HSRN Symposium 2014
Title: Developing and implementing service innovation in the provision of
glaucoma outpatient clinics: the problem of aligning multiple organisational
actors
Authors: Simon Turner1*, Christos Vasilakis2*, Martin Utley1, Paul Foster1,
Aachal Kotecha1, Steve Morris1, Naomi Fulop1
Institution: 1University College London 2University of Bath
Job title: 1*Senior Research Associate; 2*Senior Lecturer
Email addresses: simon.j.turner@ucl.ac.uk; cv280@management.bath.ac.uk
Presentation
Abstract
Background: The role of professional groups and organisational factors in mediating
the implementation of service innovation within hospitals is well documented. Studies
at the organisational level tend to focus on intra-organisational processes e.g.
receptivity of the organisational culture, the nature of clinical-managerial relations,
and inter-professional communication. This paper also focuses on organisational
interactions in the innovation process, but describes the involvement of a wider range
of stakeholders, internal and external to hospitals, that influence the development
and implementation of service innovation, including clinicians, operational managers,
management consultants, technology organisations, and commissioners.
Methods: Two case studies focusing on the development of clinical service redesign
projects within the ophthalmology service of an acute NHS hospital are presented.
Service redesign aimed to increase the capacity of overrunning outpatient glaucoma
clinics. Stakeholder interviews (23) and non-participant observation (36.5 hours) took
place of outpatient clinics and service and directorate level meetings in which the
projects were discussed. Operational research techniques were used to map patient
flows within the clinics.
Results: Drawing upon actor-network theory, socio-technical analysis was used to
explore how these multiple stakeholders shaped the implementation of innovation.
Findings describe different stakeholders’ perceptions of the organisation of existing
outpatient clinics, the drivers within the hospital for improving the running of clinics,
and the development of the two service improvement projects studied.
Implications: The implementation of ‘local’ service innovation involves a range of
‘internal’ and ‘external’ stakeholders; what types of innovation management
processes do health care providers need to support their alignment?