Introduction to the Seven Interconnected Principles for Spread and Adoption

The recently launched Guide, Leading the Spread and Adoption of Innovation and Improvement: A Practical Guide, offers seven interconnected principles. This blog is the first of a series, giving details of these principles, and gives an overview and introduction. Weekly blogs will follow with each one focusing on one of the seven principles. 

All seven principles are important, they are interconnected and each will have a different importance and require different actions in different settings.

What are the seven principles for spread and adoption?

These principles represent important aspects to consider for spread and adoption, they are summarised below with more detail and explanation in the Guide. 

Complexity – spread and adoption in health and care is an increasingly complex activity so understanding complexity and the implications for your work is important. Health and care is a complex adaptive system. This means we can’t assume an idea or innovation that has worked in one local system will spread and work in another place, because different local systems have different needs and interdependencies and the overall system is always evolving. More detail on the complexity principle in the Guide here.

Leadership – an enabling leadership style is needed which requires a mindset shift such that ‘my role is to think about how I can facilitate and enable adaptation, emergence and change’, rather than directing people what to do. Leaders should strive to create the environment and relationships for innovation development, spread and adoption and to create a learning system where people share and seek learning from and with others. More detail on the leadership principle in the Guide here.

Individual – the perspective of the individual – patient, carer, staff member – is pivotal to enable the behaviour change needed for spread and adoption. Consider what the impact, positive or negative, of the innovation might be for them. Understand how to influence behaviour change and the importance of motivation, engagement and providing a supportive, safe setting. Appreciate that resistance, as an inevitable part of change, may reflect a missing relevance that warrants exploring. More detail on the individual principle in the Guide here.

Benefit – focus on the why rather than the what i.e. focus on the benefit rather than the innovation. This means explaining the benefits for patients, staff and carers and the system, to the adopters. Create a system needs focus [Pull approach] rather than an innovation focus [Push approach]. Each context is unique which presents the challenge of predicting how an innovation will work in that context, the benefit it may create and what is needed for the innovation to be adopted, adapted and routinely used in that setting. More detail on the benefit principle in the Guide here.

Adopter focus – increase the focus on the role of adopters to energise and spread through their commitment and agency. Involving a wide range of people [and contexts] in the innovation development process maximises spread and adoption. Early involvement of adopters in the development process increases commitment and ownership of the innovation. More detail on the adopter focus principle in the Guide here.

Networks – build communities, energising and connecting individuals. Spread and adoption is a social process, dependent on both social and technical aspects of change, so increased connectivity leads to increased spread which is why networks are so important. Networks enable connections and relationships between individuals – increasing communication, interaction and collaboration and therefore the flow of knowledge and learning as well as development of communities. More detail on the networks principle in the Guide here.

Learning – develop a learning system and habit of learning, sharing knowledge with and seeking it from others. Seek learning from own adaptation and adoption or from others’ experience, reflect on insights and implications for own practice and /or for others’ practice and share learning within own context and wider. More detail on the learning principle in the Guide here.

Relational, interpersonal elements of spread and adoption – looking at how people can work together – is a common thread within each of the principles.

This short video gives a brief summary of the seven principles. 

What do the principles mean in practice? 

These principles can be used by individuals, or by a team, and at all levels; local, regional and national and settings where the spread and adoption of complex change is needed.

These interconnected principles can be used to inform planning and to inform ongoing reviews.

Details of how these principles apply to the work we do are described in How the Seven Spread and Adoption Principles Work in Practice: the Continuing Healthcare Improvement Collaborative case study. 

We would love to hear your feedback about the Guide, and how you will use it. Send a tweet to @DianeKetley @HorizonsNHS #nhsspread. If you prefer email, get in touch at England.si-horizons@nhs.net.

More information on the seven spread and adoption principles and system convening is available on the NHS Horizons website.

If you're interested to read more there are previous blogs and further blogs to follow. Please do subscribe to this blog and follow @DianeKetley @HorizonsNHS, #nhsspread.