The ties that bind: innovation configurations in low- and middle-income healthcare delivery settings.

PURPOSE: This study examines innovation configurations (i.e. sets of product/service, social and business model innovations) and configuration linkages (i.e. factors that help to combine innovations) across six organizations as contingent upon organizational structure. DESIGN/METHODOLOGY/APPROACH: Using semi-structured interviews and available public information, qualitative data were collected and examined using content analysis to characterize innovation configurations and linkages in three local/private organizations and three foreign-led/public-private partnerships in Repiblik Ayiti (Haiti). FINDINGS: Organizations tend to combine product/service, social, and business model innovations simultaneously in locally founded private organizations and sequentially in foreign-based public-private partnerships. Linkages for simultaneous combination include limited external support, determined autonomy and shifting from a "beneficiary mindset," and financial need identification. Sequential combination linkages include social need identification, community connections and flexibility. RESEARCH LIMITATIONS/IMPLICATIONS: The generalizability of our findings for this qualitative study is subject to additional quantitative studies to empirically test the suggested factors and to examine other health care organizations and countries. PRACTICAL IMPLICATIONS: Locally led private organizations in low- and middle-income settings may benefit from considering how their innovations are in service to one another as they may have limited resources. Foreign based public-private partnerships may benefit from pacing their efforts alongside a broader set of stakeholders and ecosystem partners. ORIGINALITY/VALUE: This study is the first, to our knowledge, to examine how organizations combine sets of innovations, i.e. innovation configurations, in a healthcare setting and the first of any setting to examine innovation configuration linkages.

Understanding the integration of artificial intelligence in healthcare organisations and systems through the NASSS framework: a qualitative study in a leading Canadian academic centre.

BACKGROUND: Artificial intelligence (AI) technologies are expected to "revolutionise" healthcare. However, despite their promises, their integration within healthcare organisations and systems remains limited. The objective of this study is to explore and understand the systemic challenges and implications of their integration in a leading Canadian academic hospital. METHODS: Semi-structured interviews were conducted with 29 stakeholders concerned by the integration of a large set of AI technologies within the organisation (e.g., managers, clinicians, researchers, patients, technology providers). Data were collected and analysed using the Non-Adoption, Abandonment, Scale-up, Spread, Sustainability (NASSS) framework. RESULTS: Among enabling factors and conditions, our findings highlight: a supportive organisational culture and leadership leading to a coherent organisational innovation narrative; mutual trust and transparent communication between senior management and frontline teams; the presence of champions, translators, and boundary spanners for AI able to build bridges and trust; and the capacity to attract technical and clinical talents and expertise. Constraints and barriers include: contrasting definitions of the value of AI technologies and ways to measure such value; lack of real-life and context-based evidence; varying patients' digital and health literacy capacities; misalignments between organisational dynamics, clinical and administrative processes, infrastructures, and AI technologies; lack of funding mechanisms covering the implementation, adaptation, and expertise required; challenges arising from practice change, new expertise development, and professional identities; lack of official professional, reimbursement, and insurance guidelines; lack of pre- and post-market approval legal and governance frameworks; diversity of the business and financing models for AI technologies; and misalignments between investors' priorities and the needs and expectations of healthcare organisations and systems. CONCLUSION: Thanks to the multidimensional NASSS framework, this study provides original insights and a detailed learning base for analysing AI technologies in healthcare from a thorough socio-technical perspective. Our findings highlight the importance of considering the complexity characterising healthcare organisations and systems in current efforts to introduce AI technologies within clinical routines. This study adds to the existing literature and can inform decision-making towards a judicious, responsible, and sustainable integration of these technologies in healthcare organisations and systems.

Lighting the Path: Rekindling Innovation and Joy in Nursing Leadership: A Conversation and Reflection with Dr. Marilyn Chow.

In the dynamic and complex landscape of health care, rekindling innovation requires a blend of courage, connection, and joy. This article, drawing from an interview with Dr Marilyn Chow, a recognized "Living Legend" by the American Academy of Nursing (AAN), outlines a transformative approach for nurse leaders. Marilyn emphasizes the significance of listening to staff, patients, and communities, taking appreciative and incremental steps toward innovation, and fostering an environment where risks are encouraged and voices are amplified. Through her narrative, we explore how nurse leaders can inspire their teams, lead with joy, and drive impactful change, offering a blueprint for leading with intention and creating a legacy of innovation and care.

Foreign executives, digital transformation, and innovation performance: Evidence from Chinese-listed firms.

