A large-scale longitudinal study indicating the importance of perceived effectiveness, organizational and management support for innovative culture

• Published in: Social science & medicine (1982) Vol. 83; pp. 119 - 124
• Main Authors: Cramm, Jane M., Strating, Mathilde M.H., Bal, Roland, Nieboer, Anna P.
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01-04-2013; Elsevier; Pergamon Press Inc
• Subjects: Adult; Aged; Attitude of Health Personnel; Biological and medical sciences; Collaboration; Cooperation; Culture; Female; Humans; Innovation; Innovations; Innovative culture; Interprofessional Relations; Intervention; Long Term Care; Long term health care; Long-Term Care - organization & administration; Longitudinal Studies; Male; Management; Management support; Medical personnel; Medical sciences; Middle Aged; Miscellaneous; Multilevel Analysis; Netherlands; Organizational Culture; Organizational Effectiveness; Organizational Innovation; Organizational support; Perceived effectiveness; Public health. Hygiene; Public health. Hygiene-occupational medicine; Quality improvement; Quality Improvement - organization & administration; Quality improvement collaboratives; Quality of Health Care; Sex; Social Support; Surveys and Questionnaires; The Netherlands; Young Adult; Netherlands; Europe; The Netherlands; Management support; Quality improvement; Perceived effectiveness; Quality improvement collaboratives; Innovative culture; Organizational support; Human; Statistical analysis; Improvement; Innovation; Efficiency; Follow up study; Quality; Perception; Social medicine; Cultural aspect; Public health; Social support
• ISSN: 0277-9536; 1873-5347
• DOI: 10.1016/j.socscimed.2013.01.017

Teams participating in QI collaboratives reportedly enhance innovative culture in long-term care, but we currently lack empirical evidence of the ability of such teams to enhance (determinants of) innovative culture over time. The objectives of our study are therefore to explore innovative cultures in QI teams over time and identify its determinants. The study included QI teams participating between 2006 and 2011 in a national Dutch quality program (Care for Better), using an adapted version of the Breakthrough Method. Each QI team member received a questionnaire by mail within one week after the second (2–3 months post-implementation of the collaborative = T0) and final conference (12 months post-implementation = T1). A total of 859 (out of 1161) respondents filled in the questionnaire at T0 and 541 at T1 (47% response). A total of 307 team members filled in the questionnaire at both T0 and T1. We measured innovative culture, respondent characteristics (age, gender, education), perceived team effectiveness, organizational support, and management support. Two-tailed paired t-tests showed that innovative culture was slightly but significantly lower at T1 compared to T0 (12 months and 2–3 months after the start of the collaborative, respectively). Univariate analyses revealed that perceived effectiveness, organizational and management support were significantly related to innovative culture at T1 (all at p ≤ 0.001). Multilevel analyses showed that perceived effectiveness, organizational support, and management support predicted innovative culture. Our QI teams were not able to improve innovative culture over time, but their innovative culture scores were higher than non-participant professionals. QI interventions require organizational and management support to enhance innovative culture in long-term care settings.
► QI teams are increasingly used to improve the effectiveness and quality of healthcare and enhance innovative culture. ► Innovative culture was substantially higher among teams participating in QI collaboratives compared non-participating teams. ► QI teams were, however, not able to improve innovative culture over time (between 2006 and 2011). ► Perceived effectiveness, organizational support and management support are critical to innovative culture.