Employee-Driven Innovation in Health Organizations: Insights From a Scoping Review

Abstract

Background: Employee-driven innovation (EDI) occurs when frontline actors in health organizations use their firsthand experience to spur new ideas to transform care. Despite its increasing prevalence in health organizations, the organizational conditions under which EDI is operationalized have received little scholarly attention. Methods: This scoping review identifies gaps and assembles existing knowledge on four questions: What is EDI in health organizations and which frontline actors are involved? What are the characteristics of the EDI process? What contextual factors enable or impede EDI? And what benefits does EDI bring to health organizations? We searched seven databases with keywords related to EDI in health organizations. After screening 1580 studies by title and abstract, we undertook full-text review of 453 articles, retaining 60 for analysis. We performed a descriptive and an inductive thematic analysis guided by the four questions. Results: Findings reveal an heterogeneous literature. Most articles are descriptive (n=41). Few studies are conceptual and empirical (n=15) and four are conference papers. EDI was often described as a participatory, learning innovation process involving frontline clinical and non-clinical staff and managers. Majority EDI were top-down, often driven by the organization’s focus on participatory improvement and innovation and research-based initiatives. Five categories of methods is used in top-down EDI, two thirds of which includes a learning, a team and/or a digital component. Hybrid EDI often involves a team-based component. Bottom-up EDI emerged spontaneously from the work of frontline actors. Enablers, barriers and benefits of EDI are seen at macro, organizational, team and individual levels; some benefits spread to other health organizations and health systems. Conclusion: This scoping review provides a comprehensive understanding of the organizational conditions under which EDI is operationalized. It offers insights for researchers, health organizations and policy makers about how and why frontline actors’ involvement is crucial for the transformation of care.

Standing together at the helm – how employees experience employee-driven innovation in primary care

“…Our findings show that the employee-driven innovation efforts at the primary care centre resulted in new common work routines that standardised workflows, which according to the employees, in the long run, saved time, improved local care practice and increased job satisfaction. This aligns with prior research highlighting how incremental, practice-driven change processes can ultimately transform care systems and enhance care practice [ 50 – 52 ]. However, while the employees in this study were predominantly positive towards the innovation efforts, a certain ambivalence could still be discerned.…”

“…One such coping strategy employed was to temporarily suspend innovation efforts for a predetermined period, which requires open and trusting communication between the employees and the management. The importance of trust-based and supportive management to drive and continuously sustain employee-driven innovation efforts has been highlighted in several studies [ 50 , 54 – 57 ].…”