Spread and adoption

How to get the good stuff to go further.

Enabling Spread and Adoption of Innovation and Improvement – Emerging Thinking

Innovations and improvements don’t spread as widely as we need them to. We need a new mindset and way of approaching spread.

Horizons emerging thinking is focused around seven principles and the model of system convening which are derived from the literature and experience.

We believe these seven principles and the model of system convening will significantly help increase the spread and scale of innovation and improvement.

What is spread?

We see spread as a:

• ‘dynamic, reciprocal interacting, iterative and evolving activity’
• ‘developmental, contextualised, adaptive, learning and social process’

So definitely not a not linear and mechanistic activity.

How to increase spread and adoption?

We offer seven interconnected principles, shown in the diagram, which are important aspects to consider for spread

• The individual
• Networks
• Value
• Innovation Development
• Complexity
• Learning
• Leadership

The model of System Convening involves:

• Matching approach to spread with complexity of the situation
• Applying the seven principles in practice
• Providing enabling activities delivered by a team or a number of people
• All levels in the system

More details of the seven interconnected principles and model of system convening are available in our EXPO 2019 slide set here

More about spread, adoption and system convening

Read more in our spread blogs:

• Understanding and Working with Complexity
• ‘That’s what I do’ – voluntary partnerships, complexity and an activity named system convening’
• ‘Adaptive Spaces’ for an emerging future
• Why an ‘Enabling Leadership’ Style is Needed for Innovation, Spread and Adoption
• The Importance of Local Adaptation in Innovation Spread and Adoption
• COVID-19 Crisis: Creating Adaptive Spaces and Enabling the Spread and Adoption of Innovation
• COVID-19 – A Complexity Leadership Response
• Adaptive Spaces, Networks…. and a Challenge Called Spread
• Spread and Complexity
• System convening
• Three theoretical lenses to inform spread
• Complex systems, networks and adaptive spaces
• Moving to Action: Spreading and Scaling Change Session at Expo 2019

Case studies

These case studies illustrate how the 7 spread and adoption principles and the model of system convening apply in practice.

• A winning partnership – System Convening combined with Programme Management improves patient experience: full video here, short video here and blog here
• A winning combination: programme management with system convening to develop and spread the BASIC STEP tool in North West Ambulance Service (NWAS): video here and blog.
• Spread, adoption and systems convening: the Welsh Ambulance Service Trust (WAST) falls framework: video here and blog ‘Complexity and System Convening – a lightbulb moment.

Videos

• Mary Uhl-Bien in Conversation: COVID-19, complexity leadership and spread of innovation
• What is Adaptive space? a Brief Introduction by Gareth Evans [ 2 mins]
• Adaptive Space in Action by Matthew Mezey [4 mins]
• Adaptive space – Overview of the work of Mary Uhl-Bien by Diane Ketley [4 mins], and related blog with links and details ‘Adaptive Spaces’ for an emerging future

Case Study from AHSN network

Improving Detection and Treatment of Atrial Fibrillation Across England, April 2021 details here

Further reading

• Care Quality Commission Enabling innovation and adoption in health and social care: Developing a shared view. 2021.
• Nuffield Trust Achieving scale and spread. 2020.
• The Health Foundation. The spread challenge. 2018
• Innovation Unit and Health Foundation. Against the odds: Successfully scaling innovation in the NHS. 2018.
• King’s Fund. Adoption and spread of innovation in the NHS. 2018
• Nuffield Trust. Falling short: Why the NHS is still struggling to make the most of new innovations. 2017.
• Braithwaite, J. Changing how we think about healthcare improvement, BMJ 2018; 361: https://doi.org/10.1136/bmj.k2014

Get in touch

This page will be updated as our thinking progresses. Any comments or questions please contact Diane Ketley or via @DianeKetley

You can also follow the hashtag #nhsSpread on Twitter.