Intuition and rationality in intrapreneurship and innovation outputs: The case of health professionals in primary health care

The aim of this article is to explore the role of cognitive styles and intrapreneurship in health professionals’ innovation outputs, as well the mediated effect of intrapreneurship between cognitive styles and innovation output. This study used the survey method of data collection, through a self-administered questionnaire. Partial least square structural equation modelling method was used to analyse the result of the sample of 209 professionals of primary health care providers in Northern Portugal. Our findings reveal that cognitive style plays a significant role in intrapreneurship and innovation outputs, which are mediated by intrapreneurship. In particular, health care professionals with the rational cognitive style are likely to be more of a intrapreneur and innovative as compared to those with a intuitive cognitive style. Promoting intrapreneurship is crucial for successful innovation outputs. This study reveals that an understanding of the cognitive style of the health care professionals can help managers allocate appropriate individuals to different healthcare tasks. Our primary contribution to theory has been to highlight the importance of cognitive styles in intrapreneurship and innovation within the context of primary health care organizations.

     

Local government reform between ‘exogenous’ and ‘endogenous’ driving forces

Abstract

Configuration is an appealing concept to help understanding the complex arrangements that guide organizations' actions and contribute to their coherence. Although health care organizations are often described as professional bureaucracy a deep understanding of their structure and systems is still lacking. In this article, we draw on empirical data gathered in a Canadian teaching hospital to expose the nature of interdependencies and themes that drive some of its configurations at health care unit level. Five clinical activities were investigated (ocular surgery, brachytherapy, vascular surgery, rheumatology and geriatrics) using direct systematic observation. Four sub-orchestrating themes emerged. Based on the findings it is argued that the operating core of health care organizations is not homogeneous but rather heterogeneous. Therefore it is our contention that hospitals and other public organizations where professionals control the activities at operating level might be better regarded as ‘diversified professional federation’ than as professional bureaucracy.     

Moderating effect of employee perception of responsible downsizing on job satisfaction and innovation commitment

Abstract

Firms strive to innovate and enhance their competitive advantage. However, firm innovation relies on employee willingness to innovate. Therefore, how job satisfaction motivates employees to innovate has become a crucial topic. Additionally, for firms implementing a downsizing strategy to achieve a competitive edge, employee perception of downsizing may moderate the effect of employee job satisfaction on innovation commitment. To investigate the relationships between critical variables and employee innovation, we studied 277 nonsupervisory employees and three groups of stakeholders in a company and employed quantitative and qualitative methods to examine our research construct. The results revealed that job satisfaction regarding direct supervisors, pressure at work, peer relations, support of family, and health substantially affected employee innovation commitment. Employee perception of responsible downsizing strategy altered the influence of these factors. The findings of this research construct can guide organizational research and managerial practices.     

Effect of Certificate of Need Law on the intensity of competition: The market for emergency care

PurposeThis article aims to contribute to the academic literature in better understanding the impact of Certificate of Need (CON) Law on Emergency Department (ED) care. Impact of CON Law on ED competition remains an unanswered empirical question.MethodsWe examine the impact of CON Law and its stringency on the intensity of competition (rivalry among competitors) between EDs measured by the Herfindahl-Hirschman Index (HHI). We then estimate the effects of CON Law on HHI by treating CON as an exogenous (endogenous) variable.FindingsOn average the CON legislation enhances ED competition. A possible reason is that the law hinders predatory behavior, and therefore acts as an effective anti-trust tool. Other findings indicate that competition is found to be positively related to a state's population size and median income and negatively related with the prevalence of employer provided insurance and magnitude of illegal immigration in a state.Practical implicationsThis article sheds some light on how political regulations could affect healthcare market and hence may provide public policy makers some insights on reducing healthcare cost.OriginalityOur analysis of the impact of CON regulation on ED competition significantly contributes to the healthcare and strategy literature. The law potentially serves as an anti-trust tool in the hands of the government. We extend the empirical literature by treating CON Law and its stringency as exogenous (endogenous). Our comprehensive analysis considers a host of control variables such as population demographics, their health status and access to health care, healthcare facilities, political environment, in addition to the CON features.     

Who Speaks,and in What Voice? The Challenge of Engaging ‘The Public’ in Health Policy Decision-Making

Abstract

Despite widespread calls for greater public involvement in governance, especially in relation to health policy, significant challenges remain in identifying any such legitimate ‘public’ voice. This research investigates this problem through a case study. It examines how actors experienced and interpreted a government-commissioned citizen’s jury on health spending prioritization in relation to the work of the local health care consumers’ organization. The analysis highlights an unproductive tension around this encounter, and points to more complementary ways in which such top–down and bottom–up efforts might be coordinated. It, therefore, contributes significantly to efforts to strengthen the public voice in contemporary health governance.     

