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Normalization process theory

In order to successfully introduce innovations into complex adaptive systems, such as doctors' offices or hospitals, we need to understand how implementation processes and their contexts depend on each other. In particular, detailed knowledge of what actions actors take to give an innovation meaning and to integrate it into their work processes, as well as knowledge of contextual elements that influence actions, are an essential prerequisite for the transition of an innovation from model project status to model project status Everyday supply. The Normalization Process Theory (NPT), which is currently one of the most prominent theories in implementation research, can provide guidance in this context. It characterizes the introduction and embedding of innovations as a social process of collective action and less as an effort by individuals. As a medium-range theory, it describes a series of generative mechanisms of different types that motivate and structure the actions of those involved in integrating innovations into care.

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First publication date: 23.03.2022

Citation: Köblelein-Neu, J., Piotrowski, A.; “Normalization process theory”, in “Monitor Health Services Research” (02/22), pp. 42-43. http://doi.org/10.24945/MVF.02.22.1866-0533.2389Köberlein-Neu, J.: ORCID: 0000-0002-3451-7847Piotrowski, A.: ORCID: 0000-0001-5206-4514

Plain Text

>> The normalization process theory is a sociological theory that aims to raise awareness of mechanisms that are fundamental to the implementation, embedding and integration of new technologies and organizational innovations (May & Finch 2009). The focus is particularly on the cognitive and social processes that people go through in order to integrate an innovation into their everyday practices and maintain its use. In this context, it can be used to identify factors at various stages of an implementation process that promote and/or inhibit the routine integration of new practices into everyday practice (Murray et al. 2010; May 2006, May 2013).
The NPT emerged as an extension of the Normalization Process Model (NPM) by May and colleagues (May et al. 2007) and provides four non-linear generative core mechanisms for understanding implementation processes (see Table 1):
• Coherence: the awareness-building that individuals and groups engage in to develop an understanding of how an innovation differs from other practices, what benefits it offers, and what people need to do to take advantage of it.
• Cognitive Participation: the relational work to ensure that the right people are involved in implementing the innovation, as well as the legitimacy and commitment of groups of people to reorganize themselves to exploit the innovation.
• Collective action: people's efforts to operationalize an innovation.
• Reflexive monitoring: the individual and collective assessment of the change work and the sustainable use of the innovation.

Each core mechanism is also conceptualized in depth via four subcomponents (not listed within the scope of this article), enabling an in-depth understanding of the mechanisms. <<

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