Understanding innovators' experiences of barriers and facilitators in implementation and diffusion of healthcare service innovations: A qualitative study

This article is made available through the Brunel Open Access Publishing Fund - Copyright @ 2011 Barnett et al.Background: Healthcare service innovations are considered to play a pivotal role in improving organisational efficiency and responding effectively to healthcare needs. Nevertheless, healthcare organisations encounter major difficulties in sustaining and diffusing innovations, especially those which concern the organisation and delivery of healthcare services. The purpose of the present study was to explore how healthcare innovators of process-based initiatives perceived and made sense of factors that either facilitated or obstructed the innovation implementation and diffusion. Methods: A qualitative study was designed. Fifteen primary and secondary healthcare organisations in the UK, which had received health service awards for successfully generating and implementing service innovations, were studied. In-depth, semi structured interviews were conducted with the organisational representatives who conceived and led the development process. The data were recorded, transcribed and thematically analysed. Results: Four main themes were identified in the analysis of the data: the role of evidence, the function of inter-organisational partnerships, the influence of human-based resources, and the impact of contextual factors. "Hard" evidence operated as a proof of effectiveness, a means of dissemination and a pre-requisite for the initiation of innovation. Inter-organisational partnerships and people-based resources, such as champions, were considered an integral part of the process of developing, establishing and diffusing the innovations. Finally, contextual influences, both intra-organisational and extra-organisational were seen as critical in either impeding or facilitating innovators' efforts. Conclusions: A range of factors of different combinations and co-occurrence were pointed out by the innovators as they were reflecting on their experiences of implementing, stabilising and diffusing novel service initiatives. Even though the innovations studied were of various contents and originated from diverse organisational contexts, innovators' accounts converged to the significant role of the evidential base of success, the inter-personal and inter-organisational networks, and the inner and outer context. The innovators, operating themselves as important champions and being often willing to lead constructive efforts of implementation to different contexts, can contribute to the promulgation and spread of the novelties significantly.This research was supported financially by the Multidisciplinary Assessment of Technology Centre for Healthcare (MATCH)

Team climate, intention to leave and turnover among hospital employees: Prospective cohort study

<p>Abstract</p> <p>Background</p> <p>In hospitals, the costs of employee turnover are substantial and intentions to leave among staff may manifest as lowered performance. We examined whether team climate, as indicated by clear and shared goals, participation, task orientation and support for innovation, predicts intention to leave the job and actual turnover among hospital employees.</p> <p>Methods</p> <p>Prospective study with baseline and follow-up surveys (2–4 years apart). The participants were 6,441 (785 men, 5,656 women) hospital employees under the age of 55 at the time of follow-up survey. Logistic regression with generalized estimating equations was used as an analysis method to include both individual and work unit level predictors in the models.</p> <p>Results</p> <p>Among stayers with no intention to leave at baseline, lower self-reported team climate predicted higher likelihood of having intentions to leave at follow-up (odds ratio per 1 standard deviation decrease in team climate was 1.6, 95% confidence interval 1.4–1.8). Lower co-worker assessed team climate at follow-up was also association with such intentions (odds ratio 1.8, 95% confidence interval 1.4–2.4). Among all participants, the likelihood of actually quitting the job was higher for those with poor self-reported team climate at baseline. This association disappeared after adjustment for intention to leave at baseline suggesting that such intentions may explain the greater turnover rate among employees with low team climate.</p> <p>Conclusion</p> <p>Improving team climate may reduce intentions to leave and turnover among hospital employees.</p

Effect of exploitation and exploration on the innovative as outcomes in entrepreneurial firms