‘Why Partnership Working Doesn't Work’

Abstract

English public services in general (and health and social care in particular) have become increasingly dominated by the notion of partnership working. Despite this, more recent years have seen something of a reaction against partnerships. This article reviews lessons learned from a case study of a forensic mental health partnership, arguing that the service in question reveals a number of common pitfalls in terms of the way that partnerships are established and put into practice. In many ways, this was not the fault of the case study partnership, but the product of the wider institutional context in which health and social care partnerships have been developed and promoted. Ultimately, the article suggests some additions to the partnership theoretical literature, before concluding that the current concept of partnership working may lose credibility without additional work to clarify its meaning and contribution.     

Drivers of exploitative and explorative innovation in a collaborative public-sector context

ABSTRACT

This paper studies multilevel networks, in which municipalities collaborate with higher tiers of government (upward collaboration), with peers (outward) and with local stakeholders (inward) to discover innovative ways to create public value. A set of hypotheses was developed on the effects of three forms of collaboration (i.e. inward, outward and upward) on two types of innovation (i.e. exploitative and explorative innovation). A range of network and municipality characteristics was also considered. The model was tested by capturing the perceptions of 656 municipal representatives. The research findings provide evidence of complex links between forms of collaboration and types of innovation.     

The influence of intelligent manufacturing on financial performance and innovation performance: the case of China

ABSTRACT

Artificial intelligence is increasingly used in advanced manufacturing systems to realise intelligent manufacturing. However, there is still a lack of empirical research on the impact of intelligent manufacturing on enterprise performances, especially for China. The author adopts the enterprise panel data of intelligent manufacturing implemented by China’s manufacturing industry in 2014 to 2019, and uses propensity score matching with difference in differences (PSM-DID) method to investigate the impact of intelligent manufacturing on financial performance and innovation performance. The research yields two main conclusions. First, the implementation of intelligent manufacturing has a significant role in promoting the financial performance and innovation performance of manufacturing enterprises. Second, technology-intensive industries improve the quantity of innovation by implementing intelligent manufacturing, thus promoting the improvement of short-term financial performance, but the improvement of innovation quality has a negative impact on short-term financial performance. In labour-intensive industries, the relationship between financial performance and innovation performance is not obvious.     

The Link Between Participation in Management Decision-Making and Quality of Patient Care as Perceived by Chinese Doctors

Abstract

This study examined whether and how participation by doctors in management decision-making was associated with patient care. A questionnaire survey was conducted in three hospitals operating in China. Staff members of the selected hospitals were invited to participate in the survey, measuring perceived quality of patient care, employee participation in management decisions, psychological empowerment and affective commitment. This study focuses on the results of the 160 doctors employed by the hospitals who completed the questionnaire. The study found that psychological empowerment and affective commitment mediated the relationship between participation in management decisions and the quality of patient care as perceived by the doctors. Implications are drawn for public management practice in Chinese health care settings.     

The cognitive and the action-oriented elements of competence along the innovation process – evidence from R&D teams in the medical equipment sector

Abstract

Organizations are constantly searching for ways to enhance their innovative capacity and to sustain their competitive advantage. Much of the literature focuses on knowledge as the key driver for this pursuit. Unlike other studies, we define experience and knowledge as two basic elements of competence by borrowing from the experiential and cognitive learning theories and contrast their impact on the innovativeness of R&D teams. Building on the competence based perspective, we posit that the differences in competence inputs explain variations in team innovation performance along the innovation process. To test our assumptions, we analyzed the aggregated knowledge and experience levels for different technology competences of 868 employees in 49 R&D teams in a large contract-engineering corporation in the medical equipment sector. The findings reveal that technology experience is particularly fruitful within innovation implementation and is a driver for successful market introduction. The research contributes to the understanding when competence elements are especially important.     

Disentangling the Role of Management Control Systems for Product and Process Innovation in Different Contexts

ABSTRACT

This paper studies the relationship between the use of management control systems and different types of innovation (product and process), taking into account innovation contexts (high-tech versus low-tech sectors). We develop and test our hypotheses based on a large sample of Spanish manufacturing firms and find that input controls have a positive association only with process innovation in both innovation contexts. Behavior controls have similar effects on both types of innovation outcomes for high-tech firms, while they have stronger positive associations with process than with product innovation for low-tech firms. Output controls are equally relevant for product and process innovation in both contexts.     

Policy innovation in isolation?

