Background: Moving knowledge into healthcare practice and the implementation of innovations in healthcare organizations remain significant challenges. The objective of this study was to examine the key interpersonal-, organizational-, and system-level factors that influenced the implementation and use of an innovation – synoptic reporting tools – in three specific cases of cancer care. Methods: Using case study methodology, this study examined three cases in Nova Scotia, Canada, wherein synoptic reporting tools were implemented within clinical departments/programs. Three theoretical perspectives guided the design, analysis, and interpretation of the study. Data were collected through semi-structured interviews with key informants across four units of analysis (individual user, implementation team, organization, and larger system), document analysis, nonparticipant observation, and examination/use of the synoptic reporting tools. Analysis involved production of case histories, an in-depth analysis of each case, and a cross-case analysis. Results: Numerous factors – which existed at multiple levels of the system and which were often related – were important to the implementation and use of synoptic reporting tools. The cross case analysis revealed five common factors that were particularly influential to implementation and use across the three cases studied: stakeholder involvement, managing the change process, administrative and managerial support, the presence of clinical champions, and attributes of the tools themselves. Key factors distinct to one or two of the cases were: implementation approach, project management, resources, culture, leadership, monitoring and feedback mechanisms, and components of the healthcare system (e.g., care delivery structures, system infrastructure, and socio-historical context). The analyses suggested that several contextual factors, including the timing of implementation and technical requirements of the tool, contributed to the differences across cases. Discussion: This study contributes to our knowledge base on the multi-level factors, and the relationships amongst factors in specific contexts, that influence implementation and use of innovations such as synoptic reporting tools in health care. Importantly, the findings add to our understanding of several important issues that are under-developed in the existing literature in this area: organizational management; healthcare system components; interpersonal aspects of implementation, including stakeholder involvement; and the complex nature of implementation processes.

This explanatory mixed-methods policy analysis describes how school counselors' thoughts and attitudes contribute to the implementation fidelity of the Academic and Career Plan (ACP) policy in a suburban Virginia school division. A quantitative survey investigated counselor thoughts about the policy, implementation behaviors, and counselor ideas about equity issues related to providing college and career planning services to at risk students. Counselor interviews were conducted to provide deeper insight about the street level implementation practices and beliefs of counselors. Findings reveal that counselors place substantial value in the ACP policy and think the process is useful for connecting student interests and postsecondary goals to high school programs of study. Counselors implement the ACP policy with high fidelity because the policy incorporates counselor beliefs such as integrating the career pathway model into the course selection process. Counselors report spending more time assisting higher socioeconomic groups with college planning which results in less time for supporting at risk students. Findings indicate that counselors recognize the need at risk students have for additional support during postsecondary planning but are inhibited by the demands of higher socioeconomic groups. Finally, implications for school leaders related to improving counselor services to at risk students are discussed.

The main goal of my thesis is to suggest a methodology for a knowledge management implementation and to implement this methodology in a chosen organization. The last part of my thesis deals with the critical aspects of the knowledge management implementation and possible solutions. Organizations, which haven't started with knowledge management implementation yet, are in a disadvantage compare to the organizations which have already implemented knowledge management into their processes. The importance of a human capital is still growing and the organizations need to know how to work with knowledge of their employees effectively.

Purpose – The purpose of this paper is to show how knowledge intensive information technology (IT) applications within an organisation can be identified and analysed to achieve two corporate goals: First, an optimisation of the corporate IT landscape that avoids inefficiencies or redundancies. Second the implementation of a knowledge management (KM) system that is aligned with the corporate IT infrastructure. Design/methodology/approach – Methodically, the approach can be described as a practical two-step procedure. In the first step the knowledge intensive IT systems are identified through a questionnaire that is performed in the IT department of the organisation. Based on the expertise of the IT management adequate information concerning benefits and utilization of the applications and the description of technical conditions can be determined. On the basis of the work of the first step, selected user groups (key-user, admin-user, heads of departments, etc.) are surveyed on a broader base through semi-structured interviews. The focus here is to determine the application within its processes and to identify the importance in the fulfilment of the daily tasks as well as the capabilities in knowledge management. Therefore the survey covers the main questions regarding the classification of KM and provides a solid foundation for optimisations regarding the IT infrastructure. The two-step approach also provides the flexibility to identify future processes concerning an appropriate KM system and to identify practical adaptions of the existing IT landscape. Originality/value – The suggestion of a newly developed method to identify and assess knowledge intensive IT systems – what includes hard- and software – within an organisation. The results of the method can be used to develop recommendations to improve the conceivably of already existing KM or to originate an organisational KM as well as to enhance the existing IT landscape. This includes in particular the consideration of the processes in which knowledge is generated, stored, used and shared. Practical implications – The identification, utilization and harmonization of KM intensive systems can be a substantial advantage during the implementation or enhancement process of KM for two reasons: First, the important and implicitly for KM purposes used systems are identified and evaluated before the inception of the organisational KM. Second, the knowledge management orientation of the approach allows reducing both, the complexity and the variety of IT applications within an organisation.