[EN] The main aim of this study is to establish the effect of the Exploitation and Exploration; and the influence of these learning flows on the Innovative Outcome (IO). The Innovative Outcome refers to new products, services, processes (or improvements) that the organization has obtained as a result of an innovative process. For this purpose, a relationship model is defined, which is empirically contrasted, and can explains and predicts the cyclical dynamization of learning flows on innovative outcome in knowledge intensive firms. The quantitative test for this model use the data from entrepreneurial firms biotechnology sector. The statistical analysis applies a method based on variance using Partial Least Squares (PLS). Research results confirm the hypotheses, that is, they show a positive dynamic effect between the Exploration and the Innovative as outcomes. In the same vein, they results confirm the presence of the cyclic movement of innovative outcome with the Exploitation.In addition, this research is part of the Project ECO2015-71380-R funded by the Spanish Ministry of Economy, Industry and Competitiveness and the State Research Agency. Co-financed by the European Regional Development Fund (ERDF).Vargas-Mendoza, NY.; Lloria, MB.; Salazar Afanador, A.; Vergara Domínguez, L. (2018). Effect of exploitation and exploration on the innovative as outcomes in entrepreneurial firms. International Entrepreneurship and Management Journal. 14(4):1053-1069. https://doi.org/10.1007/s11365-018-0496-5S10531069144Alegre, J., & Chiva, R. (2008). Assessing the impact of organizational learning capability on product innovation performance: an empirical test. Technovation, 28, 315–326.Amara, N., Landry, R., Becheikh, N., & Ouimet, M. (2008). Learning and novelty of innovation in established manufacturing SMEs. Technovation, 28, 450–463.Aragón-Mendoza, J., Pardo del Val, M., & Roig, S. (2016). The influence of institutions development in venture creation decision: a cognitive view. Journal of Business Research, 69(11), 4941–4946.Ardichvili, A. (2008). Learning and knowledge sharing in virtual communities of practice: motivators, barriers, and enablers. Advances in Developing Human Resources, 10(4), 541–554.Argyris, C., & Schön, D. (1978). Organizational learning: a theory of action perspective. Reading: Addison Wesley.Bagozzi, R. P., Yi, Y., & Singh, S. (1991). On the use of structural equation models in experimental designs: two extensions international. Journal of Research in Marketing, 8, 125–140.Belda, J., Vergara L., Salazar, A., & Safont G. (2018). Estimating the Laplacian matrix of Gaussian mixtures for signal processing on graphs, accepted for publication in Signal Processing.Boland, R. J. J., & Tenkasi, R. V. (1995). Perspective making and perspective taking in communities of knowing. Organization Science, 6(4), 350–372.Bontis, N., (1998). Intellectual capital: an exploratory study that develops measures models. Management Decision, 36, 63–76.Bontis, N. (1999). Managing an organizational learning system by aligning stocks and flows of knowledge: an empirical examination of intellectual capital, knowledge management, and business performance. 1999. Management of Innovation and New Technology Research Centre, McMaster University.Bontis, N., Keow, W., & Richardson, S. (2000). Intellectual capital and the nature of business in Malaysia. Journal of Intellectual Capital, 1(1), 85–100Bontis, N., Hullan, J., & Crossan, M. (2002). Managing an organizational learning system by aligning stocks and flows. Journal of Management Studies, 39, 438–469.Brachos, D., Kostopulos, K., Sodersquist, K. E., & Prastacos, G. (2007). Knowledge effectiveness, social context and innovation. Journal of Knowledge Management, 11(5), 31–44.Calantone, R. J., Cavusgil, S. T., & Zhao, Y. (2002). Learning orientation, firm innovation capability, and firm performance. Industrial Marketing Management, 31, 515–524.Chang, T. J., Yeh, S. P., & Yeh, I. J. (2007). The effects of joint rewards system in new product development. International Journal of Manpower, 28(3/4), 276–297.Chin, W. (1998). The partial least square approach to structural equation modeling. In G. A. Marcoulides (Ed.) (pp. 294–336). New Jersey: Lawrence Erlbaum Associates.Cho, N., Li, G., & Su, C. (2007). An empirical study on the effect of individual factors on knowledge sharing by knowledge type. Journal of Global Business and Technology, 3(2), 1–15.Cohen, W. M., & Levin, R. C. (1989). Empirical studies of innovation and market structure. In R. Schmalansee & R. D. Willing (Eds.), Handbook of industrial organization II. New York: Elsevier.Cohen, W. M., & Levinthal, D. A. (1990). Absorptive-capacity – a new perspective on learning and innovation. Administrative Science Quarterly, 35, 128–152.Cooper, R. G. (2000). New product performance: what distinguishes the star products. Austrian Journal of Management, 25, 17–45.Crossan, M., & Berdrow, I. (2003). Organizational learning and strategic renewal. Strategic Management Journal, 24, 1087–1105.Crossan, M., & Apaydin, M. (2010). A multi-dimensional framework of organizational innovation: a systematic review of the literature. Journal of Management Studies, 47(6), 1154–1191.Crossan, M., Lane, H. W., & White, R. E. (1999). An organizational learning framework: from intuition to institution. Academy of Management Review, 24, 522–537.Damanpour, F., & Aravind, D. (2012). Managerial innovation: conceptions, processes, and antecedents. Management and Organization Review, 8(2), 423–454.Damanpour, F., & Shanthi, G. (2001). The dynamics of the adoption of products and process innovations in organizations. Journal of Management Studies, 38(1), 21–65.Decarolis, D. M., & Deeds, D. L. (1999). The impact of stock and flows of organizational knowledge on firm performance: An empirical investigation of the biotechnology industry. Strategic Management Journal, 20, 953–968.Demartini, C. (2015). Relationships between social and intellectual capital: empirical Evidence from IC statements. Knowledge and Process Management, 22(2), 99–111.Dupuy, F. (2004). Sharing knowledge: they why and how of organizational change. Hampshire: Palgrave Macmillan.Fornell, C., & Bookstein, F. I. (1982). Two structural equation models: LISREL and PLS applied to consumer exit-voice theory. Journal of Marketing Research, 19, 440–452.Ganter, A., & Hecker, A. (2013). Deciphering antecedents of organizational innovation. Journal of Business Research, 66(5), 575–584.Ganter, A., & Hecker, A. (2014). Configurational paths to organizational innovation: qualitative comparative analyses of antecedents and contingencies. Journal of Business Research, 67, 1285–1292.Gopalakrishnan, S., & Damanpour, F. (1997). A review of innovation research in economics, sociology and technology management. International Journal of Management Science, 25, 15–28.Hedberg, B. (1981). How organizations learn and unlearn. In P. Nystrom & W. Starbuck (Eds.), Handbook of organizational design. New York: Oxford University.Hedlund, G., & Nonaka, I. (1993). Models of knowledge management in the west and Japan. In: P. Lorange, B. Chacravrarthy, J. Ross, and J. Van de ven (Eds.) Cambridge: Basil Blackwell.Henseler, J., Ringle, C.M., & Sinkovics, R.R. (2009). The use the partial least squares path modeling. In: R. Sinkovics and N. Pervez (Eds.) 277–319.Hsu, I. (2006). Enhancing employee tendencies to share knowledge-case studies on nine companies in Taiwan. International Journal of Information