Abstract

Innovations in public policy are difficult to realize if decision-making arrangements are not scrutinized at the same time. Rigid institutional arrangements often hinder the realization of policy breakthroughs. Consequently, in the day-to-day practice of public administration, more and more experiments with innovative arrangements towards realizing groundbreaking policy decisions are being seen. Two rather different examples of such arrangements in the Dutch context are transition arenas and pilot projects (proeftuinen). In this article we describe these arrangements from an innovation management perspective and evaluate their functioning by focusing on their approaches to two dilemmas: the dilemma between diversity and closedness within the innovation plans and the dilemma between openness and closedness of the plan in relation to its context, the outside world. From their comparison we can learn about the context-specific application of different innovation plans and the results of different ways of handling these innovation dilemmas.     

The effect of local and global linkages on the innovativeness in ICT SMEs: does location-specific context matter?

Abstract

Countries differ significantly with regard to the location-specific contexts in which they are embedded. The aim of this paper is to extend the discussion on the effects of local and global innovation collaborations on the degree of novelty of innovation by considering this context. Our main question is: Does embeddedness in the developed or emerging country context affect the likelihood of benefiting from local or global linkages for innovations with higher novelty?

The paper is based on data gathered through a survey of firms in the ICT sector in an emerging economy (India) context and from two Scandinavian countries (Sweden and Norway). The findings of this study show that global linkages do indeed impact the degree of novelty of innovation. However, country context does have a moderating effect. While the effect of global linkages is highly positive on the innovativeness of Scandinavian firms, for the Indian SMEs, the linkages that give novel innovations are the regional ones.     

Industrial clusters,flagship enterprises and regional innovation

ABSTRACT

For a sample of all 88 counties in the State of Ohio over a 5-year period, this study documents the effect of flagship enterprises and concentrated industrial clusters on regional innovation. Consistent with the agglomeration arguments and the knowledge spillover theory of entrepreneurship, both appear to affect regional innovation positively. Additionally, regional educational attainment positively moderates the effect of industrial clusters on innovation. At the same time, flagship enterprises primarily affect regional innovation in regions with low education levels. Results are obtained with the help of conservative econometric techniques and are robust to the choice of alternative dependent variables and estimators. The findings have major policy implications and provide insights into alternative routes to encouraging regional innovation.     

Social Return on Investment (SROI) and Performance Measurement

Abstract

Social enterprises are being promoted as responsive and innovative way to deliver public services. As part of this promotion, these organizations are being required to demonstrate the social and economic value they generate. Social return on investment (SROI) is a performance measurement tool currently being encouraged to capture this impact. This paper draws on survey and interview data to analyse how SROI is used and understood in health and social care settings. It indicates that despite being accepted as an internationally recognized measurement tool for social enterprise, SROI is underused and undervalued due to practical and ideological barriers.     

Why People Co-Produce: Analysing citizens’ perceptions on co-planning engagement in health care services

Abstract

The aim of this article is to comprehend the motivation of citizens to co-produce. More specifically, it considers citizens’ motivations to engage in co-planning activities of health care services. The article brings together theoretical insights and empirical data. First, we integrate insights from different strands of literature. We combine literature on citizen participation, political efficacy, co-production, volunteerism, public service motivation, and customer engagement to offer a first understanding of citizens’ motivations to actively engage as co-producers of public services. Next, empirical data are derived from one specific case: citizens participating in client councils in health care organizations. Q-methodology, a method designed to systematically study persons’ viewpoints, is used to distinguish different perspectives citizen have on their engagement in co-production. Our analysis of citizens’ motivations to engage in client councils enables us to identify four types of citizen co-producers, which we label: the semi-professional, the socializer, the network professional, and the aware co-producer. Implications for future research studying citizens’ motivations in a broader range of co-production cases are discussed.     

Public and Patient Engagement in Commissioning in the English NHS: An idea whose time has come?

Abstract

Public and patient engagement (PPE) has a limited record of achievement in the English National Health Service (NHS), and this has been further complicated by the split between commissioning and providing remits. The passage of the NHS and Social Care Act 2012 has opened up new possibilities for enhancing PPE in the commissioning of health care. This article outlines the new context, describes a conceptual framework for locating different sorts of PPE activity, and provides some practical illustrations. It argues for greater conceptual clarity and clearer understandings on the purpose of PPE as prerequisites to change.     

A Mediating Effect of Knowledge Integration and Moderating Effect of Organizational Task Environment

ABSTRACT

In order to clearly analyse how IT-driven knowledge management capability affects enterprise’s breakthrough innovation activities, this paper systematically constructs a mechanism model of IT-driven knowledge capability influencing enterprise’s breakthrough innovation based on knowledge absorption capability theory, knowledge integration theory and organisational task environment theory. Through enterprise survey data, it is found that IT-driven knowledge competence has a significant positive impact on enterprise breakthrough innovation through enterprise knowledge integration, and organisational task environment effectively regulates this impact relationship.