Research in focus: Strategic management of individuals and innovation: Case studies in a hospital context.

The economic success of organizations is associated to a greater or lesser degree with their capacity to innovate. Aware of the advantages of innovation for companies, organizations from various sectors have aimed to develop products, services or processes that create a competitive advantage. Similarly, organizations in the hospital sector have made significant investments in innovation, concentrating on developing new diagnostic and therapeutic technologies that decrease the high indices of healthcare mistakes.

However, such innovations have proved to be insufficient in terms of improving the quality of services and reducing costs. The conservative nature of health organizations is identified as a main factor of the failure of innovations in the sector in addition to the absence of a strategic vision for moving forward in healthcare quality and increasing patient safety. In this context, the greatest challenge for these institutions is overcoming the organizational and cultural aspects of healthcare practice that undermine the success of the innovations that are introduced.

Interested in understanding how organizational variables and human resources management practices can favor innovation in hospital organizations, FGV-EBAPE professor Ana Carolina Queiroz, USP professor Lindolfo Galvão de Albuquerque, and FGV-EAESP professor Ana Maria Malik conducted a study on three hospitals, two Brazilian hospitals and one American hospital. These organizations were chosen because they are recognized as having adopted innovative solutions in the healthcare sector. The three institutions have also been accredited by the Joint Commission (in the United States) or by the Joint Commission International (in Brazil), which indicates that they are comparable in relation to the services that they provide.

Hospital A, which is recognized as possessing the most sophisticated equipment for the treatment of highly complex diseases in Latin America, has a structure that is similar to a professional bureaucracy. In recent years, the hospital has implemented innovations in its personnel management practices, including changes aimed at increasing employee loyalty and forming multiprofessional teams. Among these changes, the most significant are the separation of medical practice from healthcare practice, the designation of corporate staff to monitor and control healthcare standards and the increase in investment in professional training and development .

Hospital B, which is located in the United States, may be regarded as the most innovative of the studied institutions. It develops products and services that have a significant impact on the medical area. The hospital’s organizational model is based on a matrix structure that consists of multiprofessional teams, with different specialists collaborating on patient treatment. To integrate the different specializations, IT resources are used, such as electronic patient records and online test results. Another factor that contributes to this integration is the cooperation of the family doctor, who is responsible for sharing information on patients and for forwarding it to the teams.

Hospital C is a leading institution in cardiology in Latin America. As the hospital is smaller than the other two hospitals, its progress in administrative modernization has been slower. However, it has made significant changes to its structure, evolving from a centralized mechanistic model to a functional one, and to its staff management practices, through which it has improved communication and the integration of new areas into the organization. Consequently, it has decentralized its decision-making process, encouraged working in multiprofessional teams and employed new performance evaluation methods.

The researchers concluded that the studied hospitals are at different stages of organizational development. Hospital B has personnel management practices that are aligned with a matrix structure and with its wider organizational strategy, which includes innovation as one objective. At the Brazilian hospitals, the adoption of flexible organizational and personnel management practices that encourage innovation has occurred in response to market pressures, the demands of certification processes or the need to remain on an equal footing with industry peers. However, the authors emphasize that this ‘copycat’ approach has benefited these organizations and helped bring about changes in the rigid structure that had been hindering innovation.

Queiroz, Albuquerque and Malik state that organizational and personnel management variables cannot be directly related to the innovations made by these institutions. However, when comparing the hospitals, the researchers conclude that these variables may favor innovation. They stress that “when the organizational strategy includes innovation objectives and when the variables of the organizational context and staff management policies and practices are aligned with these objectives, the healthcare organization is capable of overcoming the cultural and organizational limitations that are inherent to its practices”.
 
Contact the author Ana Maria Malik.
 
Learn more about the research conducted by Ana Maria Malik.