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Published in: BMC Health Services Research 1/2019

Open Access 01-12-2019 | Care | Study protocol

LearnOvation: an intervention to foster exploration and exploitation behaviour in health care management in daily practice

Authors: Gunilla Avby, Sofia Kjellström

Published in: BMC Health Services Research | Issue 1/2019

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Abstract

Background

Innovation has been identified as an important engine for improving the quality, productivity and efficiency of health care. Little is known about how to stimulate innovation capacity in primary health care in general; even less is known about how specific interventions should be designed to support managements’ work with practice-based innovations. Research has shown that if managers and teams are excellent at handling the challenges of production (exploitation) and development (exploration), they are better at innovation. The aim of the study is to develop a dynamic management support programme to increase innovation leadership skills in daily practice.

Methods

The study has an interactive approach that allows the need for empirical and theoretical knowledge to emerge and merge, and a quasi-experimental cross-over design. Eight primary health care centres will participate in the study. In the first phase, the management teams at four health care centres will participate in the intervention, and the other four centres will serve as a control group. Thereafter, the units will switch places and the control group will experience the intervention. All staff at the 8 units will answer questionnaires at four points in time (before, during, after, 6 months later) to evaluate the effects of the intervention.

Discussion

The study will contribute to knowledge on how to organize processes of innovation and support exploitation and exploration behaviours by co-producing and testing a tailor-made management support programme for innovation work in primary health care. An expected long-term effect is that the support system will be disseminated to other centres both within and beyond the participating organizations.
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Literature
1.
go back to reference Young T. Can innovation help us deliver an NHS for the 21st century? Br J Gen Pract. 2017;67(657):152–3.CrossRef Young T. Can innovation help us deliver an NHS for the 21st century? Br J Gen Pract. 2017;67(657):152–3.CrossRef
2.
go back to reference Organisation for Economic Co-operation and Development. Fostering innovation: the policy challenge. In: The OECD Innovation Strategy: Getting a Head Start on Tomorrow. Paris: OECD; 2010. p. 17–28. Organisation for Economic Co-operation and Development. Fostering innovation: the policy challenge. In: The OECD Innovation Strategy: Getting a Head Start on Tomorrow. Paris: OECD; 2010. p. 17–28.
3.
go back to reference Rosen R. Transforming general practice: what are the levers for change? Briefing. UK: Nuffield Trust; 2015. Rosen R. Transforming general practice: what are the levers for change? Briefing. UK: Nuffield Trust; 2015.
4.
go back to reference Van de Ven AH, Polley DE, Garud R, Venkataraman S. The innovation journey. Oxford: Oxford University Press; 1999. Van de Ven AH, Polley DE, Garud R, Venkataraman S. The innovation journey. Oxford: Oxford University Press; 1999.
5.
go back to reference Damanpour F, Schneider M. Characteristics of innovation and innovation adoption in public organizations: assessing the role of managers. J Public Adm Res Theory. 2009;19(3):495–522.CrossRef Damanpour F, Schneider M. Characteristics of innovation and innovation adoption in public organizations: assessing the role of managers. J Public Adm Res Theory. 2009;19(3):495–522.CrossRef
6.
go back to reference Walker R, Damanpour F, Devece C. Management innovation and organizational performance: the mediating effect of performance management. J Public Adm Res. 2010;21:367–86.CrossRef Walker R, Damanpour F, Devece C. Management innovation and organizational performance: the mediating effect of performance management. J Public Adm Res. 2010;21:367–86.CrossRef
