Examining innovation in hospital units: a complex adaptive systems approach

Abstract

Background: We are in an innovation age for healthcare delivery. Some note that the complexity of healthcare delivery may make innovation in this setting more difficult and may require more adaptive solutions. The aim of this study is to examine the relationship between unit complexity and innovation, using a complex adaptive systems approach in a hospital setting. Methods: We conducted a quantitative study of 31 hospital units within one hospital and use complex adaptive systems (CAS) theory to examine how two CAS factors, autonomy and performance orientation, moderate the relationship between unit complexity and innovation. Results: We find that unit complexity is associated with higher innovation performance when autonomy is low rather than high. We also find that unit complexity is associated with higher innovation performance when performance orientation is high rather than low. Our findings make three distinct contributions: we quantify the influence of complexity on innovation success in the health care sector, we examine the impact of autonomy on innovation in health care, and we are the first to examine performance orientation on innovation in health care. Conclusions: This study tackles the long debate about the influence of complexity on healthcare delivery, particularly innovation. Instead of being subject to the influence of complexity with no means of making progress or gaining control, hospitals looking to implement innovation programs should provide guidance to teams and departments regarding the type of innovation sought and provide support in terms of time and management commitment. Hospitals should also find ways to promote and make successful pilot implementations of such innovations visible in the organization. A close connection between the targeted innovation and the overall success and performance of the hospital unit is ideal.

The impact of individual creativity, psychological capital, and leadership autonomy support on hospital employees’ innovative behaviour

“…Based on our ndings, hospital division managers, as well as hospital unit managers, should be aware of the impact of LAS and navigate employees' IIB by investing in employees' PsyCap. Healthcare is a complex system[72], and the ndings of this study reveal the many advantages of capitalizing on PsyCap. As such, healthcare managers (both hospital division and hospital unit managers) are encouraged to pay extra attention to employees' growth and positive emotions at work.…”

“…Fifth, the study did not take into account the complexity of the healthcare setting. In a recent study, Glover et al examined how the complexity of healthcare in uences innovation performance in complex units [72]. The idea of ambidextrous leadership-that "the complexity of innovation activities needs to be matched by an equally complex leadership approach" [73]-provides opportunities for future research in exploring the in uence of complex adaptive systems to IIB in healthcare.…”

Fostering innovative behavior in health organizations: a PLS-SEM analysis of Norwegian hospital employees

“…Worldwide, with the current technological advances and increased performance expectations for hospital employees [7], there has been an apparent increase in the challenges faced by health sector organizations [8].…”

“…Worldwide, with the current technological advances and increased performance expectations for hospital employees [ 7 ], there has been an apparent increase in the challenges faced by health sector organizations [ 8 ]. Hospital employees’ IIB has been identified as a key factor in increasing innovation at work [ 7 ], improving effectiveness and performance [ 9 ] as well as efficiency [ 10 ].…”

“…It responds to calls to investigate the conditions that encourage innovation and factors that relates to individual process innovation [ 7 ]. Few studies have adequately examined the IIB of hospital employees [ 7 ] and even fewer have empirically examined its direct and indirect relationships in a health sector context [ 8 ].…”