This study investigates the effect of foreign executives on firms' innovation performance and the mediation role of digital transformation in Chinese-listed firms from 2011 to 2021. Our findings indicate that the presence of foreign executives in top management teams promotes firms' innovation performance by enhancing digital transformation. Further analyses show that foreign executives contribute significantly to improving firms' radical innovation performance rather than incremental innovation performance. We also examine the moderating effect of negative performance feedback and financing constraints between foreign executives and innovation performance, finding that foreign executives can promote innovation performance particularly in firms with negative performance feedback and weak financing constraints.

A Multi-Level Model of Institutional Innovation and Knowledge Creation Capabilities: Insights From the Development of Taiwan's Nation Health Insurance.

This study proposes a multi-level model of institutional innovation in the healthcare sector-in other words, field-level institutional change pressures that start as network-level institutional innovation by hospitals and government for their organizational performance, with an emphasis on the effect of organizational-level construct-knowledge creation capabilities. A case study using in-depth interviews and a historical inquiry approach has been used to qualitatively analyze our cases during the development of Taiwan's National Health Insurance (NHI). Our results propose a multi-level explanation of institutional innovation by showing how field-level institutional change pressures can stimulate the government's institutional innovation at the network level. Moreover, knowledge creation capabilities may positively influence the government hospitals' ongoing institutional change pressures induced institutional innovation activity for their performance at the organizational level in an institutional setting. This study contributes to health organization management researchers and administrators by developing explanations of institutional innovation and creating a much-needed multi-level insight into hospital behavior in the highly institutionalized healthcare sector.

Facilitators of and barriers to County Behavioral Health System Transformation and Innovation: an interview study.

BACKGROUND: Inadequate and inequitable access to quality behavioral health services and high costs within the mental health systems are long-standing problems. System-level (e.g., fee-for-service payment model, lack of a universal payor) and individual factors (e.g., lack of knowledge of existing resources) contribute to difficulties in accessing resources and services. Patients are underserved in County behavioral health systems in the United States. Orange County's (California) Behavioral Health System Transformation project sought to improve access by addressing two parts of their system: developing a template for value-based contracts that promote payor-agnostic care (Part 1); developing a digital platform to support resource navigation (Part 2). Our aim was to evaluate facilitators of and barriers to each of these system changes. METHODS: We collected interview data from County or health care agency leaders, contracted partners, and community stakeholders. Themes were informed by the Consolidated Framework for Implementation Research. RESULTS: Five themes were identified related to behavioral health system transformation, including 1) aligning goals and values, 2) addressing fit, 3) fostering engagement and partnership, 4) being aware of implementation contexts, and 5) promoting communication. A lack of fit into incentive structures and changing state guidelines and priorities were barriers to contract development. Involving diverse communities to inform design and content facilitated the process of developing digital tools. CONCLUSIONS: The study highlights the multifaceted factors that help facilitate or hinder behavioral health system transformation, such as the need for addressing systematic and process behaviors, leveraging the knowledge of leadership and community stakeholders, fostering collaboration, and adapting to implementation contexts.

Assessing early feasibility of a novel innovation to increase consumer partnership capability within an Australian health innovation organisation using a mixed-method approach.

OBJECTIVE: Engagement-capable health organisations recognise that consumer engagement (also known as patient engagement, consumer engagement, patient and public involvement) must occur at every level of the organisation if it is to be meaningful and genuine. Despite this aspiration, health organisations struggle to adopt, implement, and embody consumer engagement capability in a way that has yielded impact. The Partner Ring (PR) is an embedded model for building staff capability for consumer partnerships. It is hosted by an employed Patient Partner. PR was implemented at the Agency for Clinical Innovation in New South Wales, Australia. The aim of this study was to assess the feasibility (acceptability, demand and practicality) of this innovation to increase consumer engagement capability. DESIGN: One-group post-intervention mixed methods approach to assess feasibility. PARTICIPANTS: ACI staff engaged in the PR (n=40 of 89 members). DATA COLLECTION AND ANALYSIS: Qualitative data was collected through an artificial intelligence (AI)-driven interactive interview, with 40 responses received between 29 June and 12 July 2023. A framework analysis and Generative AI causal mapping were conducted to identify and visualise causal claims within the texts. Cost and session attendance collected from the same point in time supplemented the analysis. FINDINGS: Findings were categorised by the following feasibility constructs: acceptability, demand and practicality. Almost all the respondents indicated their intent to continue using the PR and outlined personal benefits and professional benefits. For example, (n=23, 57%) reacted positively to the psychological safety of the PR, and professionally people identified attendance increased their knowledge and skills (n=23, 57%). CONCLUSION: The PR is feasible and likely to be an acceptable innovation for building staff capability and consumer engagement skills across a large health system or organisation. It could be adopted or adapted by other jurisdictions.

