Analysing barriers to service improvement using a multi-level theory of innovation

The Case of Glaucoma Outpatient Clinics

Bibliographic Data

ID2249362
AuthorsSimon Turner (0000-0002-1801-8351, Centre for Primary Care Division of Population Health Health Services Research and Primary Care School of Health Sciences Faculty of Biology, Medicine and Health University of Manchester Manchester UK, corresponding author), Christos Vasilakis (0000-0001-9289-5427, Centre for Healthcare Innovation & Improvement, School of Management University of Bath Bath UK, corresponding author), Martin Utley (0000-0001-9928-1516, Clinical Operational Research Unit University College London London UK, corresponding author), Paul J Foster (0000-0002-4755-177X, Moorfields Eye Hospital NHS Foundation Trust, corresponding author), Paul Foster (0009-0008-3268-5426, NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology London UK), Aachal Kotecha (0000-0003-4989-9216, NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology London UK, corresponding author), Naomi Fulop (0000-0001-5306-6140, Department of Applied Health Research University College London London UK, corresponding author)
Year2018
Volume40
Issue4
Pages654-669
Publication date2018-05-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueSociology of Health & Illness (JOURNAL)
Journal identifiersISSN: 0141-9889 • E-ISSN: 1467-9566
PublisherWiley (PUBLISHER • GB)
DOI10.1111/1467-9566.12670
PMID29441595
OpenAlexW2767970710
LanguageEN
References cited36

The development and implementation of innovation by healthcare providers is understood as a multi-determinant and multi-level process. Theories at different analytical levels (i.e. micro and organisational) are needed to capture the processes that influence innovation by providers. This article combines a micro theory of innovation, actor-network theory, with organisational level processes using the 'resource based view of the firm'. It examines the influence of, and interplay between, innovation-seeking teams (micro) and underlying organisational capabilities (meso) during innovation processes. We used ethnographic methods to study service innovations in relation to ophthalmology services run by a specialist EnglishNHSTrust at multiple locations. Operational research techniques were used to support the ethnographic methods by mapping the care process in the existing and redesigned clinics. Deficiencies in organisational capabilities for supporting innovation were identified, including manager-clinician relations and organisation-wide resources. The article concludes that actor-network theory can be combined with the resource-based view to highlight the influence of organisational capabilities on the management of innovation. Equally, actor-network theory helps to address the lack of theory in the resource-based view on the micro practices of implementing change

Actor–network theory · Business · Health care · Knowledge management · Network theory · Process (computing · Process management · Relation (database · Resource (disambiguation · Service (business · Service innovation · Sociology · Computer Science · Healthcare Quality and Management · Healthcare Systems and Technology · Marketing · Patient Satisfaction in Healthcare