Institutional entrepreneurship, innovation, implementation and scale-up for healthcare improvement - transforming the health care system

The thesis examines frontline healthcare improvement through the integrated lens of implementation science and institutional entrepreneurship. The research aimed to explore the factors that enable and inhibit the take-up, spread, and sustainability of improvement initiatives. It also examined how improvement can be influenced by local conditions and contextual factors. The research demonstrates the vital role of leadership in collaboration and iterative learning with end-users and frontline clinicians. It emphasised the strengths of leaders with both clinically and scientifically rigorous implementation proficiency, and the importance of engaging multi-disciplinary expertise, and cross-sector skills given the complexity of healthcare improvement