Exploring the Synergies Between the Magnet Recognition Program® and the International Council of Nurses' Charter for Change.

Healthcare organizations across the globe apply the Magnet® Model framework to achieve excellence in nursing practice, thriving work environments, and improved patient, nursing, and organizational outcomes. The International Council of Nurses' (ICN) Charter for Change (2023) commissioned actionable measures for change to advance the nursing profession into the future. This article explores the synergies between the Magnet Recognition Program® and the ICN Charter for Change, aiming to demonstrate that integrating the principles of both models can provide a roadmap for healthcare organizations to enhance nursing professional development, foster a culture of innovation and evidence-based practice, and ultimately improve healthcare outcomes for patients and communities globally.

Long-term oriented culture, performance pressure and corporate innovation: Evidence from China.

This paper extracts culture element of long-term orientation from Chinese listed firm's annual report, then argue and testify whether long-term orientation can help firms to hang on risky decision especially as innovation, when firms are under performance pressure. There are three main conclusions. First, we report that the higher degree of long-term oriented culture a firm has, the stronger innovation capability the firm shows. Second, we find that long-term oriented culture can improve employee's educational qualification to promote corporate innovation, as well as improve the corporate internal control to promote innovation. Third, when firms are subjected to internal or external performance pressure in their business process, higher long-term oriented culture will make firms more innovative.

Unveiling the Nexus: Influence of learning motivation on organizational performance and innovative climate of Chinese firms.

This study delves into the interplay between learning motivation, organizational performance, and the innovative climate within Chinese firms. It is a subject of frequent discussion in literature but there is little concrete evidence supporting this viewpoint within the context of small and medium size enterprises in China. Drawing upon a comprehensive review of existing literature and empirical data gathered, this research aims to uncover the connections between employee learning motivation and its impact on the organizational dynamics in the context of Chinese firms. A cross sectional survey is used to collect the data of 115 Chinese firms and structural equation modelling (SEM) is used for empirical analysis. The results show that success of firms in terms of innovation is significantly influenced by organizational learning motivation. Moreover, innovative environment of the firms increases the overall performance of the organizations. It is also found that factors affecting the innovations have a significant impact on organizational performance. The findings of the study suggest that firms should develop organizational learning motivation to boost their innovation capability and overall performance. This study offers insights and recommendations for organizations and policymakers seeking to harness the potential of learning motivation to drive sustainable growth, competitiveness, and innovation in Chinese firms.

The HR revolution: Redefining performance paradigms in Pakistan's pharma landscape through moderating role of innovative climate.

The main objective of this research is to examine whether the implementation of new human resource management practices (NHRM) can enhance innovative performance (IP) by fostering innovation capability (NC). Additionally, it examines the moderating influence of an innovative climate (IC) and its associated attributes on the association with new human resource management and innovation capability, a factor that has been relatively overlooked in prior research. The study's data was obtained from 398 employees in the pharmaceutical sector of Pakistan, and hierarchical regression analysis was utilized to analyze the data. The results from the mediating and moderating analyses underscore the significance of NHRM practices, innovation capability, and an innovative climate, along with its specific attributes, in promoting innovative performance through factors such as operational efficiency, suitable practices, and employees' willingness to participate in organizational endeavors. Furthermore, the moderated mediation analysis findings reveal that the influence of innovation capability as a mediator is strengthened when the workplace climate is more conducive to innovation. These findings have implications for both theoretical understanding and practical application, particularly in similar developing countries. The study offers insights that can be generalized to developing nations with comparable economic and social structures.

Driving change: NICHE community engagement, integration, and adoption initiatives.

As NICHE enters its fourth decade, it is a nursing innovation that has endured and adapted to meet the needs of older adults by fortifying the geriatric nursing workforce. Examining "Why NICHE and why now?" to guide NICHE implementation is important for the NICHE program and its members. The next steps for the NICHE community aim to build on our collective strengths, deepen integration with established geriatric quality programs and nursing professional organization partners, and increase the adoption of the NICHE practice model. These priorities and ways NICHE members may join in achieving them are outlined in this month's column.

