The fourth mission of hospitals: exploring the role of researchers as innovation drivers in the public healthcare sector

Earlier versions of this paper were presented at the Spanish Conference on Sociology 2010 and 2013: (Pamplona, Spain, July 1-3, 2010; Madrid, Spain, July 10-12, 2013) and ALTEC 2013. XV Latin Ibero-American Conference on Management of Technology (Porto, Portugal, 27-31 Octubre 2013).[EN] Scientific research can be an instrument for innovation. This article explores the role of researchers as innovation drivers in the public healthcare sector. Triple Helix model is proposed for the analysis of the role of public hospitals in knowledge generation and innovation processes. We discuss the role of public hospitals in innovation and in economic and social development, and identify this role as a ‘fourth mission’ of hospitals in addition to their widely recognized threefold function of healthcare provision, education and research. We discuss the evolution of hospital administration from healthcare towards the ‘entrepreneurial hospital’ model. More specifically, we investigate the extent to which the incorporation of full-time researchers can help to foster innovation at research and healthcare centres affiliated with the Spanish National Health System. Data were obtained through a survey of researchers, research group leaders and heads of departments and centres where these researchers worked, as well as through content analysis of researchers’ annual reports. Their incorporation mainly favoured the extension of foreign innovation through the incorporation of new techniques and technologies in research groups.[ES] Se estudia el papel de los investigadores como promotores de la innovación en el sector sanitario público. Se propone el modelo de la Triple Hélice como una aproximación adecuada para el estudio del papel de los hospitales públicos en los procesos de generación de conocimiento y de innovación. Se identifican la innovación y la contribución al desarrollo económico y social como la ‘cuarta misión’ de los hospitales públicos, adicional a su triple misión asistencial, docente e investigadora. Este enfoque aboga por una evolución desde el modelo asistencial tradicional hacia fórmulas operativas más novedosas como la del ‘hospital emprendedor’. Tomando como caso de estudio el Programa FIS/Miguel Servet, se investiga en qué medida la incorporación de investigadores contribuye a fomentar la innovación en los centros del Sistema Nacional de Salud español. Los datos proceden de sendas encuestas a los investigadores y a los responsables de los grupos y de los distintos departamentos y centros a los que éstos se incorporaron, así como del análisis de contenido de los informes anuales de los investigadores. La incorporación de estos investigadores favorece la innovación principalmente a través de la incorporación a los grupos de investigación de nuevas técnicas y tecnologías.This work was supported by the Carlos III Health Institute-General Subdirectorate for the Evaluation and Promotion of Research, Spanish Ministry of Health, and by the Spanish Ministry of Education and Science, within the framework of the Spanish RDI Plan (grant numbers PI06/0983, SAF2005-24634-E