Organizational Innovation in Public Sector: the case of Primary Care
Organizational Innovation in Public Sector:
the case of Primary Care
Research project
The broad topic of this research project – organizational innovation in healthcare services - is extremely important but little studied. Most of the research on innovation considers innovation in private companies, and the phenomenon studied tend to be physical products, and the technological processes used to produce them.Toward a combination of two fields of literature – organizational design, on one hand, and public sector innovation, on the other hand – this project aims to contribute to the understanding of innovation processes, in the context of primary care.
In particular, while organizational design refers to the process of decomposition of the organization into subparts (departmentalization), and the consequent integration of those subparts through appropriate coordination mechanisms (Lowrence and Lorsch 1967), the field of studies of public sector innovation focuses on the need toimport innovation in public service provision, starting from the public policy definition (Osborne 2010). This literature distinguishes among:
-Service innovations (SI): new services offered by public organizations to meet users’ needs (Osborne 1998);
-Organizational innovations (OI): changes in the relationships among actors, roles, procedures and structures within the organization(Damanpour et al. 1989);
-Ancillary innovations (AI): changes in relationships across boundaries (Damanpour 1987)with other service providers, users, or other public agencies.
In the context of healthcare, in particular, while SIs are driven mainly by the development of healthcare treatments and technologies, the contribution of organizational design theory can significantly contribute to the implementation of OIs and AIs.
The aim of this project is to study the contribution of organizational design to the innovation in public healthcare system, with a specific focus on primary care.In particular, this research project aims to contribute answering the following research questions:
-How organizational theory can support the implementation of OI and AI in primary care?Which are the drivers of OI and AI in primary care? How they change in different National/Local institutional context?
-Which are the coordination mechanisms adopted to manage integrated primary care initiatives? How are they implemented?
Due to the qualitative nature of the research questions, in this project a multiple case study approach is adopted.
This qualitative approach isconsidered as the most appropriate since it does not aim to establish cause-effect relations among variables, but to determine the basic characteristics of particular modes of organization (Yin, 2009). Furthermore, qualitative tools are potentially powerful instruments to gain understandings of a phenomenon, thanks to their capabilities to gain in-depth information, and to carry out comparative analyses (Alcock and Scott, 2005).
Research program
The research program can be articulated under the following work packages (WP):
WP1: Context analysis
WP1 includes the development of a map of the most significant organizational models adopted in primary care service provision, both at national and international level.
WP2: Theoretical framework definition
WP2 aims to develop the theoretical framework that will be adopted for the empirical analysis. This includes a literature review on the main contributions of both organizational and ancillary innovation in public sector (primary care, in particular), and organizational design in healthcare organizations. Based on the literature review, a first release of the research protocol will be developed.
WP3: Case studies selection
Crossing the theoretical framework of WP2 with the context analysis of WP1, a significant number of case studies for the qualitative assessment (from 3 to 7) will be selected. Through the identification of a list of the key actors to be interview for each case study, the research protocol will be finalized.
WP4: Data Gathering and Analysis
WP4 includes the data gathering phase through semi-structure interviews to the key actors, and focus groups. Secondary data concerning the selected case studies (i.e. reports, financial and social reporting, newspaper articles) will be selected too.Through the adoption of qualitative techniques (i.e. content analysis, comparative tables), data will be analyzed.
Expected outcomes
-With reference to WP1 and WP2, two research reports on the best practices in primary care, and a literature review on innovation in public sector;
-With reference to the results of the overall project, submissions of scientific papers toConferences andJournalsin the field of public administration/healthcare management/nonprofit management.
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