Innovation in healthcare services: a customer focused approach

Although the various tools and techniques of quality management are routinely deployed in order to improve healthcare quality, an integrated approach is lacking, which combines the customer focus to identify quality issues, analytical techniques for prioritising improvement measures and a project management approach to plan, implement and evaluate the improvement projects. This study develops an innovative framework using Quality Function Deployment (QFD) and a logical framework in order to address this issue, and demonstrates its effectiveness using a case study on the intensive care unit of a hospital.

The phenomenology of minority-majority status:effects on innovation in argument generation

In three experiments, we manipulated participants' perceived numerical status and compared the originality and creativity of arguments generated by members of numerical minorities and majorities. Independent judges, blind to experimental conditions, rated participants' written arguments. In Studies 1 and 2, we found that participants assigned to a numerical minority generated more original arguments when advocating their own position than did numerical majorities. In Study 3, an equal-factions control group was included in the design, and all participants were instructed to argue for a counter-attitudinal position. Those in the numerical minority generated more creative arguments than those in both the majority and equal-factions conditions, but not stronger arguments. We propose cognitive and social processes that may underlie our obtained effects and discuss implications for minority influence research.

Leadership clarity and team innovation in health care

The relationships among leadership clarity (i.e., team members' consensual perceptions of clarity of and no conflict over leadership of their teams), team processes, and innovation were examined in health care contexts. The sample comprised 3447 respondents from 98 primary health care teams (PHCTs), 113 community mental health teams (CMHTs), and 72 breast cancer care teams (BCTs). The results revealed that leadership clarity is associated with clear team objectives, high levels of participation, commitment to excellence, and support for innovation. Team processes consistently predicted team innovation across all three samples. Team leadership predicted innovation in the latter two samples, and there was some evidence that team processes partly mediated this relationship. The results imply the need for theory that incorporates clarity and not just style of leadership. For health care teams in particular, and teams in general, the results suggest a need to ensure leadership is clear in teams when innovation is a desirable team performance outcome. © 2003 Elsevier Inc. All rights reserved.

When promoting positive feelings pays:Aggregate job satisfaction, work design features, and innovation in manufacturing organizations

This study investigates the relationship between aggregate job satisfaction and organizational innovation. In a sample of manufacturing companies, data were gathered from 3717 employees in 28 UK manufacturing organizations about their job satisfaction and aggregated to the organizational level. Data on innovation in technology/processes were gathered from multiple respondents in the same organizations 24 months later. The results revealed that aggregate job satisfaction was a significant predictor of subsequent organizational innovation, even after controlling for prior organizational innovation and profitability. Moreover the data indicated that the relationship between aggregate job satisfaction and innovation in production technology/processes was moderated by two factors: job variety and a commitment to "single status". Unlike previous studies, we conceptualize job satisfaction at the aggregate rather than the individual level and examine innovation rather than creativity. We propose that where the majority of employees experience job satisfaction, they will endorse rather than resist innovation and work collaboratively to implement as well as to generate creative ideas.

Reflexivity for team innovation in China:The contribution of goal interdependence

Teams that can manage their internal functioning may be able to continue to work effectively so that they innovate. This study suggests that cooperative but not competitive or independent goals are a foundation for effective team reflexivity. Two hundred employees in 100 work teams in China completed measures of their team's goal interdependence (cooperative, competitive, and independent) and reflexivity. The managers of these 100 teams rated their team's innovation. Results support the theorizing that cooperative goals can contribute to team reflexivity. Structural equation analysis suggested that cooperative but not competitive or independent goals promote reflexivity that in turn results in team innovation. These results, coupled with previous research, were interpreted as suggesting that cooperative goals and reflexivity are complementary foundations for team innovation.

Getting the most out of multidisciplinary teams: a multi-sample study of team innovation in health care

Driven by the assumption that multidisciplinarity contributes positively to team outcomes teams are often deliberately staffed such that they comprise multiple disciplines. However, the diversity literature suggests that multidisciplinarity may not always benefit a team. This study departs from the notion of a linear, positive effect of multidisciplinarity and tests its contingency on the quality of team processes. It was assumed that multidisciplinarity only contributes to team outcomes if the quality of team processes is high. This hypothesis was tested in two independent samples of health care workers (N = 66 and N = 95 teams), using team innovation as the outcome variable. Results support the hypothesis for the quality of innovation, rather than the number of innovations introduced by the teams.

