This book has several objectives. Most basically it presents an approach to assessing interorganizational innovation diffusion. To do this we have tried to link contempo­ rary organizational theory with more person-centered diffusion theory. We have also combined contingency theory with the resource dependence perspective to explain why organizations might choose to initially consider an innovation, re­ define it to suit their particular environmental context, and then implement it. Another objective has been to examine how environmental constraints can limit the ways in which diffusion channels form, and can determine when diffusion can be truly organizational and when it will depend upon individuals. In doing so, we have tried to indicate how organizational structures emerge to manage re­ sources in ways that are consistent with those environmental constraints. We have borrowed the notion of boundary management from resource dependence, and we have used it to examine how organizations use various boundary management strategies to preserve their autonomy in exchange relationships with other organi­ zations. We have done this both at the network level and at the level of individual organizations.

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1 Medical Innovations and Interorganizational Diffusion.- Historical Background of Networks in the Health Sector.- Background of the Head and Neck Cancer Demonstration Networks.- Organizational Networks and the Diffusion of Innovation.- Focus of This Study.- 2 Data and Methods.- Introduction: Process Evaluation and Retrospective Case Studies.- Primary Sources.- Secondary Sources.- The Process of Synthesis.- Thumbnail Sketches.- 3 Network Environment and Response to Uncertainty: Performance Gaps and Definition of the Innovation.- Diffusion and Uncertainty.- Types and Characteristics of Innovations.- The Innovation in Head and Neck Cancer Treatment.- Performance Gaps, Agenda Setting, and the Network Programs.- 4 Considering the Environment: Environmental Context and Network Form.- Boundary Spanners and Interorganizational Linkage.- The Innovation Diffusion Model.- Considering the Environment.- Relating Environmental Characteristics to Diffusion Channel Form.- Summary.- 5 Network Form, Network Structure, and Boundary Management.- Network Form and Boundary Management.- Boundary Management and Network Structure.- General Purpose Linkages: Analysis of the Relationship between Context and Linkage Structure.- Summary.- 6 Variation across Hospitals in Network Program Participation.- Organizational Power.- Interest Structure.- Measuring Power, Interest Structure, and Participation.- Power and Participation.- Interest Structure and Participation.- Summary and Conclusions.- 7 Definition and Diffusion of the Innovation.- Definition of the Innovation.- Reinvention: Alternative Definitions of the Innovation.- Implementation Strategies.- Persuasion.- Summary.- 8 Network Outcomes: Transformation, Survival, and Institutionalization.- The Nature of the Organization and Organizational Effectiveness.- Measures of Effectiveness.- Network Constituencies.- Levels of Analysis.- Process Measures of Network Performance.- Structural Measures of Network Performance.- Outcome Measures: Ongoing Network Structures to Survive.- Early Network Failure: Lessons Learned from the Mississippi Network.- National Policy Changes and the Survival of the Networks.- Beyond Cancer Networks.- Appendixes.- A. Site Visit Outline.- B. Interview Protocol.- C. CEO Cover Letter and Questionnaire.- References.