Antecedents of innovative work behaviour in healthcare: does efficacy play a role?

• DOI: https://doi.org/10.1108/IJPSM-12-2018-0267
• Pages: 45-61
• Published date: 23 October 2019
• Date: 23 October 2019
• Author: Chiara Oppi,Afsaneh Bagheri,Emidia Vagnoni
• Subject Matter: Public policy & environmental management,Politics,Public adminstration & management

Antecedents of innovative work

behaviour in healthcare: does

efficacy play a role?

Chiara Oppi

Department of Economics and Management, University of Ferrara, Ferrara, Italy

Afsaneh Bagheri

Department of Entrepreneurship Development, Faculty of Entrepreneurship,

University of Tehran, Tehran, Iran, and

Emidia Vagnoni

Department of Economics and Management, University of Ferrara, Ferrara, Italy

Abstract

Purpose –Exploring how to enhance innovative work behaviour (IWB) has been the main concern of top

managers and researchers, particularly in knowledge-intensive and public organizations. Yet, studies

investigating factors that shape innovative behaviour at work are scarce. Focussing on the healthcaresetting,

the purpose of this paper is to hypothesize a direct relationship between individuals’perceived creative

self-efficacy (CSE), creative collective efficacy (CCE) and IWB.

Design/methodology/approach –The research used survey data from 446 clinical managers working in

public healthcare organizations in six different Italian regions and a set of previously validated

questionnaires to measure the study variables.

Findings –Findings suggest that clinical managers’perceptions of their CSE and their perceived CCE

significantly influence their self-reported IWB.

Research limitations/implications –Findings highlight the importance of constructing and developing

clinical managers’efficacy in creativity at both an individual and team level in order to incentivize the

emergence of innovation behaviour. Further research is needed to assess the existence of mediating and/or

moderating mechanisms underlying the relationships emerging from this study in order to support decision

makers in diffusing innovation and creativity in healthcare organizations.

Originality/value –The research adds to the debate on improving IWB by introducing perceived individual

and team creative efficacy as determinants of IWB in healthcare organizations. The research is among the

first attempts to contribute to healthcare organizations’management through exploring clinical managers’

characteristics that influence their IWB.

Keywords Creative self-efficacy, Clinical managers, Healthcare organizations, Innovative work behaviour,

Team creative self-efficacy

Paper type Research paper

Introduction

After the implementation of New Public Management reforms, innovation gained

increasing relevance in the public sector (Gonzalez et al., 2013). Innovation is frequently

recognized as a critical driver for quality improvement and as a way to increase an

organization’s capability to deal with environmental challenges (Damanpour and

Schneider, 2009; De Vries et al., 2016). Innovation also plays a strategic role in public

organizations due to their high complexity (Mintzberg, 1983) and knowledge-based

processes (Richards and Duxbury, 2014). However, innovation in the public sector

undergoes more public scrutiny, sometimes before the innovation is fully developed, than

private sector innovation (Albury, 2005). Specifically, in the healthcare sector, innovation

in clinical and managerial processes generates both positive and negative outcomes,

because it entails financial, social and ethical risks (Länsisalmi et al., 2006).

The emergence of innovation in the public sector consistently relies on employees’and

teams’creative capabilities (Damanpour and Schneider, 2009; Bantel and Jackson, 1989),

International Journal of Public

Sector Management

Vol. 33 No. 1, 2020

pp. 45-61

© Emerald PublishingLimited

0951-3558

DOI 10.1108/IJPSM-12-2018-0267

Received 20 December 2018

Revised 27 May 2019

12 August 2019

Accepted 15 September 2019

The current issue and full text archive of this journal is available on Emerald Insight at:

www.emeraldinsight.com/0951-3558.htm

45

Antecedents of

innovative

work behaviour

in healthcare

although few studies have investigated the consequences of individuals’and groups’

creativity on their innovation behaviour (Shalley et al., 2004). Innovation capabilities in

public sector knowledge-intensive organizations (Bos-Nehles et al., 2017) are related to the

extent of employees’perceptions of less formal control over their activities and more

opportunities for self-development and knowledge sharing.

In healthcare, the role of health professionals and their innovative capabilities is

extremely important in revising standards, adopting new care paths (West and Wallace,

1991; Bagheri and Akbari, 2018), implementing a new managerial culture (Abernethy and

Stoelwinder, 1995) and shaping their new role as managers (Kurunmaki, 2004). In this

setting, clinical managers have become the key professionals to enhance both clinical and

managerial innovations (Lapsley and Wright, 2004). They are responsible for the results of

clinical units in terms of outcomes, quality and efficiency (Marcon and Panozzo, 1998) and

have been required to adopt accounting technologies to communicate strategies and

objectives and share information with their peers at lower levels (Llewellyn, 2001).

Therefore, clinical managers’capabilities to innovate and infuse innovation in their

organizations are crucial to align the management of healthcare organizations with

government’s expectations. However, it can be difficult to foster innovation when clinicians

resist changes and tend to protect their autonomy and reputation (Länsisalmi et al., 2006).

Despite the risks of enhanced innovation, public sector and healthcare organizations

should encourage the development of managers’innovative work behaviour (IWB) by

creating a supportive work environment to enhance organizational performance (Shanker

et al., 2017). The management literature (Scott and Bruce, 1994; Yuan and Woodman, 2010)

has long related IWB determinants to informal norms and attitudes in organizations.

Among these, creativity appeared to be a precondition for the development of innovation

(Tierney and Farmer, 2002; Kessel et al., 2012). The literature emphasized the importance

of knowledge sharing and employee engagement to translate organizational capital

into individual IWB (Mura et al., 2012; Alfes et al., 2013), which is relevant to the role of

clinical managers.

Despite the importance of developing employees’IWB to promote organizational

innovation, particularly in knowledge-intensive organizations (Damanpour and Schneider,

2009; Bos-Nehles et al., 2017), few studies have attempted to explore the determinants of

IWB in healthcare (Bagheri and Akbari, 2018; Kessel et al., 2012; Malik et al., 2016). Newman

et al. (2018) recently suggested the significant impact of individual employees’creative

self-efficacy (CSE) on their IWB. However, there is a huge gap in our knowledge on the role

of creative collective efficacy (CCE) in directing the innovative behaviour of employees (as

requested by Dampérat et al., 2016), although a few authors provided support for the

potentialities of CCE as a predictor of IWB (Salanova et al., 2014).

This paper aims at investigating managers’perceptions of CSE and CCE as predictors

of IWB to provide further evidence of the alignment of the IWB of human capital with

organizational needs in the public healthcare sector. Through a survey of 446 clinicians

with managerial responsibilities (responsible for health units and departments) working

in Italian public healthcare organizations, the paper extends the literature about the

determinants of IWB. This research is a response to the call to further explore

the antecedents of innovation in the public sector and, in particular, the factors that

determine actors’innovation capabilities in terms of intra-organizational dynamics that

influence IWB (De Vries et al., 2016). In addition, this paper addresses the calls for

empirical studies that examine simultaneously individualand group creativity (Woodman

et al., 1993), and CSE and CCE (Bissola et al., 2014). Testing the impact of CSE and CCE on

IWB in public sector knowledge-intensive organizations, the paper also addresses

Damanpour and Schneider’s (2009) call for conducting studies on innovation in non-

Anglo-Saxon countries and in non-governmental public organizations.

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