Getting a handle on the social processes of implementation: social network research

An important part of any implementation project in healthcare settings is understanding the underlying social processes. Healthcare involves many socially based interactions and relationships, such as communication, shared decision-making, and sensemaking involving clinical and non-clinical staff, patients, and their families. Moreover, implementation outcomes, such as acceptability and adoption, are also complex social processes, often relying on group understandings and the influence of respected opinion leaders. Social network research is a methodology that maps and quantifies relationships. Collecting data from as many people as possible who are involved in the project, key social processes can be graphed and analysed. Social network research can give insights into actual (not just assumed) information flows, identify key people who influence or support others, and find groups that may be isolated and literally out of the loop. This information can contextualize, describe, evaluate, and diagnose issues in implementation.