Innovation in teams : a qualitative and quantitative study of team behaviours

This thesis explores the processes of team innovation. It utilises two studies, an organisationally based pilot and an experimental study, to examine and identify aspects of teams' behaviours that are important for successful innovative outcome. The pilot study, based in two automotive manufacturers, involved the collection of team members' experiences through semi-structured interviews, and identified a number of factors that affected teams' innovative performance. These included: the application of ideative & dissemination processes; the importance of good team relationships, especially those of a more informal nature, in facilitating information and ideative processes; the role of external linkages in enhancing quality and radicality of innovations; and the potential attenuation of innovative ideas by time deadlines. This study revealed a number key team behaviours that may be important in successful innovation outcomes. These included; goal setting, idea generation and development, external contact, task and personal information exchange, leadership, positive feedback and resource deployment. These behaviours formed the basis of a coding system used in the second part of the research. Building on the results from the field based research, an experimental study was undertaken to examine the behavioural differences between three groups of sixteen teams undertaking innovative an task to produce an anti-drugs poster. They were randomly assigned to one of three innovation category conditions suggested by King and Anderson (1990), emergent, imported and imposed. These conditions determined the teams level of access to additional information on previously successful campaigns and the degree of freedom they had with regarding to the design of the poster. In addition, a further experimental condition was imposed on half of the teams per category which involved a formal time deadline for task completion. The teams were video taped for the duration of their innovation and their behaviours analysed and coded in five main aspects including; ideation, external focus, goal setting, interpersonal, directive and resource related activities. A panel of experts, utilising five scales developed from West and Anderson's (1996) innovation outcome measures, assessed the teams' outputs. ANOVAs and repeated measure ANOVAs were deployed to identify whether there were significant differences between the different conditions. The results indicated that there were some behavioural differences between the categories and that over the duration of the task behavioural changes were identified. The results, however, revealed a complex picture and suggested limited support for three distinctive innovation categories. There were many differences in behaviours, but rarely between more than two of the categories. A main finding was the impact that different levels of constraint had in changing teams' focus of attention. For example, emergent teams were found to use both their own team and external resources, whilst those who could import information about other successful campaigns were likely to concentrate outside the team and pay limited attention to the internal resources available within the team. In contrast, those operating under task constraints with aspects of the task imposed onto them were more likely to attend to internal team resources and pay limited attention to the external world. As indicated by the earlier field study, time deadlines did significantly change teams' behaviour, reducing ideative and information exchange behaviours. The model shows an important behavioural progression related to innovate teams. This progression involved the teams' openness initially to external sources, and then to the intra-team environment. Premature closure on the final idea before their mid-point was found to have a detrimental impact on team's innovation. Ideative behaviour per se was not significant for innovation outcome, instead the development of intra-team support and trust emerged as crucial. Analysis of variance revealed some limited differentiation between the behaviours of teams operating under the aforementioned three innovation categories. There were also distinct detrimental differences in the behaviour of those operating under a time deadline. Overall, the study identified the complex interrelationships of team behaviours and outcomes, and between teams and their context.

The Once and future pioneers? : the role of voluntary organizations in innovation in the personal social services

This thesis explores the innovative capacity of voluntary organizations in the field of the personal social services. It commences with a full literature review, which concludes that the wealth of research upon innovation in the organization studies field has not addressed this topic, whilst the specialist literatures upon voluntary organizations and upon the personal social services have neglected the study of innovation. The research contained in this thesis is intended to right this neglect and to integrate lessons from both fields. It combines a survey of the innovative activity of voluntary organizations in three localities with cross-sectional case studies of innovative, developmental and traditional organizations. The research concludes that innovation is an important, but not integral, characteristic of voluntary organizations. It develops a contingent model of this innovative capacity of voluntary organizations, which stresses the role of external environmental and institutional forces in shaping and releasing this capacity. It concludes by considering the contribution of this model both to organization studies and to the study of voluntary organizations.