Management, 26(4), 326–338.Hsu, I. (2008). Knowledge sharing practices as a facilitating factor for improving organizational performance though human capital: a preliminary test. Expert Systems with Application, 35, 316–1326.Huang, Q., Davison, R., & Gu, J. (2008). Impact of personal and cultural factors on knowledge sharing in China. Asia Pacific Journal Management, 25(3), 451–471.Ibarra, H. (1993). Network centrality, power, and innovation involvement – determinants of technical and administrative roles. Academy of Management Journal, 36(3), 471–501.Iebra, I. L., Zegarra, P. S., & Zegarra, A. S. (2011). Learning for sharing: an empirical analysis of organizational learning and knowledge sharin. International Entrepreneurship Management Journal, 7, 509–518.Ipe, M. (2003). Knowledge sharing in organizations: a conceptual framework. Human Resource Development Review, 2(4), 337–359.Jenkin, T. (2013). Extending the 4I organizational learning model: information sources, foraging processes and tools. Administrative Sciences, 3, 96–109.Jiménez-Jiménez, D., & Sanz-Valle, R. (2011). Innovation, organizational learning, and performance. Journal of Business Research, 64, 408–417.Kane, G. C., & Alavi, M. (2007). Information technology and organizational learning: an investigation of exploration and exploitation processes. Organization Science, 18(5), 796–812.Kleinbaum, D. G., Kupper, N. N., Muller, K. E. (1988). Applied regression analysis and other Multivariable’s methods, PWS KENT.Klomp, L., & Van Leeuwen, G. (2001). Linking innovation and firm performance: a new approach. International Journal of the Economics of Business, 8(3), 343–364.Lansisalmi, H., Kivimaki, M., Aalto, P., & Ruoranen, R. (2006). Innovation in healthcare: a systematic review of recent research. Nursing Science Quarterly, 19(1), 66–72.Laperrière, A., & Spence, M. (2015). Enacting international opportunities: the role of organizational learning in knowledge-intensive business services. Journal of International Entrepreneurship, 13(3), 212–241.Levitt, B., & March, J. G. (1988). Organizational learning. Annual Review of Sociology, 14, 319–340.Lin, H. (2007). Knowledge sharing and firm innovation capability: an empirical study. International Journal of Manpower, 28(3/4), 315–332.Lloria, M. B., & Moreno-Luzón, M. D. (2014). Organizational learning: proposal of an integrative scale and research instrument. Journal of Business Research, 67, 692–697.March, J. G. (1991). Exploration and exploitation in organizational learning. Organizational Science, 2, 71–87.Matikainen, M., Terho, H., Parvinen, P., & Juppo, A. (2016). The role and impact of firm’s strategic orientations on launch performance: significance of relationship orientation. Journal of Business & Industrial Marketing, 31(5), 625–639.Mone, M. A., McKinley, W., & Barker, V. L. (1998). Organizational decline and innovation: a contingency framework. Academy of Management Review, 23, 115–132.Moreno-Luzón, M. D., & Lloria, B. (2008). The role of non-structural and informal mechanisms of integration and integration as forces in knowledge creation. British Journal of Management, 19, 250–276.Moskaliuk, J., Bokhorst, F., & Cress, U. (2016). Learning from others' experiences: how patterns foster interpersonal transfer of knowledge-in-use. Computers in Human Behavior, 55, 69–75.Nonaka, I., & Takeuchi, H. (1995). The knowledge-creating company. How Japanese companies create the dynamics of innovation. New York: Oxford University Press.Nonaka, I., & von Krogh, G. (2009). Perspective tacit knowledge and knowledge conversion: controversy and advancement in organizational knowledge creation theory. Organization Science, 20(3), 635–652.Parida, V., Lahti, T., & Wincent, J. (2016). Exploration and exploitation and firm performance variability: a study of ambidexterity in entrepreneurial firms. International Entrepreneurship Management Journal, 12, 1147–1164.Pew, H., Plowman, D., & Hancock, P. (2008). The involving research on intellectual capital. Journal of Intellectual Capital, 9, 585–608.Potter, R. E., & Balthazard, P. A. (2004). The role of individual memory and attention processes during electronic brainstorming. MIS Quarterly, 28(4), 621–643.Ramadani, V., Hyrije, A. A., Léo-Paul, D., Gadaf, R., & Sadudin, I. (2017). The impact of knowledge spillovers and innovation on firm-performance: findings from the Balkans countries. International Entrepreneurship Management Journal, 13, 299–325.Ren, S., Shu, R., Bao, Y., & Chen, X. (2016). Linking network ties to entrepreneurial opportunity discovery and exploitation: the role of affective and cognitive trust. International Entrepreneurship and Management Journal, 12(2), 465–485.Ringle, C. M., Wende, S., & Will, A. (2005). Smart PLS 2.0 (M3) beta, Hamburg: http://www.smartpls.de .Ringle, C. M., Sarstedt, M., & Straub, D. (2012). A critical look at the use of PLS-SEM. MIS Quarterly, 36(1), iii–xiv.Sanchez, R., & Heene, A. (1997). A competence perspective on strategic learning and knowledge management. En Sanchez, R. and Heene, A. (eds.) Strategic learning and knowledge management. John Wiley and Sons.Seidler-de Alwis, R., & Hartmann, E. (2008). The use of tacit knowledge within innovative companies: knowledge management in innovative enterprises. Journal of Knowledge Management, 12(1), 133–147.Shrivastava, P. (1983). A typology of organizational learning systems. Journal of Management Studies, 20, 7–28.Tansky, J., Ribeiro, D., & Roig, S. (2010). Linking entrepreneurship and human resources in globalization. Human Resource Management, 49(2), 217–223.Teece, D. (2012). Dynamic capabilities: routines versus entrepreneurial action. Journal of Management Studies, 49(8), 1395–1401.Tenenhaus, M., Vinzi, V., Chatelin, Y., & Lauro, C. (2005). PLS path modeling. Computational Statistics and Data Analysis, 49, 159–205.vande Vrande, V., de Jong, J., Vanhaverbeke, W., & Rochemont, M. (2009). Open innovation in SMEs: trends, motives and management challenges. Technovation, 29, 423–437.Vargas, N., & Lloria, M. B. (2014). Dynamizing intellectual capital through enablers and learning flows. Industrial Management and Data Systems, 114(1), 2–20.Vargas, N., & Lloria, M. B. (2017). Performance and intellectual capital: how enablers drive value creation in organisations. Knowledge and Process Management, 24(2), 114–124.Vargas, N., Lloria, M. B., & Roig-Dobón, S. (2016). Main drivers of human capital, learning and performance. The Journal of Technology Transfer, 41(5), 961–978.Vergara, L., Salazar, A., Belda, J., Safont, G., Moral, S., & Iglesias, S. (2017). Signal processing on graphs for improving automatic credit card fraud detection. Proceeding of 2017 I.E. 51st international Carnahan Conference on Security Technology (ICCST 2017), https://doi.org/10.1109/CCST.2017.8167820 , 23–26 Oct, 2017, Madrid, Spain.Wallin, M. W., & Von Krogh, G. (2010). Organizing for open innovation: focus o the integration of knowledge. Organizational Dynamics, 39(2), 145–154.Wang, C. L., & Ahmed, P. K. (2004). Linking innovation and firm performance: a new approach. European International Journal of Technology Management, 27, 674–688.Wold, H. (1980). Model construction and evaluation when theoretical knowledge is scarce. In J. Kmenta & J. B. Ramsey (Eds.), Evaluation of econometric models (pp. 47–74). Cambridge: Academic Press.Wold, H. (1985). Factors influencing the outcome of economic sanctions. In Sixto Ríos Honorary. Trabajos de Estadística and de Investigación Operativa, 36(3), 325–337

