Diffusing Innovative Roles Within Ontario Hospitals: Implementing the Nurse Practitioner as the Most Responsible Provider.

Hospitals require identification of the most responsible provider (MRP) for care of admitted patients. Traditionally, the MRP has been a physician. However, legislation changes within Ontario authorize the nurse practitioner (NP) to admit and provide care for hospital in-patients. There is little evidence illustrating adoption of the NP-as-MRP model in Ontario. Reasons for a delayed adoption of this innovative model of care are unclear and warrant investigation. One hospital implemented the NP-as-MRP as an appropriate and beneficial model to maximize access to care for senior patients. Rogers' (2003) model of diffusion of innovation provides a framework to describe the processes undertaken that led to their adoption of the NP-as-MRP model. Detailed processes are highlighted for hospital leaders, hospital board members, and NPs. Other sites are encouraged to evaluate whether the NP-as-MRP model will be appropriate for specific populations; each site should undertake a process that is as detailed to ensure thorough preparation of all who will be affected by this change. Evaluation of the outcomes of the NP-as-MRP model is necessary and must be population- and institution-specific, as these provide new evidence in the early stages of this recent NP-related innovation in Ontario.