Technology policy and technological innovation in the People's Republic of China

The objective of this research is to unveil the dynamics of technological innovation in planned economies in transition. It is proposed in the thesis that all innovation systems in the world, in fact, consist of certain configurations of market and hierarchy. These systems have always been shifting from one existing market-hierarchy mix to a new one, which is expected to be more conducive to technological innovation and economic development. Current reforms in many planned economies in transition reflect this theoretical proposition. A research framework is constructed to include three main dimensions for the study of a specific innovation system, i.e. Arrangements, Achievements and Actors. China, which has undergone reforms since 1978, is chosen as the empirical basis of the research. The research examined technology policy and technological innovation in China between 1978 to 1988. The thesis starts from Arrangements - R&D System in China and Its Reform. The thesis illustrates reforms in the R&D system in relation to government technology policy. There exist coherent government efforts to promote innovations through various plans, and the planning process incorporates both market and command elements. The institutional structure of Chinese R&D system remains still vertically departmentalised, but horizontal links are created through the market. Secondly, Achievements - Performance of Chinese R&D System is assessed through patterns of technological innovation. Data from National Awards for S&T Progress (1978-1988) are included in a substantial database, which is used to generate patterns of technological innovation and patterns of innovating organisations. These patterns were presented and interpreted in relation to geographical differences, sectoral differences, typological differences, forms of co-operation and the impacts of S&T policy and reform. The third dimension is study on Actors - Innovation in Applied R&D institutes. Through semi-structured interviews and questionnaire survey, internal structure and research management are analysed in the light of ongoing reforms. The reform of R&D funding system greatly affected the way applied R&D institutes operate. Both organisational and individual incentives for innovating are increasingly associated with economic or material benefits. The research suggests there is a need to put reforms in the R&D system into a wider societal and political context. Some general attributes of applied R&D institutes are also discussed in the thesis.

The response to and effects of microcomputers in the education sector:the introduction of an innovation in local authority secondary schools

The study addresses the introduction of an innovation of new technology into a bureaucratic profession. The organisational setting is that of local authority secondary schools at a time at which microcomputers were being introduced in both the organisational core (for teaching) and its periphery (school administration). The research studies innovation-adopting organisations within their sectoral context; key actors influencing the innovation are identified at the levels of central government, local government and schools.A review of the literature on new technology and innovation (including educational innovation), and on schools as organisations in a changing environment leads to the development of the conceptual framework of the study using a resource dependency model within a cycle of the acquisition, allocation and utilisation of financial, physical and intangible resources. The research methodology is longitudinal and draws from both positivist and interpretive traditions. lt includes an initial census of the two hundred secondary schools in four local education authorities, a final survey of the same population, and four case studies, using both interview methods and documentation. Two modes of innovation are discerned. In respect of administrative use a rationalising, controlling mode is identified, with local education authorities developing standardised computer-assisted administrative systems for use in schools. In respect of curricular use, in contrast, teachers have been able to maintain an indeterminate occupational knowledge base, derived from an ideology of professionalism in respect of the classroom use of the technology. The mode of innovation in respect of curricular use has been one of learning and enabling. The resourcing policies of central and local government agencies affect the extent of use of the technology for teaching purposes, but the way in which it is used is determined within individual schools, where staff with relevant technical expertise significantly affect the course of the innovation.

Innovation in the pharmaceutical industry:a study of the effects of regulation on the U.K. pharmaceutical industry

A history of government drug regulation and the relationship between the pharmaceutical companies in the U.K. and the licensing authority is outlined. Phases of regulatory stringency are identified with the formation of the Committees on Safety of Drugs and Medicines viewed as watersheds. A study of the impact of government regulation on industrial R&D activities focuses on the effects on the rate and direction of new product innovation. A literature review examines the decline in new chemical entity innovation. Regulations are cited as a major but not singular cause of the decline. Previous research attempting to determine the causes of such a decline on an empirical basis is given and the methodological problems associated with such research are identified. The U.K. owned sector of the British pharmaceutical industry is selected for a study employing a bottom-up approach allowing disaggregation of data. A historical background to the industry is provided, with each company analysed or a case study basis. Variations between companies regarding the policies adopted for R&D are emphasised. The process of drug innovation is described in order to determine possible indicators of the rate and direction of inventive and innovative activity. All possible indicators are considered and their suitability assessed. R&D expenditure data for the period 1960-1983 is subsequently presented as an input indicator. Intermediate output indicators are treated in a similar way and patent data are identified as a readily-available and useful source. The advantages and disadvantages of using such data are considered. Using interview material, patenting policies for most of the U.K. companies are described providing a background for a patent-based study. Sources of patent data are examined with an emphasis on computerised systems. A number of searches using a variety of sources are presented. Patent family size is examined as a possible indicator of an invention's relative importance. The patenting activity of the companies over the period 1960-1983 is given and the variation between companies is noted. The relationship between patent data and other indicators used is analysed using statistical methods resulting in an apparent lack of correlation. An alternative approach taking into account variations in company policy and phases in research activity indicates a stronger relationship between patenting activity, R&D Expenditure and NCE output over the period. The relationship is not apparent at an aggregated company level. Some evidence is presented for a relationship between phases of regulatory stringency, inventive and innovative activity but the importance of other factors is emphasised.