7.
go back to reference Borins S. Leadership and innovation in the public sector. Leadership Organ Dev J. 2002;23(8):467–76.CrossRef Borins S. Leadership and innovation in the public sector. Leadership Organ Dev J. 2002;23(8):467–76.CrossRef
8.
go back to reference Charlesworth KP. Cook and G. crozier. Leading change in the public sector: making the difference. Manag Serv. 2003;47(11):12–5. Charlesworth KP. Cook and G. crozier. Leading change in the public sector: making the difference. Manag Serv. 2003;47(11):12–5.
9.
go back to reference Damanpour F. Organizational innovation a meta-analysis of effects of determinants and moderators. Acad of Manag J. 1991;34:555–90. Damanpour F. Organizational innovation a meta-analysis of effects of determinants and moderators. Acad of Manag J. 1991;34:555–90.
10.
go back to reference Kotter JP. Leading change. Boston: Harvard Business School Press; 1996. Kotter JP. Leading change. Boston: Harvard Business School Press; 1996.
11.
go back to reference Reay T, Chreim S, Golden-Biddle K, Goodrick E, Williams BE, Casebeer A, Pabo A, Hinings CR. Transforming new ideas into practice: An activity based perspective on the institutionalization of practices. J Manag Stud. 2013;50:6.CrossRef Reay T, Chreim S, Golden-Biddle K, Goodrick E, Williams BE, Casebeer A, Pabo A, Hinings CR. Transforming new ideas into practice: An activity based perspective on the institutionalization of practices. J Manag Stud. 2013;50:6.CrossRef
12.
go back to reference Crossan M, Lane H, White R. An organizational learning framework: from intuition to institution. Acad Manag Rev. 1999;24(3):522–37.CrossRef Crossan M, Lane H, White R. An organizational learning framework: from intuition to institution. Acad Manag Rev. 1999;24(3):522–37.CrossRef
13.
go back to reference March JG. Exploration and exploitation in organizational learning. Org Sci. 1991;2(1):71–87.CrossRef March JG. Exploration and exploitation in organizational learning. Org Sci. 1991;2(1):71–87.CrossRef
14.
go back to reference Nählinder J. Understanding innovation in a municipal context: a conceptual discussion. Innovation, Manag, Policy & Prac. 2013;15(3):315–25.CrossRef Nählinder J. Understanding innovation in a municipal context: a conceptual discussion. Innovation, Manag, Policy & Prac. 2013;15(3):315–25.CrossRef
15.
go back to reference Walker R. An empirical evaluation of innovation types and organizational characteristics: towards a configuration framework. J Pub Admin Res Theory. 2008;18:591–615.CrossRef Walker R. An empirical evaluation of innovation types and organizational characteristics: towards a configuration framework. J Pub Admin Res Theory. 2008;18:591–615.CrossRef
16.
go back to reference Fuglsang L. Bricolage and invisible innovation in public service innovation. J Innov Econ Manag. 2010;1(5):67–87.CrossRef Fuglsang L. Bricolage and invisible innovation in public service innovation. J Innov Econ Manag. 2010;1(5):67–87.CrossRef
17.
go back to reference Andersson-Gäre B, Neuhauser D. The health care quality journey of Jönköping county council, Sweden. Qual Manag Health Care. 2007;16(1):2–9.CrossRef Andersson-Gäre B, Neuhauser D. The health care quality journey of Jönköping county council, Sweden. Qual Manag Health Care. 2007;16(1):2–9.CrossRef
18.
go back to reference Batalden PB, Davidoff F. What is “quality improvement” and how can it transform health care? Qual Saf Health Care. 2007;16:2–3.CrossRef Batalden PB, Davidoff F. What is “quality improvement” and how can it transform health care? Qual Saf Health Care. 2007;16:2–3.CrossRef
19.
go back to reference Avby G, Kjellström S, Andersson Bäck M. Tending to innovate in Swedish primary health care: a qualitative study. BMC Health Sci Res. 2019;19(42):1–10. Avby G, Kjellström S, Andersson Bäck M. Tending to innovate in Swedish primary health care: a qualitative study. BMC Health Sci Res. 2019;19(42):1–10.
