Fig. 3
From: Integrating new practices: a qualitative study of how hospital innovations become routine
Process of integration unfolding over three stages. During the Improvisation stage, innovation proponents maintain compliant use, allowing experience to reveal the innovation-values fit to practitioners in the expansion stage. At the same time, innovation proponents improve the climate for implementation, enhancing innovation-values fit. Those innovations with high innovation-values fit go on to be integrated through shifts in attitudes and norms, leading to committed use in the disappearance stage and further strengthening the climate for implementation. Innovations with low innovation-values fit can be integrated through revised performance standards, leading to compliant use in the disappearance stage. Innovations with low innovation-values fit may alternatively be integrated through automation. Characteristics of the environment and the innovation can facilitate integration in the improvisation and expansion stages