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Cited by 74Organizational Change and LeadershipOrganizational Management and ChangeAppreciative Inquiry and Organizational Change

Change and Innovation in Healthcare: Findings from Literature

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Milella, Frida, Minelli, Eliana Alessandra, Strozzi, Fernanda, Croce, Davide·2021·ClinicoEconomics and Outcomes Research
DOI 10.2147/ceor.s301169PMC PMC8141398
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Abstract

BACKGROUND: Change is an ongoing process in any organizations. Over years, healthcare organizations have been exposed to multiple external stimuli to change (eg, ageing population, increasing incidence of chronic diseases, ongoing Sars-Cov-2 pandemic) that pointed out the need to convert the current healthcare organizational model. Nowadays, the topic is extremely relevant, rendering organizational change an urgency. The work is structured on a double level of analysis. In the beginning, the paper collects the overall literature on the topic of organisational change in order to identify, on the basis of the citation network, the main existing theoretical approaches. Secondly, the analysis attempts to isolate the scientific production related to the healthcare context, by analysing the body of literature outside the identified citation network, divided by clusters of related studies. METHODOLOGY: This review adopted a quantitative-based method that employs jointly systematic literature review and bibliographic network analysis. Specifically, the study applied a citation network analysis (CNA) and a co-occurrence keywords analysis. The CNA allowed detecting the most relevant papers published over time, identifying the research streams in literature. RESULTS: The study showed four main findings. Firstly, consistent with past studies, works reviewed pointed out a convergence on the micro-level perspective for change's analysis. Secondly, an organic viewpoint whereby individual, organization and change's outcome contribute to any organizational change's action has been found in its early stage. Thirdly, works reported change combined with innovation's concept, although the structure of the relationship has not been outlined. Fourth, interestingly, contributions have been limited within the healthcare context. CONCLUSION: Human dimension is the primary criticality to be managed to impede failure of the re-organizational path. Individuals are not passive recipients of change: individual change acceptance has been found a key input. Few papers discussed healthcare professionals' behaviour, and those available focused on technology-led changes perspective. In this view, individual acceptance of change within the healthcare context resulted being undeveloped and offers rooms for further analyses.

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  • Many factors identified in our analysis reflect established findings on implementation of other innovations and NASSS framework constructs.

    “Many factors identified in our analysis—including context (at system, organization, and service levels), leadership and engagement approaches, technological considerations, use of data, and local capacity and resourcing (e.g., finance, people)–reflect established findings on implementation of other innovations, digital or otherwise,21,27, 28, 29, 30 and NASSS framework constructs.20”

    From Procurement and early deployment of artificial intelligence tools for chest diagnostics in NHS services in England: a rapid, mixed method evaluation (2025) · cites this paper as [30]

    The Results (Clusters from Keywords Analysis; page unavailable) link implementation of change to leadership, clinician involvement, communication, participation and IT, supporting several of the factors attributed to this source. The cited paper does not establish the full list, particularly use of data and local financial or staffing capacity. The sentence cites a different source for NASSS constructs, so that portion is not attributed to this paper. (LLM, conf=0.86)

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Sorted by citations

Authors
Milella, F., Minelli, E. A., Strozzi, F., & Croce, D.
Affiliations
  • IRCCS Ospedale Galeazzi - Sant'Ambrogio (IT)
  • University Carlo Cattaneo (IT)
  • University of the Witwatersrand (ZA)
Corresponding author
Milella, Frida
ORCID
Venue
ClinicoEconomics and Outcomes Research
Publisher
Informa UK Limited
Published
2021-05
Volume
Volume 13
Pages
395-408
ISSN
1178-6981 (ISSN-L)
DOI
10.2147/ceor.s301169
PMC
PMC8141398
OpenAlex
W3161438847
Cited by
74
References
4
Citations by year
2026: 12 · 2025: 13 · 2024: 22 · 2023: 18 · 2022: 5 · 2021: 3
FWCI
2.04
Type
journal article
Language
en
Open access
Licence
Locations
  • ClinicoEconomics and Outcomes Research (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • BOA (University of Milano-Bicocca) (submittedVersion, cc-by-nc)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
Topics
  • Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Organizational Change and Leadership
  • Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Organizational Management and Change
  • Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Appreciative Inquiry and Organizational Change
Keywords
organizational change, healthcare innovation, healthcare organizations, organic change, COVID-19 pandemic, population aging, chronic disease

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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