Innovation in hospitals: a survey of the literature

Innovation in crisis: The role of 'exaptive relations' for medical device development in response to COVID-19

The COVID-19 pandemic has resulted in huge disruption to the healthcare sector. In response to this, there have been collaborative efforts between many different public and private organizations to foster medical innovations. The effect of crisis upon innovation, particularly medical innovation, remains a debatable subject. In addition, the role of inter-personal relations is becoming more widely acknowledged as a critical feature of innovation. Drawing upon exaptation literature, the study aims to understand the nature of the micro-relations within medical innovations that are undertaken in response to COVID-19. The findings of this paper contribute to the limited literature that examines the performance of medical innovation in response to crisis. In addition to confirming the importance of exaptive pools, exaptive events, and exaptive forums in fostering serendipitous developments, the study makes a contribution to theory by identifying a further form of serendipitous encounter that is 'exaptive relations'.

The Value Relevance of Operational Innovation: Insights from the Perspective of Firm Life Cycle

This study investigates the effect of innovation on firm value at each stage of the firm life cycle (FLC): growth, mature and decline stages. Innovation involves improving the yield of input resources and creating new revenue sources. Thus, we define operational innovation as overall efficiency in business operations and divide the operational innovation into technical innovation and scale innovation. We adopt data envelopment analysis to measure a firm’s operational innovation and Dickinson’s method to determine the firm’s life cycle stage. The findings show that the effect of operational innovation on firm value differs among different stages of the firm life cycle, indicating that firms seeking value maximisation should improve the performance of technical innovation at the growth stage and that of scale innovation at the decline stage. In addition, technical innovation is positively related to the firm’s future value at every stage of its life cycle, signifying that the firm’s sustainability is associated with technical innovation rather than scale innovation. This study contributes to the existing literature by presenting the value relevance of the operational innovation that firms should pursue in each life cycle stage.

The Field of “Public Health” as a Component of Sustainable Development—Poland Compared to the European Union

The objective of the article is to analyse selected indicators of sustainable development in the field of “public health”, especially those related to health and health-related inequalities. The article focuses on the analysis of indicators in the field of “public health” presented by Eurostat. These indicators were presented in terms of averages and medians. Moreover, the paper indicates the amount of funds allocated for prevention in health care. In addition, the cluster method was used to identify EU countries similar to each other in terms of the leading indicator of sustainable development (SD). The study was conducted using annual data for 2010–2019 for Poland as compared to other EU countries. The study used data from the Eurostat and OECD databases. In almost all of the analysed countries, in relation to the demographic and health situation, there is a close link between the financial situation, health and inequalities in health-related fields. Patients’ sense of safety has decreased in Poland, which is the result of the growing consumption of health services and emerging problems with the availability of health care services as well as environmental pollution. Among others, the percentage of people with health problems and low income has increased. Although the percentage of unmet needs resulting from income inequalities has decreased over the past year in the analysed groups of countries, it is still high in Poland. The low level of expenditure on prevention makes these difficulties even more severe. In summary, capturing changes in indicators describing public health in the context of its impact on sustainable development plays a key role in balancing out inequalities in the EU countries and in managing a common policy.

[Lab Santé, an innovation accelerator]

Lab Santé is an association created by the Île-de-France regional health agency to accelerate innovative health care solutions. Its expertise, its agility and its network made up of various stakeholders from across the region enable it to successfully carry out the projects it supports and the experiments it conducts.

