Innovation adoption as facilitated by a change-oriented workplace.
Becan J.E., Knight D.K., Flynn P.M. Journal of Substance Abuse Treatment: 2012, 42, p. 179–190.

Message from this large US study is that 'bottom-up' practice improvements in treatment services initiated by counsellors are still strongly influenced by the climate-setting and support offered by an organisation's leadership and ethos, especially how far they foster professional development.

Summary
Although innovations may be initiated or mandated by leadership to improve clinical practice, the decision to implement a new intervention in client care is often determined by the individual counsellor. The main focus of this study was on 'bottom-up adoption', the degree to which individuals in an organisation choose to try an innovation, not the degree to which leaders mandate it. In turn this perspective focuses attention on how leaders and organisations foster staff commitment to practice improvements.

In investigating these issues, the study was guided by an influential model of the processes involved in the planning and adoption of innovations developed by Texas Christian University's Institute of Behavioral Research, which has researched these processes in the UK as well as the USA and other countries.

The study was conducted in nine US states and derived its data from 421 counselling staff at 71 outpatient drug-free programmes, a subset of the 92 where more than one staff member had completed a survey on how they saw the treatment environment at their centre. It aimed to tease out what makes counsellors more or less likely to adopt and spread innovations in the treatment of substance use problems, a 'propensity to innovate' tapped by questions such as how often they had adopted new ways of working as a result of training workshops, how often they had encouraged other counsellors to use new ideas they had adopted, and how well clients respond to new ideas and materials.

Other questions looked for qualities in the counsellor which might have influenced their propensity to innovate, such as feeling they influence others in their workplace, flexibly adapt to work demands, feel it is important to and take steps to foster their professional development, and are confident of their abilities.

The study hypothesised that it was by bolstering such qualities in their staff that leaders foster their adoption of new practices, so another set of questions asked about their programme director's leadership qualities such as setting an example, encouraging new ways of looking at the work, and providing well defined performance goals and objectives. It was also expected that the positive influence of these leadership virtues on staff would be greatest when the climate of the organisation as a whole was conducive to change, tapped by questions about the climate at their centre in respect of the clarity and nature of its mission, cohesion among the staff, delegation of authority over their work to staff, adequacy of communications, staff stress, and how receptive the organisation is to change.

In assessing interrelationships between these variables the study adjusted as needed for any influence of differing staff experience levels, qualifications, professional certification status, and caseloads, and the possible clustering of similar views among staff at the same centre.