Abstract
BackgroundAre creativity and compliance mutually exclusive? In clinical settings, this question is increasingly relevant. Hospitals and clinics seek the creative input of their employees to help solve persistent patient safety issues, such as the prevention of bloodstream infections, while simultaneously striving for greater adherence to evidence-based guidelines and protocols. Extant research provides few answers about how creativity works in such contexts.MethodsCross-sectional survey data were collected from employees in 24 different U.S.-based outpatient hemodialysis clinics. Linear mixed-effects models were utilized to test study hypotheses. Professional status, clinic climate variables, and interaction terms were modeled as fixed effects, with a random effect for clinic included in all models.ResultsOur results show that high status employees contributed more creative patient safety improvement ideas compared to low status employees. However, when high status employees were part of clinics with a stronger safety climate of compliance, they contributed fewer creative ideas compared to their counterparts working in clinics with a reduced compliance orientation. We also predicted low status employees working in less punitive clinics would contribute more creative ideas, but this hypothesis was not fully supported.ConclusionsThis study suggests that in hospitals and clinics that rely on strict protocols and formal hierarchies to meet their goals, the factors that promote creativity may be distinctively context-dependent. Implications for theory, practice, as well as future directions for research examining creativity in healthcare and safety critical contexts are discussed.
Highlights
Are creativity and compliance mutually exclusive? In clinical settings, this question is increasingly relevant
We explored two dimensions of organizational safety climate hypothesized to influence creativity among higher and lower status staff based upon theoretical relationships proposed in Vogus, Sutcliffe, and Weick’s [21] model of organizational safety and well accepted definitions and measures of creative problem solving from management and organizational behavior research [22]
Results from Model 1 indicated that status was significantly related to Clinic Staff Creativity after accounting for variation between clinics (χ2 = 13.82, p = 0.003)
Summary
Are creativity and compliance mutually exclusive? In clinical settings, this question is increasingly relevant. Much of the existing empirical work to date focuses on organizations in sectors focused on strategic innovation, such as technology firms and research and development laboratories These types of organizations typically try to provide an environment conducive to individual creativity. Employees may be provided with greater opportunities for autonomous work [8], a factor shown to encourage workplace creativity [9] While these types of provisions are possible in some organizations for certain types of roles, great autonomy is not typically characteristic of many of the job roles in safety critical settings, such as health care facilities. Most hospitals and clinics rely on highly specified behavioral protocols to run safely and efficiently
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