Perspective of Business Models and Innovation for Sustainability Transition in Hospitals

Hospitals have valuable resources but are have facedsignificant changes over recentdecades. The adoption of principles that drive the strategic development of business models as innovation is imperative in these institutions. This research study aims to articulate a conceptual review of business models, innovation, and sustainability transition in the context of health business. It proposes a model for future applications in hospitals. This proposed model emphasizes the relations that arise under the multiple-level perspective. It also addresses the evolution of the concepts of business models and innovation that might contribute to the sustainability transition movement once new sociotechnical systems get space in these organizations. The main results of this conceptual review are the multiple depictions of internal and external elements that mutually interact to describe the dynamics of transitions. In the landscape level, elements such as ecological modernization and corporate social responsibility interact with elements of the regime level—legal, technological, and efficiency aspects—and with the niche’s aspects, represented by transitions from low to high quality and efficiency in services. This proposed model is justified by the lack of studies that address the sustainability transition models in hospitals and by its potential of adaption to particular contexts.

[Innovative culture and diagnosis related groups in a high complexity hospital, Colombia]

Objectives To characterize the perception of Diagnosis-Related Groups (DRGs) as an innovation among physicians, nurses and administrative staff in a hospital in Colombia. Methods A case study of innovative culture in a hospital. Surveys and focus groups were carried out with the medical, nursing and administrative staff. Descriptive statistics were calculated for the perceptions of innovative culture. Comparative analysis was done between professional groups. The results of the focus groups were transcribed and analyzed to deepen the findings of the surveys. Results Significant differences were found in perceptions of the innovative culture. The nursing staff were more enthusiastic than doctors when evaluating the innovative culture and leadership. Physicians felt more autonomy when discussing professional issues. Administrative staff assessed the Hospital's disposition to acquire new medical technologies as higher than that of physicians. The three groups know little about DRG's. Conclusions When implementing a health innovation it is advisable to analyze its effect on the professionals who participate in the implementation. Physicians perceive DRGs as a threat to their professional autonomy, while nurses see it as a pro-innovation force. It is important to involve nursing and administrative staff when implementing this kind of innovation.

Investigating the effects of ICT on innovation and performance of European hospitals: an exploratory study

Hospitals are making big investments in various types of ICT, so it is important to investigate their effects on innovation and performance. This paper presents an empirical study in this direction, based on data for 743 hospitals from 18 European countries. We specified and estimated econometrically five equations: one for product innovation, one for process innovation and three equations for the three different dimensions of (ICT-enabled) hospital performance. All five equations included various ICT-related variables reflecting ICT infrastructure and a series of important ICT applications, some of them hospital-specific, and some others of general business use, and also ICT personnel (viewed as a kind of 'soft' ICT investment), while the performance equations also included the two innovation measures.

Stand-alone laboratory information systems versus laboratory modules incorporated in the electronic health record

The increasing availability of laboratory information management modules within enterprise electronic health record solutions has resulted in some institutional administrators deciding which laboratory information system will be used to manage workflow within the laboratory, often with minimal input from the pathologists. This article aims to educate pathologists on many of the issues and implications this change may have on laboratory operations, positioning them to better evaluate and represent the needs of the laboratory during this decision-making process. The experiences of the authors, many of their colleagues, and published observations relevant to this debate are summarized. There are multiple dimensions of the interdependency between the pathology laboratory and its information system that must be factored into the decision. Functionality is important, but management authority and gap-ownership are also significant elements to consider. Thus, the pathologist must maintain an active role in the decision-making process to ensure the success of the laboratory.

From translational research to open technology innovation systems

Purpose

– The purpose of this paper is to question whether the emphasis placed within translational research on a linear model of innovation provides the most effective model for managing health technology innovation. Several alternative perspectives are presented that have potential to enhance the existing model of translational research. A case study is presented of innovation of a clinical decision support system. The paper concludes from the case study that an extending the triple helix model of technology transfer, to one based on a quadruple helix, present a basis for improving the performance translational research.

Design/methodology/approach

– A case study approach is used to help understand development of an innovative technology within a teaching hospital. The case is then used to develop and refine a model of the health technology innovation system.

Findings

– The paper concludes from the case study that existing models of translational research could be refined further through the development of a quadruple helix model of heath technology innovation that encompasses greater emphasis on user-led and open innovation perspectives.

