Learning Objectives for this Presentation:
By the end of the presentation participants will be able to idetify factors affecting organization's adoption of practice guidelines

Background:
The Standards are a compilation of the best research in methods for improving vaccination services and coverage levels. Their dissemination and “packaging” have used the most current formulations in effective health communication to providers. However, medical care facilities are now comprised of multiple levels of decision making. This suggests that optimal adoption of the Standards will require an understanding of how Organizations make decisions to adopt guidelines like the Standards. This presentation will describe the results of a study analyzing organizational decision making using Diffusion of Innovation as a theoretical framework.

Objectives:
To provide a framework for understanding organizational decision making

Methods:
Semi-structured interviews and workflow analysis with health care organization administrative personnel in San Diego County California and Monroe County New York.

Results:
Health care organizations are more influenced by regulatory and funding agencies then by peer or professional organizations. Furthermore, decision making and implementation responsibilities are now divided amongst a number of different administrative structures. Effective dissemination and adoption of the Standards would increase if they were “re-packaged” to reflect common organizational structures

Conclusions:
Federal, State and local Public Health Departments can facilitate implementation of the Standards of Vaccination Practices by parsing and matching specific components of the Standards to specific organizational structures within health care organizations, as well as marketing to funding and legislative agencies.