementation of this initiative would start performing their roles differently than how they have been doing it previously.

The adoption of an idea and innovation does not happen simultaneously in a healthcare organization. Instead, it is a process where some nurses and physicians are more apt to adopt the innovation than others. The model asserts that people who adopt an idea earlier have distinct features than those who embrace an idea later. There are five adopter categories proposed in DOI. They include innovators, early adopters, early majority, late majority, and laggards (Mohammadi et al., 2018). These adopter categories are used to appeal to the target population when promoting an innovation.

Innovators: Innovators are a set of customers that use new products as soon as they are launched, that is are the first set of customers of any new technology or new products it count for 2.5% and product example of Innovation model is Foldable Phones, Foldable phones are very few in few in numbers and is a very new product, one will hardly find people using it. There is extraordinarily little that needs to be done to the initiative to appeal to these people.

Early adopters: These are people who represent opinion leaders. These are people who embrace change opportunities in an organization and enjoy leadership roles. These people are aware that an organization needs change, and therefore they are comfortable adopting innovative ideas, and they do not need the information to convince them to change.

Early Majority: These are the set of customers those who widely adopt an innovative new product and are accepted by the society as a products and people smart using it. Such products become constant for group of people and majority of people start using it. These counts for 34% example of such products are Debit cards and credit cards. Many customers nowadays use these cards for payments. These people need to see evidence to be convinced that the initiative works.

Late majority: The late majority comprises a population of people who are skeptical about changing. These people will only adopt an idea after the majority has tried it. These people require information to be convinced of the effectiveness of the initiative.

Laggards: Laggards consist of people who are bound with tradition, and they are also conservative. are the set of customers those who avoid using technology and stick to old technology and they use new products when they become old. These count for 16%. Product example is 2G internet service.

This theory has been used successfully in many fields, including public health. Using this theory to implement the proposed change in my organization would ensure that the initiative is slowly and steadily adopted in the organization to enable it to gain momentum and become effective.

Part E – Implementation Plan

The implementation of any change requires a lot of finance used to buy equipment and tools for achieving the needs of the new initiative. The implementation process of pay for performance would require an increase in human capital as health professionals would be rewarded based on the quality of their work. The implementation of this reward system requires motivation from all health professionals. This would mean that all the nurses and physicians would require training and education to compete and achieve the needs of the new initiative. The implementation of the initiative will require a pay increase. This will need the organization to reduce supplies to concentrate on service delivery to obtain more funds for implementing the initiative.

The feasibility of the implementation plan is concerned with the practicability of the initiative. The cost of purchasing computers for the implementation process is estimated at the cost of $200,000. The implementation of the initiative would require five computers that would be used to monitor the work of employees, record re-hospitalization rates, quality of care management per health professional, and the rates of chronic conditions reported in the organization. The organization will hire five professionals to facilitate the implementation of the initiative. These professionals would comprise an accountant, a health informaticist, and three IT experts. Each person will be paid $40,000 per month. These professionals will coordinate and manage the system. These professionals will do the activities such as data collection, analysis, storage, interpretations, and dissemination. Other costs incurred during the implementation of the initiative will include purchasing office equipment like tables, chairs and redesigning one room that will be used as the office for the implementors. The office equipment will cost $20,000, and the cost for restructuring and designing the new office will be $10,000.

The potential barrier that will need to be assessed and eliminated during the initiative’s implementation is resistance to change. The pay for performance initiative is characterized by many disadvantages like affecting teamwork and leaving the possibility of subjectivity (Leite, Bateman & Radnor, 2020). Nurses and doctors who are the major stakeholders in this initiative may resist the implementation of the initiative. However, by informing the employees about the benefits of the initiative early and communicating how I plan to manage the problems, the problem will be eliminated.

The implementation process of the proposed initiative will start on 1 January 2022 and is expected to end on 30 December 2022. The following steps will be followed: assessing the project plan, executing the plan, making changes as needed, analyzing project data, and gathering feedback, and providing a final report.

References

García‐Avilés, J. A. (2020). Diffusion of innovation. The International Encyclopedia of Media Psychology, 1-8.

Leite, H., Bateman, N., & Radnor, Z. (2020). Beyond the ostensible: an exploration of barriers to lean implementation and sustainability in healthcare. Production Planning & Control, 31(1), 1-18.

Mohammadi, M. M., Poursaberi, R., & Salahshoor, M. R. (2018). Evaluating the adoption of evidence-based practice using Rogers’s diffusion of innovation theory: a model testing study. Health promotion perspectives, 8(1), 25.

Appendix

Appendix One: Roger’s diffusion of innovation theory

Appendix Two: Timeline for the Project Implementation