Organization

Assess the organization’s capacity for innovation.

An innovative organization has strong leadership, good relationships between healthcare providers and managers, an open management structure, sufficient liquid resources (money and/or employees) for new projects, good lines of communication and an atmosphere in which it is acceptable to take risks and learn from failures. If an organization does not appear to meet these essential conditions for innovation, you should consider whether you need to strengthen the organization’s capacity before proceeding with your implementation. Here are some questions to help you assess innovation capacity:

Is there a culture that supports innovation and change (e.g. are employees given the confidence to put forward new ideas)?

Does the organization have systems and processes in place that support innovation and change, e.g. effective information and communication systems, opportunities for networking and learning between departments and teams?

Does senior management actively seek opportunities for improvement and encourage ideas and feedback from patients, the public and employees?

Does the organization’s leadership contribute to a facilitating environment through motivation and support, creating a vision and strengthening the change process?

Is there an open and committed management style?

Is there a history of successful change implementation in similar projects at the local level?

Are there mechanisms in place to support learning and evaluation and embed changes in daily practice, such as regular team meetings, audit and feedback processes, opportunities for professional development, and performance appraisal systems?

Assess whether innovation and system are aligned.

Even when an organization is able to successfully implement a new technology, it may be the wrong technology to implement in this organization now. Has the organization successfully implemented similar technologies in the past? Are its strategic priorities aligned with the use of the proposed technology? Or are other projects more urgent?

Assess the implications of the technology for the organization.

Tasks and processes must be carefully mapped out to determine how the technology or other innovation might affect them. Processes in which the technology is used directly (e.g. clinical care) may have indirect consequences for other processes and procedures (e.g. booking, correspondence, invoicing). You must estimate the costs (both initial and recurring) and review the necessary financial transactions. Before approving a project, management usually wants to know what investment is required, what the likely savings will be, and when these savings will occur. This resource can help with that:

Assess the level of “political” support for the innovation.

A decision to approve at organizational level can only be taken if it is supported by both senior management (a “senior sponsor”) and employees. There must be more supporters of the change than opponents, and supporters must have a strategic position. People with a lot of (negative) influence can block progress and must be involved (or bypassed). To assess this point, you can use the source below:

Take inter-organizational relationships into account.

The costs and benefits of technology projects are difficult to predict, and savings may arise elsewhere in the system. If there is no prior contractual relationship between organizations, it can be difficult to arrive at a good arrangement for managing these uncertainties.

Consider how (and by whom) success will be evaluated.

If this project goes ahead, you will need to monitor how well the change is progressing. You will almost certainly need both quantitative measurements (to answer the questions ‘how much?’ and ‘are we on track?’) and qualitative measures (to answer the question ‘how do people feel about this?’). Evaluation is everyone's job, and data can often be best collected by the person who usually performs the task. Extensive data collection can be time-consuming and slow down the project (i.e. don't overdo it).

Ensure sufficient budget.

Studies of ‘failed’ technology projects often point to inadequate funding as one of the main causes. You will probably need a significant investment and possibly a recurring budget (for things like licenses and IT support). Budget sufficiently for employee training and give them time to adapt to the new working method (see “Responding to complexity among the intended adopters” above).

Guide the transition.

Good change management involves a combination of “hard” and “soft” approaches. In addition to setting goals and milestones to monitor progress, you must also enable employees to come together and discuss the technology and any changes to working methods. As mentioned above, collective awareness, training (especially on-the-job training for both individuals and teams) and social learning from champions and super users are crucial for building support. Use creative tools such as flipcharts and exercises with post-it notes to bring any misunderstandings and concerns people may have to the surface. Invite them to come up with creative ideas and solutions for the problems they identify.

Allocate sufficient budget for this, and consider matters such as additional staff.