20.
go back to reference Greenhalgh T, Robert G, MacFarlane F, Bate P, Kyriakidou O. Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Q. 2004;82(4):581–629.CrossRef Greenhalgh T, Robert G, MacFarlane F, Bate P, Kyriakidou O. Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Q. 2004;82(4):581–629.CrossRef
21.
go back to reference Jensen M, Johnson B, Lorenz E, Lundvall B-Å. Forms of knowledge and modes of innovation. Res Policy. 2007;36:680–93.CrossRef Jensen M, Johnson B, Lorenz E, Lundvall B-Å. Forms of knowledge and modes of innovation. Res Policy. 2007;36:680–93.CrossRef
22.
go back to reference Weick K, Westley F. Organizational learning: Affirming an oxymoron. Managing Organization: Current issues; 1996. p. 190–208. Weick K, Westley F. Organizational learning: Affirming an oxymoron. Managing Organization: Current issues; 1996. p. 190–208.
23.
go back to reference Osborne S, Brown K. Managing change and innovation in public service organizations. London: Routledge; 2005.CrossRef Osborne S, Brown K. Managing change and innovation in public service organizations. London: Routledge; 2005.CrossRef
24.
go back to reference Fenwick T. Innovation: examining workplace learning in new enterprises. J of Workplac Learn. 2003;15(3):123–32.CrossRef Fenwick T. Innovation: examining workplace learning in new enterprises. J of Workplac Learn. 2003;15(3):123–32.CrossRef
25.
go back to reference Christensen C, Bohmer R, Kenagy J. Will disruptive innovations cure health care? Harv Bus Rev. 2000:102–12. Christensen C, Bohmer R, Kenagy J. Will disruptive innovations cure health care? Harv Bus Rev. 2000:102–12.
26.
go back to reference Dewey J. How we think: a restatement of the relation of reflective thinking in the educative process. Boston: D.C. Health & Co; 1910.CrossRef Dewey J. How we think: a restatement of the relation of reflective thinking in the educative process. Boston: D.C. Health & Co; 1910.CrossRef
27.
go back to reference Ellström P-E. Practice-based innovation: a learning perspective. J Workplace Learn. 2010;22(1/2):27–40.CrossRef Ellström P-E. Practice-based innovation: a learning perspective. J Workplace Learn. 2010;22(1/2):27–40.CrossRef
28.
go back to reference Salge TO, Vera A. Benefiting from public sector innovation: the moderating role of customer and learning orientation. Public Adm Rev. 2012;72(4):550–9.CrossRef Salge TO, Vera A. Benefiting from public sector innovation: the moderating role of customer and learning orientation. Public Adm Rev. 2012;72(4):550–9.CrossRef
29.
go back to reference Statistics Sweden. Innovations in health care 2012–2013. Survey study in Swedish hospitals and primary health care centres: Stockholm: Statistics Sweden; 2014. Statistics Sweden. Innovations in health care 2012–2013. Survey study in Swedish hospitals and primary health care centres: Stockholm: Statistics Sweden; 2014.
30.
go back to reference Arnaboldi M, Lapsley I, Steccolini I. Performance management in the public sector: the ultimate challenge. Financ Account Manag. 2015;31(1):1–22.CrossRef Arnaboldi M, Lapsley I, Steccolini I. Performance management in the public sector: the ultimate challenge. Financ Account Manag. 2015;31(1):1–22.CrossRef
31.
go back to reference Baldwin M. Critial reflection: opportunities and threats to professional learning and service development in social work organizations. In: Gould N, Baldwin M, editors. Social work, critical reflectionan and the learning organization. Aldershot: Ashgate; 2004. Baldwin M. Critial reflection: opportunities and threats to professional learning and service development in social work organizations. In: Gould N, Baldwin M, editors. Social work, critical reflectionan and the learning organization. Aldershot: Ashgate; 2004.
32.
go back to reference Ericsson KA. Deliberate practice and acquisition of expert performance: a general overview. Acad Emerg Med. 2008;15:988–94.CrossRef Ericsson KA. Deliberate practice and acquisition of expert performance: a general overview. Acad Emerg Med. 2008;15:988–94.CrossRef
