Factors contributing to innovation readiness in health care organizations: a scoping review

Background

Increasing innovation readiness of healthcare organizations is necessary to meet upcoming challenges, including population aging, staff shortages and reduced funding. Health care organizations differ in the extent to which they are innovation ready. This review aims to clarify the concept of innovation readiness and identify which factors contribute to innovation readiness in health care organizations.

Methods

A scoping review was conducted based on the framework from Arksey and O’Malley. PubMed/MEDLINE, CINAHL and Web of Science were searched for studies that (a) aimed to contribute to scientific knowledge about innovation readiness of health care organizations, (b) were peer-reviewed, (c) reported empirical data and (d) were written in English, Dutch or German. Factors researched in the included studies were bundled into 4 overarching main factors and 10 sub-factors.

Results

Of the 6,208 studies identified, 44 were included. The majority (n = 36) of the studies had been conducted since 2011 and almost half of the studies (n = 19) were performed in hospitals. Of the 44 studies, 21 researched factors contributing to innovation readiness in the implementation stage of the innovation process. The authors used a variety of words and descriptions addressing innovation readiness, with hardly any theoretical frameworks for innovation readiness presented. Four main factors and 10 sub-factors contributing to the innovation readiness of health care organizations were summarized: strategic course for innovation, climate for innovation, leadership for innovation and commitment to innovation. Climate for innovation (n = 16) was studied the most and individual commitment to innovation (n = 6) was the least studied.

Conclusion

Our study identified four main factors contributing to the innovation readiness of health care organizations. Research into innovation readiness of health care organizations is a rather new field. Future research could be directed towards defining the concept of innovation readiness and the development of a framework for innovation readiness. More understanding of the interplay of factors contributing to innovation readiness in all stages of the innovation process and in diverse health care settings can support health care managers to structurally embed innovation. This review contributes to the first stage of theory building on factors contributing to innovation readiness of health care organizations.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-022-08185-x.

High-involvement HRM and innovative behaviour: The mediating roles of nursing staff's autonomy and affective commitment

AIMS

The purpose of this paper was to investigate the relationship between high-involvement human resource management, autonomy, affective organisational commitment and innovative behaviours of nursing staff who care for elderly clients.

BACKGROUND

Nursing teams are increasingly required to demonstrate innovative behaviours that enhance care quality. Nursing leaders need to create environments where nursing staff have sufficient autonomy and feel a sense of commitment to support these behaviours. The appropriate implementation of these processes and practices may lead to greater involvement.

METHODS

A cross-sectional survey-based research design was employed to explore the experiences of involvement practices, autonomy, affective organisational commitment and innovative behaviours of 567 nursing staff workers from four elderly care organisations in the Netherlands.

RESULTS

The results demonstrate that a bundle of high-involvement practices positively influences innovative behaviour and that affective commitment and autonomy fully mediate this relationship.

CONCLUSIONS

The study highlights the role of autonomy and commitment as routes towards translating involvement practices into nurses' innovativeness.

IMPLICATIONS FOR NURSING MANAGEMENT

To create an innovative environment, leaders need to create a positive climate by providing nurses with opportunities to enhance their competence, relatedness and autonomy through active involvement. Leaders should, therefore, encourage involvement as a mechanism to promote innovation.

A myriad of factors influencing the implementation of transitional care innovations: a scoping review

Background

Care transitions of older persons between multiple care settings are frequently hampered by various issues such as discontinuous care delivery or poor information transfer among healthcare providers. Therefore, several innovations have been developed to optimize transitional care (TC). This review aims to identify which factors influence the implementation of TC innovations.

Methods

As part of TRANS-SENIOR, an international innovative training and research network focusing on enhancing or avoiding care transitions, a scoping review was conducted. The five stages of the Arksey and O’Malley framework were followed. PubMed/MEDLINE, EMBASE, and CINAHL were searched, and eligible studies published between years 2000 and 2020 were retrieved. Data were extracted from the included studies and mapped to the domains and constructs of the Consolidated Framework for Implementation Research (CFIR) and Care Transitions Framework (CTF).

Results

Of 1537 studies identified, 21 were included. Twenty different TC innovations were covered and aimed at improving or preventing transitions between multiple care settings, the majority focused on transitions from hospital to home. Key components of the innovations encompassed transition nurses, teach-back methods, follow-up home visits, partnerships with community services, and transfer units. Twenty-five prominent implementation factors (seven barriers, seven facilitators, and eleven factors with equivalent hindering/facilitating influence) were shown to affect the implementation of TC innovations. Low organizational readiness for implementation and the overall implementation climate were topmost hindering factors. Similarly, failing to target the right population group was commonly reported as a major barrier. Moreover, the presence of skilled users but with restricted knowledge and mixed attitudes about the innovation impeded its implementation. Among the eminent enabling factors, a high-perceived advantage of the innovation by staff, along with encouraging transition roles, and a continuous monitoring process facilitated the implementation of several innovations. Other important factors were a high degree of organizational networks, engaging activities, and culture; these factors had an almost equivalent hindering/facilitating influence.

Conclusions

Addressing the right target population and instituting transition roles in care settings appear to be specific factors to consider during the implementation of TC innovations. Long-term care settings should simultaneously emphasize their organizational readiness for implementation and change, in order to improve transitional care through innovations.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13012-021-01087-2.

“I don’t know why I’m here”: from knot-working to not-knowing

Purpose

– The purpose of this paper is to examine the idea of getting lost during field studies as a point of departure for reframing the initial research question.

Design/methodology/approach

– The paper presents field notes and reflections to illustrate the process of tracing innovation in the field by means of a theoretical concept – “knot-working” as proposed by Engeström (2008). By paying attention to seemingly irrelevant empirical data and experiences of being lost, the author infuses another theoretical concept – “not-knowing” as proposed by Lather (2007).

Findings

– By questioning research questions, it becomes possible to challenge conventional assumptions in the field under study as well as assumptions underlying existing theory. It is argued that good research questions evolve iteratively throughout a study and might be even more valuable than answers (Alvesson and Sandberg, 2013). The paper illustrates how not-knowing can serve as a methodological perspective from where ordinary held assumptions can be reconsidered, thus paving the way for novel research questions that can enhance established theory.

Originality/value

– The paper questions the initial research question: “How is the elderly care sector affected by innovation imperatives,” and ends up posing the reverse question: How are innovation imperatives affected – or how could they be affected – by the notion of care.