Abstract
BackgroundMiddle managers have received little attention in extant health services research, yet they may have a key role in healthcare innovation implementation. The gap between evidence of effective care and practice may be attributed in part to poor healthcare innovation implementation. Investigating middle managers' role in healthcare innovation implementation may reveal an opportunity for improvement. In this paper, we present a theory of middle managers' role in healthcare innovation implementation to fill the gap in the literature and to stimulate research that empirically examines middle managers' influence on innovation implementation in healthcare organizations.DiscussionExtant healthcare innovation implementation research has primarily focused on the roles of physicians and top managers. Largely overlooked is the role of middle managers. We suggest that middle managers influence healthcare innovation implementation by diffusing information, synthesizing information, mediating between strategy and day-to-day activities, and selling innovation implementation.SummaryTeamwork designs have become popular in healthcare organizations. Because middle managers oversee these team initiatives, their potential to influence innovation implementation has grown. Future research should investigate middle managers' role in healthcare innovation implementation. Findings may aid top managers in leveraging middle managers' influence to improve the effectiveness of healthcare innovation implementation.
Highlights
Middle managers have received little attention in extant health services research, yet they may have a key role in healthcare innovation implementation
Summary: Teamwork designs have become popular in healthcare organizations
This is followed by a brief review of literature that has suggested that middle managers influence innovation implementation in industries other than healthcare
Summary
Middle managers are largely overlooked in extant healthcare innovation implementation effectiveness research An innovation is ‘an idea, practice, or object that is perceived as new by an individual or another unit of adoption’ [14]. Middle managers’ role may be important for healthcare innovation implementation because they can encourage employees to prioritize innovation implementation amidst many competing demands; transcend complex staffing and operations to provide relevant information regarding innovation to employees; leverage their position over project teams to promote innovation implementation; and translate organizational strategy into clinically relevant terms. By diffusing information, synthesizing information, mediating between strategy and day-to-day activities, and selling innovation implementation, middle managers contribute to a climate in which innovation implementation is rewarded, supported, and expected (an organization-level construct). This implementation climate promotes consistent, high-quality innovation use (an organization-level construct; see Figure 1). Top managers could promote the fulfillment of these roles by: Ensuring that middle managers are privy to strategy related to innovation implementation; without information regarding strategy, middle managers would lack the knowledge required to educate, support, and encourage employees to implement innovations; giving middle managers the freedom to educate, support, and encourage employees; ensuring that middle managers have access to resources necessary to translate strategy into day-to-day activities; for example, if top managers envision information systems to be a key strategy for implementing an innovation such as the HDC, middle managers will require information systems training to better support employees’ use of the technology; and expressing their own commitment to innovation implementation; doing so would convey to employees consistent commitment to innovation implementation throughout the organization
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