33.
go back to reference Weick KE. Sense-making in organizations. Thousand Oaks: Sage; 1995. Weick KE. Sense-making in organizations. Thousand Oaks: Sage; 1995.
34.
go back to reference Areskoug Josefsson K, Avby G, Andersson Bäck M, Kjellström S. Workers’ experiences of healthy work environment indicators at well-functioning primary care units in Sweden: a qualitative study. Scandinavian J of Primary Health Care. 2018;36(4):406–14.CrossRef Areskoug Josefsson K, Avby G, Andersson Bäck M, Kjellström S. Workers’ experiences of healthy work environment indicators at well-functioning primary care units in Sweden: a qualitative study. Scandinavian J of Primary Health Care. 2018;36(4):406–14.CrossRef
35.
go back to reference Kjellström S, Avby G, Areskoug-Josefsson K, Andersson Gäre B, Andersson BM. Work motivation among healthcare professionals: a study of well-functioning primary healthcare centers in Sweden. Journal of Health Organization and Management. 2017;31(4):487–502.CrossRef Kjellström S, Avby G, Areskoug-Josefsson K, Andersson Gäre B, Andersson BM. Work motivation among healthcare professionals: a study of well-functioning primary healthcare centers in Sweden. Journal of Health Organization and Management. 2017;31(4):487–502.CrossRef
36.
go back to reference Rosing K, Frese M, Bausch A. Explaining the heterogeneity of the leadership-innovation relationship: ambidextrous leadership. Leadersh Q. 2011;22(5):956–74.CrossRef Rosing K, Frese M, Bausch A. Explaining the heterogeneity of the leadership-innovation relationship: ambidextrous leadership. Leadersh Q. 2011;22(5):956–74.CrossRef
37.
go back to reference Rosing K, Rosenbusch N, Frese M. Ambidextrous leadership in the innovation process. In: Gerybadze A, Hommel U, Reiners H, Thomaschewski D. (eds) Innovation and International Corporate Growth. Berlin: Springer, Berlin; 2010:191–204.CrossRef Rosing K, Rosenbusch N, Frese M. Ambidextrous leadership in the innovation process. In: Gerybadze A, Hommel U, Reiners H, Thomaschewski D. (eds) Innovation and International Corporate Growth. Berlin: Springer, Berlin; 2010:191–204.CrossRef
38.
go back to reference Zacher H, Rosing K. Ambidextrous leadership and team innovation. Leadersh Org Dev J. 2015;36(1):54–68.CrossRef Zacher H, Rosing K. Ambidextrous leadership and team innovation. Leadersh Org Dev J. 2015;36(1):54–68.CrossRef
39.
go back to reference Rosing K, Zacher H. Individual ambidexterity: the duality of exploration and exploitation and its relationship with innovative performance. Eur J Work Organ Psych. 2016;26(5):694–709.CrossRef Rosing K, Zacher H. Individual ambidexterity: the duality of exploration and exploitation and its relationship with innovative performance. Eur J Work Organ Psych. 2016;26(5):694–709.CrossRef
40.
go back to reference Arena M, Cross R, Sims J, Uhl-Bien MJ. How to catalyze innovation in your organization. MSMR. 2017;58(4):38–48. Arena M, Cross R, Sims J, Uhl-Bien MJ. How to catalyze innovation in your organization. MSMR. 2017;58(4):38–48.
41.
go back to reference Uhl-Bien M. Arena. Leadership for organizational adaptability: a theoretical synthesis and integrative framework. MJTLQ. 2018;29(1):89–104. Uhl-Bien M. Arena. Leadership for organizational adaptability: a theoretical synthesis and integrative framework. MJTLQ. 2018;29(1):89–104.
42.
go back to reference Anell A. Choice and privatisation in Swedish primary care. Health Econ, Policy Law. 2011;6(04):549–69.CrossRef Anell A. Choice and privatisation in Swedish primary care. Health Econ, Policy Law. 2011;6(04):549–69.CrossRef
43.
go back to reference Svensson L, Ellström P-E, Brulin G. Introduction: on Interactive Research. Inter J Action Res. 2007;3(3):233. Svensson L, Ellström P-E, Brulin G. Introduction: on Interactive Research. Inter J Action Res. 2007;3(3):233.
44.
go back to reference Brulin G, Svensson L. Managing sustainable development programmes: Alearning approach to change. England: Gower; 2012. Brulin G, Svensson L. Managing sustainable development programmes: Alearning approach to change. England: Gower; 2012.
