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Practitioners' Perceptions of the Process of Innovating in Health and Social Care in Rural Wales
Swansea University Author: Stephanie Best
The impetus for this study arose from increased interest and drive for innovation in health and social care (H&SC) in Wales. As demands, needs, and expectations for H&SC rise exponentially and outstrip resources (Wanless,2003), there has been increasing pressure for innovative practice. Addi...
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The impetus for this study arose from increased interest and drive for innovation in health and social care (H&SC) in Wales. As demands, needs, and expectations for H&SC rise exponentially and outstrip resources (Wanless,2003), there has been increasing pressure for innovative practice. Additional stresses, such as access to health and social care (H&SC) (Wilson et al2009) and an ageing population (Stockdale & Philip,2011), has resulted in rural communities experiencing this pressure more acutely than urban centres. Despite its obvious importance, innovative H&SC service delivery has lain somewhat moribund. This may in part be due to the complexity of innovating in health care as demonstrated by Plesk and Greenhalgh (2001). Equally the gap in literature between clinical research and implementation of innovation (Grol, 2001) as well and management and innovative practice (Shapiro et al, 2007) has been noted. As such, this research on innovation amongst H&SC practitioners in rural contexts is timely and addresses some of the gaps both in academic and practitioner knowledge, further adding to the originality of the current study. Early work on the process of innovation (Rogers, 1962), stresses the social element of innovating, this focus also underlies the current study. The Rural Health Local Innovation Projects (RHLIP) established in 2009 provided an opportunity for a Wales-wide study exploring the innovation journey for H&SC practitioners from the generation of novel ideas, through to adoption and implementation, and finally full circle to incorporate practitioners’ perceptions of the practice of H&SC innovating. Accordingly, the research employs the phases of innovation framework outlined by Newell et al (2009). This entails a focus on the initial phases of innovation that require the generation of a credible idea that can be influenced by concepts such as socially constructed knowledge (Newell et al 2009) or networks (Grol, 2001), and social capital (Ferlie et al 2005, Fitzgerald et al 2002). These influences are also found within the adoption and implementation phase of innovative practice. Additionally, Rycroft-Malone et al (2011) provide a dynamic conceptual model for the process of successful innovation implementation that is counter to traditional linear frameworks (e.g.Szulanski,1996) and can be utilised to consider additional factors impacting on the implementation of innovation such as contexts and evidence. Finally, the impact on practitioners of undertaking an RHLIP on future innovating draws on Argyris and Schön’s work (1974) on learning. An inductive mixed methods approach was adopted over three phases of data collection: collation of secondary data; a questionnaire; and in depth interviews. These phases contributed to the generation of five datasets for analysis. Contributions to knowledge from this study are wide ranging and include identification of lack of clarity regarding conceptualising and defining innovation, which, in turn, hinders the innovation process. In addition, the presence of a Credibility Threshold is observed which prevents ideas from surfacing, can inhibit innovation. Reluctance to diffuse knowledge acquired from innovating was, inter alia, prompted by a concern that the practice was not innovative enough. The findings provide a foundation for increased innovative activity and diffusion of knowledge, which will address issues currently experienced by practitioners as well as add to the academic discourse on innovation in practice, specifically in relation to H&SC.
Innovating, practitioners, health and social care
Faculty of Medicine, Health and Life Sciences