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There is a growing interest in living labs (a research concept in which innovations are co-created with end-users and tested in practice) as a method to test and develop health and social care innovations. However, little is known about their effect on the care organization and care providers’ quality of working life. By using the Flanders Care Living Labs program (Belgium) as a case study, the purpose of this paper is to explore how innovations in a living lab context may affect those issues.

This qualitative study combined data from document analysis, in-depth interviews and focus groups involving 23 care innovation projects. Deductive category application was used for analyzing data.

Outcomes indicate that 22/23 care innovation projects resulted in organizational changes, and that 22 affected at least one care provider’s quality of working life. Surprisingly, no project deliberately intended to affect the care organization and quality of working life. Future care innovation projects should focus on actual innovation and its implications for specific end-users, and on the broader organizational consequences and the possible effect on the care providers’ work.

This is the first study that specifically focused on care innovation’s effect on the care organization and on the quality of working life within a living labs context.

Purpose: While COVID-19 has upended lives, it has also catalyzed innovation with potential to advance health delivery. Yet, we know little about how the delivery system, and primary care in particular, has responded and how this has impacted vulnerable patients. We aimed to understand the impact of COVID-19 on primary care practice sites and their vulnerable patients and to identify explanations for variation. Approach: We developed and administered a survey to practice managers and physician leaders from 173 primary care practice sites, October-November 2020. We report and graphically depict results from univariate analysis and examine potential explanations for variation in practices' process innovations in response to COVID-19 by assessing bivariate relationships between seven dependent variables and four independent variables. Findings: Among 96 (55.5%) respondents, primary care practice sites on average took more safety (8.5 of 12) than financial (2.5 of 17) precautions in response to COVID-19. Practice sites varied in their efforts to protect patients with vulnerabilities, providing care initially postponed, and experience with virtual visits. Financial risk, practice size, practitioner age, and emergency preparedness explained variation in primary care practices' process innovations. Many practice sites plan to sustain virtual visits, dependent mostly on patient and provider preference and continued reimbursement. Value: While findings indicate rapid and substantial innovation, conditions must enable primary care practice sites to build on and sustain innovations, to support care for vulnerable populations, including those with multiple chronic conditions and socio-economic barriers to health, and to prepare primary care for future emergencies.

Diffusion of innovations, defined as the adoption and implementation of new ideas, processes, products, or services in health care, is both particularly important and especially challenging. One known problem with adoption and implementation of new technologies is that, while organizations often make innovations immediately available, organizational actors are more wary about adopting new technologies because these may impact not only patients and practices but also reimbursement. As a result, innovations may remain underutilized, and organizations may miss opportunities to improve and advance. As innovation adoption is vital to achieving success and remaining competitive, it is important to measure and understand factors that impact innovation diffusion. Building on a survey of a national sample of 654 clinicians, our study measures the extent of diffusion of value-enhancing care delivery innovations (i.e., technologies that not only improve quality of care but has potential to reduce care cost by diminishing waste, Faems et al., 2010) for 13 clinical specialties and identifies healthcare-specific individual characteristics such as: professional purview, supervisory responsibility, financial incentive, and clinical tenure associated with innovation diffusion. We also examine the association of innovation diffusion with perceived value of one type of care delivery innovation – artificial intelligence (AI) – for assisting clinicians in their clinical work. Responses indicate that less than two-thirds of clinicians were knowledgeable about and aware of relevant value-enhancing care delivery innovations. Clinicians with broader professional purview, more supervisory responsibility, and stronger financial incentives had higher innovation diffusion scores, indicating greater knowledge and awareness of value-enhancing, care delivery innovations. Higher levels of knowledge of the innovations and awareness of their implementation were associated with higher perceptions of the value of AI-based technology. Our study contributes to our knowledge of diffusion of innovation in healthcare delivery and highlights potential mechanisms for speeding innovation diffusion.

