The nature of innovation in hospital building design: a mixed grounded theory study

Abstract

PurposeDespite the undeniable need for innovation in hospital building design, the literature highlights the disconnect between research and practice as the primary knowledge gap hindering such innovation. This study shows this focus to be an oversimplification, for the complex processes that trigger design innovations and impact their ecosystems need to be examined from a systemic perspective. This paper aims to conceptualise the evolution of hospital building design and identify and explain the main factors triggering design and construction innovations over the past 100 years.Design/methodology/approachA novel hybrid research design to mixed grounded theory (MGT) methodology, with Charmaz constructivist paradigm, is developed as a new systematic way of constructing and interpreting the concepts and interconnections among them that triggered design innovation.FindingsThis study represents a taxonomy of concepts and an explanatory innovation framework, containing 617 interconnections between 146 factors classified across 14 categories. The complex innovation ecosystem comprises multi-faceted processes between heterogenous factors with both individual and collective impacts on design innovations.Originality/valueThis research highlights the main components of the innovation ecosystem and its overall behaviour in this field, and the most influential and interrelated contextual factors, as well as representing and mapping generative interactions that support innovation processes. This knowledge can help hospital researchers, designers, policymakers and stakeholders adopt a multidimensional outlook to analyse the strength of all influential factors, introduce potential novel ways of collaborating, conceptualise an organisational approach, re-formulate research questions through transdisciplinary methods and introduce interdisciplinary courses and programs in architecture schools, thereby contributing to timely design innovation.