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

Primary care needs to find strategies to deal with today's societal challenges and continue to deliver efficient and high-quality care. Employee-driven innovation is increasingly gaining ground as an accessible pathway to developing successful and sustainable organisations. This type of innovation is characterised by employees being engaged in the innovation process, based on a bottom-up approach. This qualitative study explores employees' experiences of employee-driven innovation at a primary care centre in Sweden. Data are collected by focus group interviews and analysed by inductive qualitative content analysis. The result is presented with the overarching theme "Standing together at the helm" followed by three categories: "Motivating factors for practising employee-driven innovation", "Challenges in practising employee-driven innovation" and "Benefits of employee-driven innovation", including nine subcategories. The study found that employee-driven innovation fosters organisational innovation, empowers employees, and enhances adaptability at personal and organisational levels. This enables individual and collective learning, and facilitates the shaping, development, and adaptation of working methods to meet internal and external requirements. However, new employees encountered difficulty grasping the concept of employee-driven innovation and recognising its long-term advantages. Additionally, the demanding and task-focused environment within primary care posed challenges in sustaining efforts in innovation work. The employees also experienced a lack of external support to drive and implement some innovative ideas.

Powering Up Data in the Service of Operational Excellence.

Harnessing the power of data is a necessary competency in fueling innovation, improving financial and clinical outcomes, and achieving operational excellence. It can be analyzed, visualized, dashboarded, and embedded into workflows seamlessly with very little technical expertise. Moreover, data can galvanize organizational culture with its neutrality, transparency, and portability. Using data to highlight qualitative evaluations, patient experiences, and employee performance can help validate perceptions and identify broader organizational opportunities. Yet useful data is frequently nonexistent, invalid, or insufficient. Moving from promise to realization requires reframing data management, as described here.

University innovation and start-ups: Barriers and facilitators experienced by nursing faculties - A content analysis study.

AIM: University start-ups have gained significant popularity as a means of translating knowledge and research into practical applications. However, there is a lack of understanding regarding the experiences and perspectives of nursing faculties engaged in start-up ventures. The objective of this study was to explore valuable insights into the barriers and facilitators within this context for promoting success, generating entrepreneurial attitudes, as well as enhancing the sustainability of nursing faculty-led start-ups. DESIGN: We employed a content analysis methodology to capture the real-life experiences of nursing faculties involved in university start-ups. This approach is an effective way to gain a comprehensive understanding of the subject. METHODS: Data were collected using semi-structured interviews. Graneheim and Lundman's step was used for analysis and to identify recurring patterns and themes within the collected data. Sampling was done purposefully, with convenience and snowball techniques until data saturation. The MAXQDA version 10 software was utilised to easily analyse, code and present data. RESULTS: The analysis revealed four major themes encompassed: motivational factors, personal attributes, limited entry support and barriers to scaling. These themes shed light on factors, support systems, challenges faced during growth as well as personal characteristics highlighted by the participants. Our study highlighted the factors influencing entrepreneurship in nursing faculties. Addressing the challenges of this study requires enhancing support systems and fostering personal development for entrepreneurial success in healthcare innovation. Policymakers can promote university education to expand the entrepreneurship process using more facilities and make more services accessible.

Project ECHO®: a global cross-sectional examination of implementation success.

BACKGROUND: Organizations implement innovations to disrupt the status quo and create value. Within sectors such as healthcare, innovations need to navigate large scale system and organizational factors to succeed. This research explores the implementation of a global innovation- Project ECHO®. Project ECHO® is a validated virtual communities of practice model organizational teams implement to build workforce capacity and capability. Project ECHO® has experienced broad global adoption, particularly within the healthcare sector, and is experiencing growth across other sectors. This study sought to examine the state of implementation success for Project ECHO® globally, to understand how these implementations compare across geographic and sectoral contexts, and understand what enablers/barriers exist for organizational teams implementing the innovation. METHODS: An empirical study was conducted to collect data on 54 Project ECHO® implementation success indicators across an international sample. An online survey questionnaire was developed and distributed to all Project ECHO® hub organizations globally to collect data. Data was analyzed using descriptive statistics. RESULTS: The 54 implementation success indicators measured in this survey revealed that the adoption of Project ECHO® across 13 organizations varied on a case-by-case basis, with a strong rate of adoption within the healthcare sector. Implementation teams from these organizations successfully implemented Project ECHO® within 12-18 months after completing Immersion partner launch training and operated 51 ECHO® Networks at the time of data collection. Implementation teams which liaised more regularly with ECHO® Superhub mentors often went on to launch a higher number of ECHO® Networks that were sustained over the longer term. This suggests that these implementation teams better aligned and consolidated their Project ECHO® pilots as new innovations within the local context and strategic organizational priorities. Access to research and evaluation capability, and a more automated digital client relationship management system were key limitations to showcasing implementation success outcomes experienced by the majority of implementation teams. CONCLUSIONS: These findings make a valuable contribution to address a knowledge gap regarding how a global sample of organizations adopting Project ECHO® measured and reported their implementation successes. Key successes included pre-launch experimentation and expansion, Superhub mentorship, stakeholder engagement, and alignment to strategic priorities.