Workplace Innovation in Healthcare Ecosystems

We are in a perfect storm. Even before the current pandemic struck, our care delivery systems were increasingly struggling with major new challenges such as rapid aging of the population, the greater longevity of people with multiple chronic conditions, the growing number of medical specialties, rapid technological advancement, and increasing healthcare costs.

Moreover, for individual organisations it is no longer enough to just be organisationally sound – having a vibrant connection to the larger ecosystem is essential. For instance, in Covid-19 times, hospitals not only need to reorganise their internal work processes, and take specific health and safety measures, they also must collaborate with other hospitals for balancing the amount of covid-19 patients in each hospital, support and listen to what primary care workers are doing, monitor the evolution of the infection spread in the population, formulate coordinated advice to policy makers, deal with media coverage of the pandemic, and so on.

Tackling these challenges requires that care delivery increasingly becomes seen as a shared outcome of the deployment of multiple actors at the level beyond single organisations or even formal networks. Fortunately, many different people and organisations are currently mobilising to work together in innovative ways to fight the spread of the Corona virus and to handle the care needs of people with Covid-19 infections. Those actors include individuals, such as GPs, independent nurses, and people with care needs; formal organisations, such as hospitals, home care organisations and schools; and formal networks such as mental health care networks. Although all these actors are not within a single structured entity, the Covid-19-related outcomes (i.e. – number of infections, number of people hospitalised, and also the social and economic consequences of the different measures) are being co-produced by all these actors – either directly or indirectly, either in a successful or less successful way.

As a structured approach, Workplace Innovation is an indispensable part of the way towards care that is more integrated, not only at the level of individual organisations and formal networks, but, as the current pandemic teaches us, also at the level of what we refer to as the wider ‘care ecosystem’. However, such ecosystem level workplace innovation calls for new ways of seeing, new frameworks and new practices. In our recent book Designing Integrated Care Ecosystems we argue that an ecosystem perspective on workplace innovation may support better understanding of possibilities and subsequent application of workplace innovation strategies, enabling new and better forms of integration between different actors and different activities. The book describes 15 care ecosystem redesign cases from Asia, Europe and North America. Using these and our own experience, we developed a prototype framework for ecosystem redesign, and we distilled some lessons for practice from these different case stories.

Prime among these lessons for practice is the shift from seeing the world through linear and segmented lenses, to seeing it as a continually emerging coalition of actors, resources and possibilities. This ecosystem perspective offers care policy makers, managers, practitioners, patients and scholars a way to view the bigger picture, in which interdependencies between many different activities and actors come to light, and previously hidden possibilities come to the surface. The ecosystem perspective helps us to better understand complex health system challenges, and design better strategies and solutions to address them. When the ecosystem’s many different stakeholders are meaningfully involving in the design of workplace innovations through dialogical and strength based processes, not only is resistance to change greatly reduced and the quality of the solutions improved, but the very relationships which will be required during the journey toward more integrated care creates are strengthened .

The Corona pandemic shows us that improved care coordination at the ecosystem level is, for an important part, an issue of Workplace Innovation, aimed at organising care workplaces in a more integrated, efficient and effective way. Workplace Innovation, when applied through an ecosystem rather than an individual organisation perspective can increase the quality of outcomes, reduce costs, enhance patient experience and improve staff quality of working life.