This course surveys a range of translational tools at the healthcare system level that can be used to promote the adoption of evidence-based medicine by providers and delivery systems. Strategies for change are presented in the broader context of sociological theories of organizational behavior and implementation studies. The focus of the first half of the course is on providing learners with tools for understanding and diagnosing problems in the key elements of healthcare organizations, including organizational structures and forms, organizational culture and climate, systems of power and control within healthcare organizations, and the organizational environment. Learning the tools of “organizational anatomy” equips learners with a unique capacity to diagnosis the causes and conditions of implementation failures within organizations. The second half of the course builds on this knowledge by training learners in techniques for organizational change basis, the predominant theories in the field of organizational behavior, including strategic management, theories of implementation and system failures, diffusion of innovation, street-level bureaucracy and backward mapping, along with current consolidated frameworks incorporating these approaches to organizational change.
At the end of the course, students will be able to:
- Understand the nature and scope of organizational change tools for promoting the widespread adoption of new clinical and public health interventions.
- Consider how each tool can be applied to address implementation problems in the student's substantive field of expertise.
- Complete a case study that applies selected tools to the student's area of expertise.
- Identify the parts of any healthcare organization, including its structure, culture, system of power and organizational environment.
- Understand what's unique about the healthcare industry and how this contributes to implementation challenges.
- Analyze how the parts of healthcare organizations come together to produce leverage points for change.
- Map barriers and facilitators of the successful implementation of healthcare policies within organizations.
- Understand how strategic managers adapt healthcare organizations to meet the demands of their organizational environments.
- Analyze the potential for implementation gaps and failures, and how to rig systems for implementation success.
- Develop systems change strategies that take advantage of the spontaneous diffusion of innovation.
- Promote collaborative systems change through “bottom-up” strategies that leverage off of the knowledge of front-line workers.
Audience
Clinicians, public health practitioners, healthcare professionals and researchers wishing to gain knowledge and skills in translating evidence into practice in the context of interventions situated in health care systems and organizations.
Offered: Spring Term
Prerequisites
Training or experience in clinical care, public health, epidemiology, quality improvement, health policy or health care organization leadership. Introduction to Translating Evidence into Practice strongly recommended. Exceptions for these prerequisites may be made with the consent of the instructor.
Faculty
Course Director
Laura Schmidt, PhD, MSW, MPH is a Professor of Health Policy in the School of Medicine at the University of California at San Francisco. She holds a joint appointment in the Philip R. Lee Institute for Health Policy Studies and the Department of Anthropology, History and Social Medicine. Dr. Schmidt is also Co-Director of the Community Engagement and Health Policy Program for UCSF's Clinical and Translational Sciences Institute. She received her PhD training in sociology at UC Berkeley and while there, completed doctoral coursework in public health, and also holds a masters degree in clinical social work.
Course Requirements
Required Textbooks/Materials
All course materials will be made available on the course website. In the development of case studies, students often benefit from using websites and other materials from their selected organizations.
Scholars are expected to watch the video lectures; complete assigned readings; complete each of 6 homework assignments; constructively critique other students' work via online forums; submit a final completed case study; and complete course evaluations.
Scholars will apply concepts taught in the class in a final case study project. To build the capacity to apply theory to real-world healthcare settings, over the course of this 10-week course, learners will conduct a sustained case study of a single organization in which they possess in-depth knowledge. Homework assignments are intended to support and build towards the final paper.
Completing this course will take an estimated 5-10 hours of work per module.