Conclusions
At the heart of any diffusion process are the quality of relationships that exist in the healthcare organization and the extent and duration of credibility. First, with regard to relationships, it takes a village to not only raise a child but also raise a valid perspective or practice. Especially in the siloed, specialist-saturated world of contemporary healthcare, it is often the case that solo practitioners are pushing out into the healthcare wilderness without much support or even understanding from those who remain back home. As we have seen, there are many different voices and diverse motivations and perspectives that swirl around any new idea. All of these voices, motivations, and perspectives must be taken into account if serious attention is being given to a particular idea.
Typically, it takes a particular type of physician leader to bring together these differing voices, motivations, and perspectives. Often referred to as Servant Leaders, these physician leaders do the hard work needed to bring together all of this diversity and find the glue to hold this diversity together on behalf of a new idea. In his original presentation regarding servant leadership, Robert Greenleaf (Greenleaf, 1970) described the work of a servant in preparing meals and cleaning the latrines for a group of people seeking to find a guru with the truth (this guru eventually being acknowledged as the servant). While physician leaders should not have to clean the latrines, they do have to do the often-underappreciated work of bringing people together and facilitating constructive and appreciative dialogue among those with diverse needs and outlooks (Gergen and Gergen, 2004). Under skillful servant leadership, good ideas are not only eventually embraced but also enhanced. With diversity comes creativity (Page, 2011).
Nikitas Zervanos MD is a retired Residency Program Director, who has spoken about the role of a servant leader in the engagement of a strategy and set of tools for effective diffusion of innovation in healthcare systems. McKenna and Pugno (2006, p. 149) quote Zervanos:
“Great ideas reflect ancient wisdom and have the power to bind people together while creating unity and making good things happen. But no great idea exists alone. Without the innovators and servant leaders with heart and soul, no system can live for very long.”
Along with the interpersonal skills and wholeheartedness associated with servant leadership comes the establishment of convincing credibility if an innovative perspective or practice is to be broadly accepted. From the perspective of a potential individual, departmental or organization-wide three fundamental diffusion questions should be addressed. First, why should I (we) want to consider this new perspective or practice? What need could it potentially meet? Second, how is the credibility of this idea to be assessed? What kind of expertise would be most appropriate in providing this assessment? Obviously, leadership is often required in considering these two questions. At the heart of the matter for both the leader and members of an organization is the third question: What are the ingredients that make an innovation “respectable”? How does an innovation become “mainstream”—or will it always linger at the fringe of organizational life or in the minds and hearts of innovation “geeks.”