Research limitations/implications

– The paper presents several implications for future research based on the need to enhance the model of health technology innovation used to guide policy and practice.

Practical implications

– The quadruple helix model of innovation that is proposed can potentially guide alterations to the existing model of translational research in the healthcare sector. Several suggestions are made for how innovation activity can be better supported at both a policy and operational level.

Originality/value

– This paper presents a synthesis of the innovation literature applied to a theoretically important case of open innovation in the UK National Health Service. It draws in perspectives from other industrial sectors and applies them specifically to the management and organisation of innovation activities around health technology and the services in which they are embedded.

Can international health programmes be sustained after the end of international funding: the case of eye care interventions in Ghana

BACKGROUND

There is general agreement amongst major international policy makers that sustainability is a key component of health interventions in developing countries. However, there is little evidence on the factors enabling or constraining sustainability. Diffusion of innovation theory can help explain how the continuation of activities is related to the attributes of innovations. Innovations are characterised by five attributes: (i) relative advantage; (ii) compatibility; (iii) complexity; (iv) triability; and (v) observability. An eye care programme was selected as a case study. The programme was implemented in the Brong Ahafo region of Ghana and had been funded over a ten-year period by an international organisation.

METHODS

Sustainability in the study was defined as the level of continuation of activities after the end of international funding. Measuring the continuation of activities involved checking whether each eye care activity continued (i.e. out-patient consultation, cataract surgery, outreach, school health, and statistics) or was interrupted after the end of Swiss Red Cross funding the 11 district hospitals where the programme was implemented.

RESULTS

The results showed a relationship between the level of sustainability and the attributes of every activity. The activities with the lowest score for the attributes were less sustained. School health screening was the least sustained activity after the end of international funding. This activity also held the smallest score in terms of attributes: they were the most incompatible and most complex activities, as well as the least triable and observable activities, amongst the four district activities. In contrast, compared to the three other district activities, facility-based consultations were more likely to be routinised because they were perceived by the hospital managers as very compatible, and not complex.

CONCLUSIONS

Using diffusion of innovations theories can help predict the sustainability of specific activities within a health programme. The study also highlighted the need for disentangling the various components of a health programme in order to identify which activities are more likely to be continued within a health system. The same methodology could be used in a different setting and could help predict which innovations are more likely to be adopted and maintained over time.

O papel dos hospitais na dinâmica de inovação em saúde

O artigo analisa o papel dos serviços hospitalares na dinâmica de inovação em saúde, considerando-os como força motriz do processo de inovação no Complexo Econômico-Industrial da Saúde. Além disso, enfatiza-se a potencialidade desses serviços em articular virtuosamente as dimensões socioeconômicas do desenvolvimento. Utilizando-se do arcabouço da economia política da saúde, propõem-se aportes para o desenvolvimento de uma base analítica e de novos modelos de análise estratégica das condições institucionais, tecnológicas e de gestão hospitalar, bem como de suas inter-relações no complexo produtivo da saúde. O artigo objetiva, dessa forma, aprofundar a compreensão sobre a dinâmica de inovação a partir dessas organizações.

Organizational readiness for innovation in health care: some lessons from the recent literature

There is no single intervention that will trigger or ensure innovation in health care, as the interaction between the innovation and the context of its introduction is necessarily complex and variable. Although academic attention has recently turned to the role of organizations in promoting and embedding innovation, this literature remains light on prescription, and tends to ignore the issue of substitution and disengagement. Innovation needs to be adapted as well as adopted into organizational contexts and receptive climates for innovation can only be developed incrementally over time. This paper identifies recommendations for increasing the readiness of health-care organizations for innovation. Key organizational strategies for embedding innovation include: development of incentives; sophisticated knowledge management; interfunctional and interorganizational coordination and collaboration; and development of an innovation infrastructure. More attention is required to substitution and disengagement of interventions and practices (exnovation) in the current economic climate.