Analysing organisational context: case studies on the contribution of absorptive capacity theory to understanding inter-organisational variation in performance improvement
Open accessAbstract
Background: Organisational context is frequently cited as an important consideration when implementing and evaluating quality improvement interventions in healthcare, but limited guidance is available on which aspects of context are most influential or modifiable. This paper examines how internal and external contextual factors mediate organisational-level performance improvement through applying the knowledge-based theory of absorptive capacity (AC). Methods: Three healthcare case studies are presented. Each case is a UK National Health Service organisation that had been identified as having performance problems. Qualitative data were collected through semi-structured interviews with general and clinical managers within the organisation and members of external teams supporting or overseeing performance improvement (n=22). Interview data were analysed using an existing AC framework from the literature. Results: The organisation with the highest AC showed the quickest and most comprehensive performance improvement. Internal characteristics including strategic priorities, processes for managing information, communication and orientation to learning and development impacted on the organisation's ability to engage successfully with external stakeholders and make use of available knowledge. This enabled the organisation to thrive despite the challenging external environment. Lower levels of AC appeared to delay or limit the improvement trajectory. Conclusions: Developing a more detailed and nuanced understanding of how context influences improvement is an important step towards achieving more effective and sustainable quality improvement programmes in healthcare. AC, with its focus on knowledge and organisational learning, provides a useful way to explore the relationship between context and quality improvement and represents a potentially valuable area for future research and development.
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Theories that inform the i-PARIHS framework's views about context include complexity, absorptive capacity, learning organisations, leadership and organisational culture.
“Included in this mix are theories related to complexity [72, 73], absorptive capacity [74] and learning organisations [75] as well as theories related to leadership and organisational culture [76].”
From PARIHS revisited: from heuristic to integrated framework for the successful implementation of knowledge into practice (2015) · cites this paper as [74]
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How Can Cities Build Innovation Capabilities? An Analytical FrameworkPreprint
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- Authors
- Harvey, G., Jas, P., & Walshe, K.
- Affiliations
- University of Manchester (GB)
- University of Nottingham (GB)
- Corresponding author
- Harvey, Gill
- Venue
- BMJ Quality & Safety
- Publisher
- BMJ
- Published
- 2014-10-21
- Volume
- 24
- Issue
- 1
- Pages
- 48-55
- ISSN
- 1475-3898 (ISSN-L)
- 2044-5415
- 2044-5423
- OpenAlex
- W2167046521
- Cited by
- 73
- References
- 37
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 7 · 2023: 8 · 2022: 6 · 2021: 5 · 2020: 8 · 2019: 9 · 2018: 7 · 2017: 6 · 2016: 3 · 2015: 8
- FWCI
- 10.34
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- BMJ Quality & Safety (publishedVersion)
- PubMed (publishedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- HighWire Press Open Archive (submittedVersion)
- Research Explorer (The University of Manchester) (submittedVersion)
- Funders
- Economic and Social Research Council
- Topics
- Health Sciences › Health Professions › Health Information Management › Healthcare Quality and Management
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Social Sciences › Business, Management and Accounting › Strategy and Management › Innovation and Knowledge Management
- Keywords
- absorptive capacity, organizational context, performance improvement, quality improvement, health care organization, knowledge-based view, organizational learning, knowledge management, National Health Service, strategic priorities, learning and development
- MeSH terms
- Communication, Delivery of Health Care, United Kingdom, Health Services Research, Humans, Interviews as Topic, Learning, Organizational Innovation, State Medicine, Organizational Culture, Knowledge, Qualitative Research, Quality Improvement, Health Information Management
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
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What counts as a claim ›How we measure confidence ›How we check this ›
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