Interprofessional collaborative practice within cancer teams: Translating evidence into action. A mixed methods study protocol

<p>Abstract</p> <p>Background</p> <p>A regional integrated cancer network has implemented a program (educational workshops, reflective and mentoring activities) designed to support the uptake of evidence-informed interprofessional collaborative practices (referred to in this text as EIPCP) within cancer teams. This research project, which relates to the Registered Nurses' Association of Ontario (RNAO) Best Practice Guidelines and other sources of research evidence, represents a unique opportunity to learn more about the factors and processes involved in the translation of evidence-based recommendations into professional practices. The planned study seeks to address context-specific challenges and the concerns of nurses and other stakeholders regarding the uptake of evidence-based recommendations to effectively promote and support interprofessional collaborative practices.</p> <p>Aim</p> <p>This study aims to examine the uptake of evidence-based recommendations from best practice guidelines intended to enhance interprofessional collaborative practices within cancer teams.</p> <p>Design</p> <p>The planned study constitutes a practical trial, defined as a trial designed to provide comprehensive information that is grounded in real-world healthcare dynamics. An exploratory mixed methods study design will be used. It will involve collecting quantitative data to assess professionals' knowledge and attitudes, as well as practice environment factors associated with effective uptake of evidence-based recommendations. Semi-structured interviews will be conducted concurrently with care providers to gather qualitative data for describing the processes involved in the translation of evidence into action from both the users' (n = 12) and providers' (n = 24) perspectives. The Graham <it>et al. </it>Ottawa Model of Research Use will serve to construct operational definitions of concepts, and to establish the initial coding labels to be used in the thematic analysis of the qualitative data. Quantitative and qualitative results will be merged during interpretation to provide complementary perspectives of interrelated contextual factors that enhance the uptake of EIPCP and changes in professional practices.</p> <p>Discussion</p> <p>The information obtained from the study will produce new knowledge on the interventions and sources of support most conducive to the uptake of evidence and building of capacity to sustain new interprofessional collaborative practice patterns. It will provide new information on strategies for overcoming barriers to evidence-informed interventions. The findings will also pinpoint critical determinants of 'what works and why' taking into account the interplay between evidence, operational, relational micro-processes of care, uniqueness of patients' needs and preferences, and the local context.</p

