Innovation management as a relevant task for hospitals

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1 Innovation management as a relevant task for hospitals COLLIN Conference, Kiel Carsten Schultz Seite 1

2 Extended data basis on innovation management in hospitals 296 Hospitals 20 University hospitals 15 Federal States 194 Projects 332 Surgeons 3147 Publikations 1) INNO HOSPITAL GERMANY INNO BEHAVIOR USA 1.5 Mio 1) treated patients 561 Respondents 257 Surgeons 2289 Publikations 1) ) Answers 18 University hospitals (AMCs) 1) Sum in patient patients 2) Sum questions Supported by BMBF 1) Sum Publications in PubMed and MedLine Supported by DFG Additional studies on the management of innovations in health care: EPRD: Acceptance of process innovation the case of the German endoprosthesis register KOPS: Coordination of victim help and psychological support IMIV: IT-based Management of integrated networks EIVE: Development of innovative care structures for rare diseases Clinical Trials: Success Factors of clinical trials Seite 2

3 Innovation = Research? Seite 3

4 Innovations in Hospitals: Development and implementation of new and improved medical offers and processes with the aim to New and improved medical offers New and improved processes internal Focus External Focus Krankenkasse Versicherungsverhältnis Patient Vergütung Hausärzte Behandlung improve medical outcomes and efficiencies and to increase economic returns of hospitals Fachärzte Krankenhäuser Netzwerk- Management Apotheken REHA Heilberufe Seite 4

5 Innovation activities differ between hospitals When the wind of change is blowing some build shelters while others build wind mills Additional service offerings Medical care innovation Innovation in cross-sectoral processes Innovation in close to patient processes Innovation in distant to patient processes Ø Bottom 15% Ø Top 15% Hospitals / sample: 108 German hospitals, 375 respondents, InnoHospital (2012) Seite 5

6 Innovations increase employee motivation and retention! Limited resources Organizational barriers Not Invented Here No time, no support, no resources! Something has to change! It is possible? Super, let us look for solutions! Support by top management Acceptance by colleagues Clear processes Feed Back No way! It s not that bad. That was worth it! Seite 6

7 Innovations in hospitals are challenging I Individual innovation activities of hospitals are stressed by. R&D Pressure (Exploration) & Efficiency Pressure (Exploitation) 7 Seite 7

8 Innovations in hospitals are challenging II The need for organizational ambidexterity The limited (management) capacities Product innovation in industry day-to-day business 100% Innovation in hospitals Continuous improvement O Reilly/Tushman(2004) Substantial Innovations Leifer (2007) Seite 8

9 Innovations in hospitals are challenging III High risk and personal responsibility Time critical daily work Low failure tolerance, limited experimentation Functional silos and strong hierarchies Limited inter-functional cooperation Limited participation of employees Bad communication Identification with the own profession but hardly with the organisation Innovationsbarrieren Management-employee conflicts Frequently underdeveloped controlling Missing strategic orientation Limited individual commitment for organizational change tit for tat exchange Difficult identification of innovation needs and effects Randominnovations See Schultz et al. (2011); Nembhard et al. (2009) Seite 9

10 Tasks of innovation management Definition of innovative medical offers Innovation launch and diffusion Maintaining of innovation power Invention Innovation Innovative Hospital Sustainable Success Single Success Single Success Idea established Idea established Product / Process implemented Idea established Product / Process implemented Seite 10

11 Innovation has multiple sources Innovation as strategic and planed process Idea Generation Idea Selection Development Implementation Innovation as creative and interactive process Participation Communities Teams Promotors Hierarchies & Silos Open Culture Incentives & Support Aceptance Seite 11

12 Key success factors for innovations in hospitals 1. Systematic strategy development and communication 2. Get champions engaged in innovation projects 3. Participation of employees in idea generation and selection 4. Use of formal control systems as guidelines for innovation processes 5. Systematic analysis of benefits and risks of innovations for project selection and risk management 6. Partner up! (down stream and up stream medical partners, medical technology, and with patients) 7. Start building, enhancing, and sustaining an innovation friendly culture! 12 Seite 12

13 Clear defined formal innovation processes allow to combine medical and innovation tasks Idea Development Idea Selection Development Implementation Gates Implementation Idea collection & evaluation Definition Analysis & Concept Feasibility Study Development, Validation & Tests Qualification SOPs Infrastructure, Procurement (Market-) Launch Project termination & evaluation Communication Seite 13

14 Effects of formal controls on the individual research outputs of surgeons NB Regression, Random Effects, gglamm, N= 251 surgeons, 18 AMCs, unstand. coeff. (log scale) Model 1 Model 2 Model 3 Model 4 Model 5 Model 6 Intercept 3.25*** 3.35*** 3.38*** 3.40*** 3.42*** 3.47*** Age.27***[ ].28***.32***.30***.32***.30*** H2: R&D Process Formalization *** H3: R&D Incentives.19***.25***.20***.21*** H2a: Exploration X Formalization.09***.16*** H3a: Exploration X Incentives -.06*** -.12*** H2b: Exploitation X Formalization -.18** -.06*** H3b: Exploitation X Incentives.03** -.03 H2c: Ambidexterity X Formalization.36*** H3c: Ambidexterity X Incentives -.09** Log Likelihood LL Ratio Chi-square (df) 60.8 (3)*** 192(2)*** 87.8(2)*** 171(2)*** 149(4)*** p: * <.05; ** <.01; *** < Seite 14

15 Dedicated innovation functions as key step towards professionalized innovation processes Centralized planning fosters coordination of interdependent projects Natural link between strategy and project level Better risk and portfolio management Provision of necessary support functions (project management office) Accumulation of knowledge Seite 15

16 Effects of dedicated functions for innovation management PLS Regression, N= 158 hospitals, stand. coeff. Hypotheses Path coefficients H1 Proactiveness > Innovation activity 0.30** H2 Proactiveness > Innovation performance 0.25** H3 Innovation process formalisation > Innovation activity n.s. H4 Innovation process formalisation > Innovation performance 0.19** H5 Extent of a dedicated innovation function > Proactiveness 0.17* H6 Extent of a dedicated innovation function > Innov. process formalisation 0.21** H7 Extent of a dedicated innovation function > Innovation activity 0.16* H8 Extent of a dedicated innovation function > Innovation performance -0.22** Controls > Proactiveness 0.35** Controls > Innovation process formalisation n.s. Controls > Innovation activity 0.18* Controls > Innovation performance n.s. R² = 0.28 Seite 16

17 Innovators have to kiss a lot of frogs. in order to get 1 prince Therefore Go for the ponds where the high potential frogs are. (Have an innovation strategy & secure good initiatives) Let the right people kiss a limited number of frogs. (Build good teams and give room for champions) Kiss the frogs skillfully and creatively. (Build on partners and generate valuable information) Avoid double kissing, kill the unsuccessful frogs. (Have a formalized process with strict gates) Seite 17

18 Remember Demonstrate commitment to those who are kissing me! Never stop kissing me!! Seite 18

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