Paper Title
The Role of Social Networks in the Diffusion of Innovations: The Case of the Basque Country Health Reform

Abstract
This investigation examines the role played by social networks in the diffusion of innovation in the healthcare environment, particularly the impact of social networks on the implementation of a challenging health reform conducted in the Basque Country during the IX Legislature (2009-2012). It also analyzes the mediating effect of commitment between social networks and the implementation of this healthcare reform. Using network theory and institutional logics framework, this study presents a mixed method case study based on the top management level population (231 managers) of the Basque Country Health Service. Results suggest that change- management processes which require a rapid diffusion of implicit knowledge initially benefit more from a loose network than a cohesive one. Previous research has analyzed the role of middle management on healthcare implementations and the impact of selected champions on an innovative implementation process. This investigation explores the influence of top management´s social networks at the initial stage of a change reform and reveals the strategic importance of a unique champion of innovation as the main trigger for change. Keywords - Network Relations Theory, Knowledge Diffusion, Commitment, Institutional Context