Chapter 40: Institutional entrepreneurship in Alzheimer’s disease treatment
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The problem of interest in this exploratory study is the emergence of innovative practices for the treatment of Alzheimer’s Disease (AD). Since there is little prior research on what specific activities are needed to introduce and sustain new practices in complex healthcare fields, we compare three cases of non-pharmacological AD treatment practices in Switzerland. In the first case, no radically new practices were introduced and only minimal change was intended. In the second case, a new referral and consultation process was initiated, and the change was symbolically endorsed but not fully implemented in practice and therefore was decoupled from recommendations by policy makers. In the third case, the change initiator targeted divergent change in AD treatment. He developed a new virtual reality game for early diagnosis and delay of AD symptoms, won a social enterprise fellowship and secured financing by business and philanthropic actors, thereby mobilizing new allies in the field of AD treatment. We find that active participation in vision creation, the acquisition of allies, and resource mobilization are crucial to the success of divergent change initiations. Based on the results, some preliminary policy and managerial implications are offered.

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