Product and process innovation in manufacturing firms: a 30-year bibliometric analysis

Built upon a thirty-year dataset collected from the Web of Science database, the present research aims to offer a comprehensive overview of papers, authors, streams of research, and the most influential journals that discuss product and process innovation in the manufacturing environment. The dataset is composed of 418 papers from more than 150 journals from the period between 1985 and 2015. Homogeneity analysis by means of alternating least squares (HOMALS) and Social Network Analysis (SNA) are used to accomplish the objectives listed above through the keywords given by authors. Initially, the paper highlights and discusses the similarity between the topics debated by the main journals in this field. Subsequently, a wide-range map of topics is presented highlighting five main areas of interests; namely, performance, patent, small firm, product development, and organization. A SNA is also performed in order to validate the results that emerged from HOMALS. Finally, several insights about future research avenues in the manufacturing field are provided

Female Directors and Innovation in Public Hospitals

The paper aims to examine the influence of gender diversity among hospital directors on the adoption of innovation. To this aim, it empirically analyses a sample of 108 Italian public hospitals, including general, teaching and research hospitals, for the 2015-2016 time-frame. Findings from our OLS regression analysis show that female directors enable hospitals to successfully face the innovation challenge. In particular, female directors bring specific skills to executives and enhance their knowledge base. In addition, the results of our analysis suggest that work-abroad experience promote the implementation of innovative solutions as it provides women directors with a global view and open-mindedness that enrich their intercultural skills, and therefore their attitude towards innovation. The results contribute to the existing empirical research on women in governance by providing insights into the healthcare sector that is still under-explored. Moreover, the paper suggests that policy makers should pay attention to combine a stronger participation of female in hospital leadership, and call for proper normative actions able to improve the background requirements for the recruitment of directors