45.
go back to reference Mom TJ, Van Den Bosch FA, Volberda HWJ. Joms. Investigating managers’ exploration and exploitation activities: the influence of top-down, bottom-up, and horizontal knowledge inflows. Joms. 2007;44(6):910–31. Mom TJ, Van Den Bosch FA, Volberda HWJ. Joms. Investigating managers’ exploration and exploitation activities: the influence of top-down, bottom-up, and horizontal knowledge inflows. Joms. 2007;44(6):910–31.
46.
go back to reference Welbourne TM, Johnson DE, Erez AJ. The role-based performance scale: validity analysis of a theory-based measure. Aomj. 1998;41(5):540–55. Welbourne TM, Johnson DE, Erez AJ. The role-based performance scale: validity analysis of a theory-based measure. Aomj. 1998;41(5):540–55.
47.
go back to reference Nilsen P, Nordström G, Ellström P-E. Integrating research-based and practice-based knowledge through workplace reflection. J Workplace Learn. 2011;24(6):403–5.CrossRef Nilsen P, Nordström G, Ellström P-E. Integrating research-based and practice-based knowledge through workplace reflection. J Workplace Learn. 2011;24(6):403–5.CrossRef
48.
go back to reference Nilsen P, Roback K, Broström A, Ellström P-E. Creatures of habit: accounting for the role of habit in implementation research on clinical behaviour change. Implement Sci. 2012;7(1):53.CrossRef Nilsen P, Roback K, Broström A, Ellström P-E. Creatures of habit: accounting for the role of habit in implementation research on clinical behaviour change. Implement Sci. 2012;7(1):53.CrossRef
49.
go back to reference Sackett DL, Rosenberg WMC, Gray JAM, Haynes R, Richardson WS. Evidence based medicine: what it is and what it isn’t. BMJ. 1996;312(7023):71–2.CrossRef Sackett DL, Rosenberg WMC, Gray JAM, Haynes R, Richardson WS. Evidence based medicine: what it is and what it isn’t. BMJ. 1996;312(7023):71–2.CrossRef
50.
go back to reference Lacerenza CN, Marlow SL, Tannenbaum SI, Salas E. Team development interventions: evidence-based approaches for improving teamwork. Am Psychol. 2018;73(4):517.CrossRef Lacerenza CN, Marlow SL, Tannenbaum SI, Salas E. Team development interventions: evidence-based approaches for improving teamwork. Am Psychol. 2018;73(4):517.CrossRef
51.
go back to reference Lacerenza CN, Reyes DL, Marlow SL, Joseph DL, Salas E. Leadership training design, delivery, and implementation: a meta-analysis. J Appl Psychol. 2017;102(12):1686–718.CrossRef Lacerenza CN, Reyes DL, Marlow SL, Joseph DL, Salas E. Leadership training design, delivery, and implementation: a meta-analysis. J Appl Psychol. 2017;102(12):1686–718.CrossRef
52.
go back to reference Drago-Severson E, Blum-DeStefano J, Asghar A. Learning for leadership. Thousand Oaks: Corwin Press; 2013. Drago-Severson E, Blum-DeStefano J, Asghar A. Learning for leadership. Thousand Oaks: Corwin Press; 2013.
53.
go back to reference Edmondson AC, Zhike L. Psychological safety: the history, renaissance, and future of an interpersonal construct. Annu. Rev. Organ. Psychol. Organ. Behav. 2014;1(1):23–43.CrossRef Edmondson AC, Zhike L. Psychological safety: the history, renaissance, and future of an interpersonal construct. Annu. Rev. Organ. Psychol. Organ. Behav. 2014;1(1):23–43.CrossRef
54.
go back to reference Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, et al. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. 2014;348:g1687. Hoffmann TC, Glasziou PP, Boutron I, Milne R, Perera R, Moher D, et al. Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. 2014;348:g1687.
Metadata
Title
LearnOvation: an intervention to foster exploration and exploitation behaviour in health care management in daily practice
Authors
Gunilla Avby
Sofia Kjellström
Publication date
01-12-2019
Publisher
BioMed Central
Keyword
Care
Published in
BMC Health Services Research / Issue 1/2019
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-019-4152-8

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