Torsten Oliver Salge

Hospital innovativeness and organizational performance: evidence from English public acute care.

BACKGROUND Hospitals around the world dedicate increasing attention and resources to innovation. However, surprisingly little is known about the nature of hospital innovativeness and its relationship with organizational performance. Given both the specific characteristics of the hospital sector and the rather mixed evidence from other industries, a positive innovation-performance link should not be taken for granted but requires empirical examination. PURPOSES The purposes of this study were to introduce a perspective of hospitals as vital generators of innovation, to unpack the concept of innovativeness, to propose a measurement model for hospital innovativeness, and to empirically investigate the innovativeness-performance relationship. METHODOLOGY We conducted a large-scale empirical study among the entire population of public hospital organizations that are part of the English National Health Service (n = 173) and analyzed the data using exploratory factor and regression analyses. FINDINGS Our analyses suggest a significant positive relationship between science- and practice-based innovativeness and clinical performance but provide less unambiguous support for the existence of such a relationship between innovativeness and administrative performance. In particular, we find that higher levels of innovativeness are rather associated with superior quality of care than with measurable bottom-line financial benefits. PRACTICE IMPLICATIONS Hospitals investing in innovation-generating activities might find their efforts well rewarded in terms of tangible clinical performance improvements. However, to achieve measurable financial benefits, numerous hospitals have yet to discover and capture the commercial value of some of their innovations-a challenging task that requires a holistic innovation management and an effective network of complementary partners.

Small Steps that Matter: Incremental Learning, Slack Resources and Organizational Performance

This paper examines the antecedents, consequences and moderators of incremental learning capabilities, understood as an organizations ability to gradually adapt and expand its knowledge base. Conceptualized as a dynamic capability, incremental learning is expected to be a vital driver of organizational adaptation. As dynamic capabilities consist of bundles of relatively stable routines, it is proposed that an organizations level of incremental learning capabilities will be highly persistent over time. It is also argued that building and exercising incremental learning capabilities is resource intensive and will as such tend to rely on the availability of sufficient slack resources. Last, it is suggested that incremental learning will be positively related to organizational performance, especially when the underlying business model is labour rather than capital intensive. To test these theoretical ideas, the authors draw on extensive panel data from all public non‐specialist hospitals in England and find broad support for their hypotheses.

Seamless Service? On the Role and Impact of Service Orchestrators in Human-Centered Service Systems

How can value cocreation in complex human-centered service systems (HCSSs) like health care be facilitated? We address this question by introducing the novel role of service orchestrators as dedicated actors who facilitate and orchestrate resource integration, and thereby value cocreation, between other interdependent actors in HCSSs. Specifically, we draw on findings from four complementary studies that investigate the role and impact of case managers, an ideal-typical service orchestrator in health care, through the perspectives of HCSS actors (i.e., patients in Study 1 and clinical staff in Study 2) and structures (i.e., clinical departments in Studies 3 and 4). Our findings indicate that orchestrating value cocreation through case managers enhances patient satisfaction as well as the financial and operational performance of clinical departments. Service orchestration also increases the perception of clinical staff that patients are actively involved in the cocreation of their own health service but surprisingly not that of patients themselves. As such, introducing service orchestrators might contribute to reconciling the growing tension between the quality and cost of health care. We conclude by outlining how our work serves as a possible starting point for a novel research stream on effective coordination mechanisms for value cocreation in complex HCSSs.

Fighting MRSA Infections in Hospital Care: How Organizational Factors Matter.

OBJECTIVE To identify factors associated with methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections at the level of the hospital organization. DATA SOURCES Data from all 173 acute trusts in the English National Health Service (NHS). STUDY DESIGN A longitudinal study based on trust-level panel data for the 5-year period from April 2004 to March 2009. Fixed effects negative binominal and system generalized method of moment models were used to examine the effect of (i) patient mix characteristics, (ii) resource endowments, and (iii) infection control practices on yearly MRSA counts. DATA COLLECTION Archival and staff survey data from multiple sources, including Public Health England, the English Department of Health, and the Healthcare Commission, were merged to form a balanced panel dataset. PRINCIPAL FINDINGS MRSA infections decrease with increases in general cleaning (-3.52 MRSA incidents per 1 standard deviation increase; 95 percent confidence interval: -6.61 to -0.44), infection control training (-3.29; -5.22 to -1.36), hand hygiene (-2.72; -4.76 to -0.68), and error reporting climate (-2.06; -4.09 to -0.04). CONCLUSIONS Intensified general cleaning, improved hand hygiene, additional infection control training, and a climate conducive to error reporting emerged as the factors most closely associated with trust-level reductions in MRSA infections over time.

