Promoting a new practice in hospital: a qualitative comparative analysis of alternative design

Hospitals often fail to implement new practices due to an inability to promote their use among professionals. How effective promotion can be designed and organized remains unclear, however. The present work addresses this question by investigating the implementation of a cardiologic telesurveillance system in 12 hospitals. Despite an identical technology and unproblematic installation, only in five cases full implementation was achieved. Four promotion strategies—focused on a different combination of three aspects (planning, team involvement, and hero innovation)—were identified through case studies. Qualitative comparative analysis was then employed to identify three alternative strategies for effective promotion.