Product innovation in a new technology based firm

This thesis examines the "state of the art" of product innovation in new technology In the UK. The roles in innovation attributed to small and large firms are examined. Growing attention is being focused upon the small firm sector as a seedbed for Innovation and government policy has been changing to encourage the entrepreneurial new technology based firm (NTBF). The novel perspective of this research results from working in such a firm. It provides a longitudinal study of the management of innovation in conjunction with the corporate strategy of the firm. Given that the researcher was a participant and observer in the firm studied, the research is akin to action research in methodology but is better described as grounded theory. Theoretical concepts are drawn from the prescriptive literature describing corporate strategy, and from the empirical literature which has evaluated new product success and failure. Models of the Innovation process are discussed and appropriate strategies and reasons for product innovation failure in NTBFs are described. The strategy, structure and new product development progress of the company are examined, using both the researcher's observations and company documents. This provides information on the methods and practices adopted for product innovation in a NTBF. The thesis analyses the performance of the firm In terms of product innovation. The models and strategies derived from the literature are then tested in the light of the experience of the company. Conclusions are drawn regarding strategies for innovation in NTBFs and about the innovation process in general. The importance of a NTBF adopting a synergistic strategy is shown. Links are established between the existence of synergy in the strategy and coupling in the management of innovation. Innovation is shown to be a laterally interdisciplinary exercise and therefore the "pipeline model" Is criticised. Finally a set of guidelines Is produced for the managers of NTBFs.

Product innovation in a medium size mature manufacturing company

This thesis is concerned with the management of product innovation inside the medium size, mature, manufacturing company. An academic perspective of innovation is integrated with an account of direct participation acquired over a two year period. The emergent synthesis provides fresh insight into some of the problems associated with producing and sustaining innovation. Product innovation is a very complex activity, and it presents particular difficulties for mature industry. However, the ability to innovate is fundamental to a company's continued survival. Three aspects of product innovation are examined in detail. Firstly, is the requirement to separate innovation activity from the on-going business interests; dependency between the degree of separation and novelty is supported. Secondly, a simple sequential model of the innovation process is tested and shown to be of considerable practical value. Thirdly a relationship is established between the age of the recipient market and the type of innovation to be found in that market All three aspects are found to have important implications for management in their pursuit of innovation. Management deficiencies which inhibited the successful resolution of innovation-linked problems are described and solutions which stress the need for commitment and coherency are proposed. The long existing management structure in the mature company which mitigates against successful and continuing innovation are examined in detail and a strategy is evolved which uses the intrinsic strengths of the mature company to promote innovation of a kind compatible with success in the market. A set of guidelines of practical value is presented for those managers wishing to pursue, and sustain, product innovation in the medium size mature company.

Technical innovation in industrial production

New techniques in manufacturing, popularly referred to as mechanization and automation, have been a preoccupation of social and economic theorists since the industrial revolution. A selection of relevant literature is reviewed, including the neoclassical economic treatment of technical change. This incorporates alterations to the mathematical production function and an associated increase in the efficiency with which the factors of production are converted into output. Other work emphasises the role of research and development and the process of diffusion, whereby new production techniques are propagated throughout industry. Some sociological writings attach importance to the type of production technology and its effect on the organisational structure and social relations within the factory. Nine detailed case studies are undertaken of examples of industrial innovation in the rubber, automobile, vehicle components, confectionery and clothing industries. The old and new techniques are compared for a range of variables, including capital equipment, labour employed, raw materials used, space requirements and energy consumption, which in most cases exhibit significant change with the innovation. The rate of output, labour productivity, product quality, maintenance requirements and other aspects are also examined. The process by which the change in production method was achieved is documented, including the development of new equipment and the strategy of its introduction into the factory, where appropriate. The firm, its environment, and the attitude of different sectors of the workforce are all seen to play a part in determining the motives for and consequences which flow from the innovations. The traditional association of technical progress with its labour-saving aspect, though an accurate enough description of the cases investigated, is clearly seen to afford an inadequate perspective for the proper understanding of this complex phenomenon, which also induces change in a wide range of other social, economic and technical variables.