Talk to Your Crowd

OVERVIEW: When crowdsourcing intermediaries lose crowd members, they lose potential high-quality solutions in the future. As the number of contests and intermediaries grows, it is increasingly critical for crowdsourcers to meet the needs of solvers and avoid seeing them migrate to the competition. Besides winning contests, intensive communication and customized feedback are solvers’ most central needs. For this study, we surveyed 202 solvers about the importance of communication in crowdsourcing contests. Based on our quantitative and qualitative insights, we derive key principles that can help crowdsourcers maintain and grow their solver base.

DON’T GET CAUGHT ON THE WRONG FOOT: A RESOURCE-BASED PERSPECTIVE ON IMITATION THREATS IN INNOVATION PARTNERSHIPS

Innovation partnerships can be a double-edged sword. While they are important vehicles for learning and value creation, such partnerships also increase a firm’s vulnerability to unintended knowledge leakage and imitation by others. In this study, we go beyond previous research by studying the imitation threats induced by innovation partnership portfolios rather than individual alliances. Drawing on the resource-based view, we develop and test a model that links salient structural attributes of partnership portfolios and distinct forms of imitation. Results from our analysis of 803 German manufacturing firms support our prediction that a firm’s probability of being imitated increases with the partnership variety of its portfolio. We also find that firms can mitigate this threat by carefully selecting innovation partners and using appropriation mechanisms.

Talk to Your Crowd: Principles for Effective Communication in Crowdsourcing

OVERVIEW: When crowdsourcing intermediaries lose crowd members, they lose potential high-quality solutions in the future. As the number of contests and intermediaries grows, it is increasingly critical for crowdsourcers to meet the needs of solvers and avoid seeing them migrate to the competition. Besides winning contests, intensive communication and customized feedback are solvers’ most central needs. For this study, we surveyed 202 solvers about the importance of communication in crowdsourcing contests. Based on our quantitative and qualitative insights, we derive key principles that can help crowdsourcers maintain and grow their solver base.

The Social Value of Information Technology: How IT Investments Enhance Hospital Reputation

We expand IT payoff research by shedding light on the social value of IT with a particular focus on the reputational impact of IT investments. We examine mediating mechanisms that link IT investmen...

Content, Contribution, and Knowledge Consumption: Uncovering Hidden Topic Structure and Rhetorical Signals in Scientific Texts:

Knowledge production and scientific discourse are observable in published scholarly texts. Citations capture knowledge consumption and impact. Drawing from the sociology of science, our theoretical framework posits scientific communities as thought collectives with distinctive thought styles that embed a hidden topic structure and rhetorical signals into a journal’s published articles. We hypothesize and uncover how an article’s topic attributes (structure, focus, and newness) and rhetorical attributes (inclusiveness, exclusiveness, tentativeness, and certainty) are related to future knowledge consumption. We empirically test our ideas by applying text mining algorithms to model topics and extract rhetorical signals from 1,646 strategy articles composed of nearly 18 million words generating 172,237 citations over 35 years. We find that strategy articles’ hidden topic structure explains 14% of variance in scientific impact. We also show that topic focus and topic newness each independently, directly, and significantly increase impact. As for newness, the first two articles published on a new topic each generate a citation premium >100%, which is higher within the focal thought collective than outside. Importantly, we find that the citation premium of newness increases with greater topic focus (which attracts attention) and greater inflow of prior intracollective knowledge (which enhances absorption). Impact also increases when authors present new topics using a rhetorical style that is more tentative than certain. Overall, our findings demonstrate that topic and rhetorical attributes, as constitutive elements of scientific content, are independently and interdependently related to the consumption of strategy articles across thought collectives in management research.

A widening gap? Static and dynamic performance differences between specialist and general hospitals

This paper develops and tests a dynamic model of hospital focus. It does so by tracing the performance trajectories of specialist and general hospitals to identify whether a performance gap exists and whether it widens or shrinks over time. Our longitudinal analyses of all hospital organizations within the English National Health Service (NHS) reveal not only a notable performance gap between specialist and general hospitals in particular with regards to patient satisfaction that widens over time, but also the emergence of a gap especially with regards to hospital staff job satisfaction. These findings reflect the considerable potential of specialization as a means to enhance hospital effectiveness. However, they also alert health policy makers to the threat of a widening performance gap between specialist and general hospitals with potential negative repercussions at the patient and health system level.