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This paper reviews the evidence base for vertical integration in health care. We describe its impact on organisational structures, on how services are provided, and on such outcomes as cost, clinical outcomes and patient experience. We also outline conditions that support successful integration.

The purpose of this paper is to better understand how and why adoption and implementation of healthcare IT innovations occur. The authors examine two IT applications, computerised physician order entry (CPOE) and picture archiving and communication systems (PACS) at the meso and micro levels, within the context of the National Programme for IT in the English National Health Service (NHS).

To analyse these multi-level dynamics, the authors blend Rogers’ diffusion of innovations theory (DoIT) with Webster’s sociological critique of technological innovation in medicine and healthcare systems to illuminate a wider range of interacting factors. Qualitative data collected between 2004 and 2006 uses semi-structured, in-depth interviews with 72 stakeholders across four English NHS hospital trusts.

Overall, PACS was more successfully implemented (fully or partially in three out of four trusts) than CPOE (implemented in one trust only). Factors such as perceived benefit to users and attributes of the application – in particular speed, ease of use, reliability and flexibility and levels of readiness – were highly relevant but their influence was modulated through interaction with complex structural and relational issues.

Results reveal that combining contextual system level theories with DoIT increases understanding of real-life processes underpinning implementation of IT innovations within healthcare. They also highlight important drivers affecting success of implementation, including socio-political factors, the social body of practice and degree of “co-construction” between designers and end-users.

The originality of the study partly rests on its methodological innovativeness and its value on critical insights afforded into understanding complex IT implementation programmes.

Using the example of medication safety, this paper aims to explore the impact of three managerial interventions (adverse incident reporting, ward‐level support by pharmacists, and a medication safety subcommittee) on different professional communities situated in the English National Health Service (NHS).

Semi‐structured interviews were conducted with clinical and managerial staff from two English NHS acute trusts, supplemented with meeting observations and documentary analysis.

Attitudes toward managerial intervention differ by professional community (between doctors, nurses and pharmacists) according to their existing norms of safety and perceptions of formal governance processes.

The heterogeneity of social norms across different professional communities and medical specialties has implications for the design of organisational learning mechanisms in the field of patient safety.

The paper shows that theorisation of professional “resistance” to managerialism privileges the study of doctors' reactions to management with the consequent neglect of the perceptions of other professional communities.

The purpose is to share strategies, rationales and lessons learnt from user involvement in a quality and safety improvement research project from the practice field in nursing homes and homecare services.

This is a viewpoint paper summarizing how researchers and co-researchers from the practice field of nursing homes and homecare services (nurse counsellors from different municipalities, patient ombudsman and next-of-kin representatives/and elderly care organization representant) experienced user involvement through all phases of the research project. The project included implementation of a leadership intervention.

Multiple strategies of user involvement were applied during the project including partnership in the consortium, employment of user representatives (co-researchers) and user-led research activities. The rationale was to ensure sound context adaptation of the intervention and development of tailor-made activities and tools based on equality and mutual trust in the collaboration. Both university-based researchers and Co-researchers experienced it as useful and necessary to involve or being involved in all phases of the research project, including the designing, planning, intervention implementation, evaluation and dissemination of results.

User involvement in research is a growing field. There is limited focus on this aspect in quality and safety interventions in nursing homes and homecare settings and in projects focussing on the leadership' role in improving quality and safety.

People with disabilities (PWD) produce aids using 3D printing in an inclusive MakerSpace in Germany. This study aims to demonstrate the pathways enabling people with disabilities to be “makers” of aids, creating a “medium-quality market”.

This study conceptualizes the foundation of the MakerSpace as a social innovation and traces supporting and hindering factors on three different layers: normative, structural and functional contexts.

3D printing can empower PWD to design and construct aids by themselves. The emerging “medium-quality” market offers potentials for availability for individualized aids. The design-thinking method used and the developed scalable approach empower PWD to create aids that best meet their own needs. The study found three arguments for printing aids that involve 3D printers: “New”: objects that are not available without a 3D printer. “Better”: objects that are available through established channels but were produced either more cheaply, quickly or on a more individualized level. “More”: objects that are available through other channels, but where 3D printing allows more of them to be produced for more people.

The qualitative study has limitations because of sample size and context dependency. Research has only been carried out in Germany. Future research should be conducted in other countries to generalize the results.

The article allows to understand the emergence of a new market for aids. It can steer producers (including PWD or sheltered workshops) in producing new aids and making them available to more people.

Understanding the functioning of the “new market for aids” can boost the accessibility of aids. Empowering PWD to produce aids can support their independence, self-determination and self-esteem. Supporting PWD to become producers of aids can support them in becoming experts and boost the quality and availability of aids.

All data presented has been collected by the authors.

This paper describes an innovative project to support people who are undertaking development of integrated systems by improving access to the evidence base. Feedback is invited on this internet‐based resource to inform the continuing development process.