Everyone is interested in innovation in
healthcare. Innovation promises better ways of organizing and
delivering treatment, improvements in the clinical and
cost-effectiveness of services, and reductions in the burdens of
illness - especially chronic illness. Most research on healthcare
innovation focuses on the outcomes of innovations - measuring their
impact and exploring their effects - but this doesn't always tell
us the things that we need to know. Researchers try to help
healthcare providers by quantifying outcomes and comparing the
effects of these innovations. But it is also understood that
outcomes evaluations are not enough, and that we need to perform
process evaluations that help us to understand how these effects
come about.
Identifying and adopting an innovative health technology, or a
new way of organizing professional work, is the beginning of the
story, not the end. Down the line, policy-makers, managers,
professionals, and patients all face two important problems as they
try to get innovations into practice.
- Process problems: about the
implementation of new ways of thinking,
acting and organizing in health care
- Structural problems: about the
integration of new systems of practice
into existing organizational and professional settings.
These are important problems for researchers and evaluators too.
To understand implementation and integration, we need focus on the
dynamic processes that lead to innovations becoming embedded in
everyday work. Normalization Process Theory is an explanatory
model that helps managers, clinicians, and researchers understand
these processes.
There's nothing so practical as a good theory, and this website
will guide you through the uses of NPT, and some of the theory's
basic concepts. Not only that, but we also provide a simple
toolkit to enable you to think through implementation and
integration problems using NPT.
NPT is a sociological toolkit that we can use
to understand the dynamics of implementing, embedding, and
integrating some new technology or complex intervention. It helps
us disassemble the human processes that are at work when we
encounter a new set of practices - whether they're bundled around a
large randomized controlled trial across many sites, or in a falls
prevention program on a single hospital ward. NPT has a robust
theoretical basis - but we don't discuss that in detail on this
website (although we do discuss what a theory is and does, and the
formal propositions that are the basis of NPT). That's because this
website is intended to translate the formal theory into something
you can use, in practice, right now.
Like all theories NPT is build up around a set
of constructs - organizing ideas that represent human
processes that really happen in the world. But it also presents
these in an idealized and abstract form. That's so they can be
transported from one problem to another in a stable way. Let's look
at the core constructs of NPT, and their
specific components. Details about the underlying theory
and its development
have been published in open access papers.