At the center of its core, Health Care is the application of a general body of knowledge to the needs of a specific patient. For centuries, this knowledge was generally regarded as the property of the healing professions and the individual clinician, not necessarily of the health care delivery organization. Managerial practice also had a tendency to treat this knowledge as an attribute of the provider, thus focusing on the resources clinicians used as they provided care and on the hotel-type functions associated with inpatient institutions. That is, there was a deliberate differentiation between management practice, focused on business processes, and clinical practice, focused on the activities and decisions of diagnosis and treatment. Though often described as bureaucratic and incrementally changing, health care is also a very dynamic and innovative field. Around the globe, research scientists, private industries, academics, and governmental and nongovernmental agencies continue to work in innovating new ways to provide better care, find cures, and improve health. At the same time, health care delivery has been undergoing a gradual but important change. Patient care, once the domain of the individual practitioner, is becoming the domain of the care delivery organization. Additionally, the mission of these organizations is shifting. As science, technology, care processes, and care teams have become more complex and diverse, the way in which the activities of care are organized and the institutional context in which they occur have become an increasingly important determinant of the effectiveness and efficiency of that care. As a result, the object of management has changed. In response to these changes, health care managers have started focusing on the management of the care as well as the management of the institutions in which the care takes place, thereby creating a set of ‘Best Practices’ which are briefly described in this paper along with how the process of innovation is developing in the health care system.

Young people who are looked after by the state face challenges as they make the transition from care to adulthood, with variation in support available. In the past decade, funding has been directed towards organisations to pilot innovations to support transition, with accompanying evaluations often conducted with a single disciplinary focus, in a context of short timescales and small budgets. Recognising the value and weight of the challenge involved in evaluation of innovations that aim to support the transitions of young people leaving care, this paper aims to provide a review of evaluation approaches and suggestions regarding how these might be developed.

As part of a wider research programme to improve understanding of the innovation process for young people leaving care, the authors conducted a scoping review of grey literature (publications which are not peer reviewed) focusing on evaluation of innovations in the UK over the past 10 years. The authors critiqued the evaluation approaches in each of the 22 reports they identified with an inter-disciplinary perspective, representing social care, public health and organisation science.

The authors identified challenges and opportunities for the development of evaluation approaches in three areas. Firstly, informed by social care, the authors suggest increased priority should be granted to participatory approaches to evaluation, within which involvement of young people leaving care should be central. Secondly, drawing on public health, there is potential for developing a common outcomes’ framework, including methods of data collection, analysis and reporting, which aid comparative analysis. Thirdly, application of theoretical frameworks from organisation science regarding the process of innovation can drive transferable lessons from local innovations to aid its spread.

By adopting the unique perspective of their multiple positions, the authors’ goal is to contribute to the development of evaluation approaches. Further, the authors hope to help identify innovations that work, enhance their spread, leverage resources and influence policy to support care leavers in their transitions to adulthood.

This paper aims to examine the effect of the characteristics of innovation and change adopters on the rate of adoption of environmental sustainability innovations in hospitals of Bihar state in India.

Data were collected from hospital administration, managers, doctors, nurses and staff working at various levels in both public and private hospitals of Bihar. Research model was tested using regression analysis with the help of statistical package for social sciences 24.

Innovation characteristics of relative advantage, simplicity, trialability and compatibility were found to significantly predict the adoption of eco-innovations while innovativeness and environmental opinion leadership failed to demonstrate any significant impact on sustainability adoption in hospitals.

This study provides important information to the change agents on how to diffuse green innovations in the unsustainable and inefficient areas and make them more sustainable. With no systematic investigation of sustainability innovations being done in the health-care sector in India, this study on eco-innovations in a resource-constrained state of India provides a fresh perspective and practical insights on the state of sustainability innovations in health care.

While there is established research that explores individual innovations across countries or developments in a specific health area, there is less work that attempts to match national innovations to specific systems of health governance to uncover themes across nations.

