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Exploring resistance to implementation of welfare technology in municipal healthcare services – a longitudinal case study

Overview of attention for article published in BMC Health Services Research, November 2016
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Title
Exploring resistance to implementation of welfare technology in municipal healthcare services – a longitudinal case study
Published in
BMC Health Services Research, November 2016
DOI 10.1186/s12913-016-1913-5
Pubmed ID
Authors

Etty R. Nilsen, Janne Dugstad, Hilde Eide, Monika Knudsen Gullslett, Tom Eide

Abstract

Industrialized and welfare societies are faced with vast challenges in the field of healthcare in the years to come. New technological opportunities and implementation of welfare technology through co-creation are considered part of the solution to this challenge. Resistance to new technology and resistance to change is, however, assumed to rise from employees, care receivers and next of kin. The purpose of this article is to identify and describe forms of resistance that emerged in five municipalities during a technology implementation project as part of the care for older people. This is a longitudinal, single-embedded case study with elements of action research, following an implementation of welfare technology in the municipal healthcare services. Participants included staff from the municipalities, a network of technology developers and a group of researchers. Data from interviews, focus groups and participatory observation were analysed. Resistance to co-creation and implementation was found in all groups of stakeholders, mirroring the complexity of the municipal context. Four main forms of resistance were identified: 1) organizational resistance, 2) cultural resistance, 3) technological resistance and 4) ethical resistance, each including several subforms. The resistance emerges from a variety of perceived threats, partly parallel to, partly across the four main forms of resistance, such as a) threats to stability and predictability (fear of change), b) threats to role and group identity (fear of losing power or control) and c) threats to basic healthcare values (fear of losing moral or professional integrity). The study refines the categorization of resistance to the implementation of welfare technology in healthcare settings. It identifies resistance categories, how resistance changes over time and suggests that resistance may play a productive role when the implementation is organized as a co-creation process. This indicates that the importance of organizational translation between professional cultures should not be underestimated, and supports research indicating that focus on co-initiation in the initial phase of implementation projects may help prevent different forms of resistance in complex co-creation processes.

Mendeley readers

The data shown below were compiled from readership statistics for 71 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 71 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 19 27%
Student > Ph. D. Student 11 15%
Researcher 8 11%
Lecturer 6 8%
Student > Bachelor 6 8%
Other 14 20%
Unknown 7 10%
Readers by discipline Count As %
Social Sciences 13 18%
Medicine and Dentistry 9 13%
Nursing and Health Professions 9 13%
Computer Science 7 10%
Business, Management and Accounting 5 7%
Other 16 23%
Unknown 12 17%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 14 September 2017.
All research outputs
#9,406,718
of 11,767,719 outputs
Outputs from BMC Health Services Research
#3,178
of 3,820 outputs
Outputs of similar age
#222,776
of 326,819 outputs
Outputs of similar age from BMC Health Services Research
#90
of 111 outputs
Altmetric has tracked 11,767,719 research outputs across all sources so far. This one is in the 11th percentile – i.e., 11% of other outputs scored the same or lower than it.
So far Altmetric has tracked 3,820 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.1. This one is in the 7th percentile – i.e., 7% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 326,819 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 19th percentile – i.e., 19% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 111 others from the same source and published within six weeks on either side of this one. This one is in the 10th percentile – i.e., 10% of its contemporaries scored the same or lower than it.