We used a cross-comparison design that employed content analysis of health governance models and innovation patterns in eight OECD nations (Australia, Britain, Canada, France, Germany, the Netherlands, Switzerland, and the United States).

Country-level model of health governance may impact the focus of health innovation within the eight jurisdictions studied. Innovation across all governance models has targeted consumer engagement in health systems, the integration of health services across the continuum of care, access to care in the community, and financial models that drive competition.

Improving our understanding of the linkage between health governance and innovation in health systems may heighten awareness of potential enablers and barriers to innovation success.

Substantial government investment has accelerated innovation activity in children’s social care in England over the past decade. Ethical concerns emerge when innovation seems to be propelled by a drive for efficiency and over-reliance on process output indicators, as well as, or even instead of, improving the lives of children, families and societies. No ethical framework exists at present to act as a check on such drivers. This paper reviews the literature with the aim of considering how best to address this gap.

This paper draws on a review of innovation in children’s social care, conducted as part of an Economic and Social Research Council-funded project exploring innovation in services for young people exposed to extra-familial risk and harm.

This study proposes a new conception of “trustworthy innovation” for the sector that holds innovation in children’s social care to the standards and principles of the code of ethics for social work. This study offers an ethical framework, informed by the interdisciplinary school of organisational ethics, to operationalise this extended definition; the analytic framework guides policymakers and the practice sector to question at every stage of the innovation process whether a particular model is ethically appropriate, as well as practically feasible within a specific context. Implications for local decision-making and national policy are set out, alongside questions raised for future research.

This paper is the first to offer an ethical framework for innovation in children's social care. The conception of “trustworthy innovation” offers a guide to policymakers and the practice sector, which they can use to ethically test every stage of the innovation process and make decisions about whether a particular model is ethically appropriate, as well as practically feasible within a specific context.

By developing a conceptual model, the purpose of this paper is to improve the understanding of the role of social assistive technologies in facilitating the process of service innovation in care providing organisations to adopt the principles of the consumer-directed care strategy and reduce perceived consumer vulnerability.

Using a cross-sectional survey method, the authors collected data through a survey questionnaire distributed among 335 aged caregivers and specialists. The conceptual model and its 11 research hypotheses were examined using confirmatory factor analysis in structural equation modelling. The rival and mediation models were also estimated.

The conceptual model was validated and eight of eleven hypotheses were supported. It was found that dynamic capabilities are crucial to developing service innovation concept in care providing organisations. In this way, social assistive technologies play a facilitating role to promote the consumer-directed care strategy throughout care providing organisations and allow care providers to enhance wellbeing of vulnerable older people based on their socio-economic status. From the lens of aged care providers, it was also found that the consumer-directed care strategy implemented in aged care facilities may help reduce consumer vulnerability among older people especially when they use social assistive technologies in their service settings.

This study suggests aged care service providers should boost dynamic service innovation capabilities to improve the need for social assistive technologies in aged care facilities with respect to the importance of the consumer-directed care strategy.

This study contributes to the development and validation of a conceptual model for the use of social assistive technologies to sustain service innovation in aged care business models and enhance the consumer-directed care strategy’s performance to better understand consumer vulnerability among older people.

This article proposes a new disruptive innovation in healthcare through the development of a physician assistant business model, which can be most readily applied in vulnerable rural health care settings.

This study reviews the current state of the health care system in terms of physician assistant utilization and primary care shortages in rural communities. The study proposes that the physician assistant-owned and -operated primary care business represents a disruptive innovation, via the application of the five principles of Clayton Christensen’s (1997) thesis on disruptive innovation.

Considering the current state of the health care industry, the study logically defends the proposed model as a disruptive innovation in that it: focuses on an underserved market, has lower costs, has few competitors, offers high quality and provides a sustainable competitive advantage.

The physician assistant business model is a viable solution for providing primary care for rural communities with educational, financial, transportation and other resource limitations.

This is a unique application of the theory of disruptive innovation, which illustrates how a new business model can solve a chronic shortage in primary care, especially in underserved populations.