{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T06:31:23Z","timestamp":1792564283179,"version":"4.5.0"},"reference-count":33,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2021,5,24]],"date-time":"2021-05-24T00:00:00Z","timestamp":1621814400000},"content-version":"unspecified","delay-in-days":23,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2021,4,9]]},"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To explore and explain success and limiting factors in UK health service innovation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Mixed methods evaluation of a series of health service innovations involving a survey and interviews, with theory-generating analysis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>The research explored innovations supported by one of the UK\u2019s Academic Health Science Networks which provides small grants, awards and structural support to health service innovators including clinical academics, health and social care professionals and third-sector organisations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>All recipients of funding or support 2014\u20132018 were invited to participate. We analysed survey responses relating to 56 innovation projects.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Responses were used to conceptualise success along two axes: value creation for the intended beneficiaries and expansion beyond its original pilot. An analysis of variance between categories of success indicated that participation, motivation and evaluation were critical to value generation; organisational, educational and administrative support were critical to expansion; and leadership and collaborative expertise were critical to both value creation and expansion. Additional limiting factors derived from qualitative responses included difficulties navigating the boundaries and intersections between organisations, professions, sectors and cultures; a lack of support for innovation beyond the start-up phase; a lack of protected time; and staff burn-out and turnover.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>A nested hierarchy of innovation needs has been derived via an analysis of these factors, providing targeted suggestions to enhance the success of future innovations.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-047943","type":"journal-article","created":{"date-parts":[[2021,5,25]],"date-time":"2021-05-25T12:36:54Z","timestamp":1621946214000},"page":"e047943","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Success and limiting factors in health service innovation: a theory-generating mixed methods evaluation of UK projects"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5010-3257","authenticated-orcid":false,"given":"Kathleen","family":"Leedham-Green","sequence":"first","affiliation":[{"name":"Medical Education Research Unit, Faculty of Medicine, Imperial College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2937-436X","authenticated-orcid":false,"given":"Alec","family":"Knight","sequence":"additional","affiliation":[{"name":"School of Population Health and Environmental Sciences, Faculty of Life Sciences and Medicine, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1839-1949","authenticated-orcid":false,"given":"Gabriel B","family":"Reedy","sequence":"additional","affiliation":[{"name":"Centre for Education, Faculty of Life Sciences and Medicine, King\u2019s College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,5,25]]},"reference":[{"key":"2025101813362259000_11.5.e047943.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)30841-4"},{"key":"2025101813362259000_11.5.e047943.2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j3895"},{"key":"2025101813362259000_11.5.e047943.3","unstructured":"Nolte E . How do we ensure that innovation in health service delivery and organization is implemented sustained and spread. World Health Organization, 2018."},{"key":"2025101813362259000_11.5.e047943.4","doi-asserted-by":"crossref","unstructured":"Bornmann L , Haunschild R . Societal Impact Measurement of Research Papers. In: Gl\u00e4nzel W , Moed HF , Schmoch U , eds. Springer Handbook of science and technology indicators. Cham: Springer International Publishing, 2019: 609\u201332.","DOI":"10.1007\/978-3-030-02511-3_23"},{"key":"2025101813362259000_11.5.e047943.5","unstructured":"Pury EF , Davide N , Jean L . Nhs top managers, knowledge exchange and leadership: the early development of academic health science networks \u2013 a mixed-methods study, 2017."},{"key":"2025101813362259000_11.5.e047943.6","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2014-003627"},{"key":"2025101813362259000_11.5.e047943.7","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)61116-8"},{"key":"2025101813362259000_11.5.e047943.8","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1108\/QROM-06-2019-1778","article-title":"Critical realism and constructivism: merging research paradigms for a deeper qualitative study","volume":"15","author":"Bogna","year":"2020","journal-title":"QROM"},{"key":"2025101813362259000_11.5.e047943.9","doi-asserted-by":"publisher","DOI":"10.1097\/ACM.0000000000003075"},{"key":"2025101813362259000_11.5.e047943.10","first-page":"240","volume-title":"Handbook of mixed methods in social and behavioral research","volume":"209","author":"Creswell","year":"2003"},{"key":"2025101813362259000_11.5.e047943.11","doi-asserted-by":"publisher","DOI":"10.1007\/s11135-017-0574-8"},{"key":"2025101813362259000_11.5.e047943.12","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-017-0707-4"},{"key":"2025101813362259000_11.5.e047943.13","doi-asserted-by":"publisher","DOI":"10.1136\/fmch-2018-000086"},{"key":"2025101813362259000_11.5.e047943.14","unstructured":"Charmaz K . Constructing grounded theory: a practical guide through qualitative analysis. London: Sage, 2006."},{"key":"2025101813362259000_11.5.e047943.15","first-page":"265","article-title":"Exploratory data analysis as a Foundation of inductive research","volume":"27","author":"Jebb","year":"2017","journal-title":"Hum Resour Manag Rev"},{"key":"2025101813362259000_11.5.e047943.16","first-page":"241","article-title":"Power study of ANOVA versus Kruskal-Wallis test","volume":"15","author":"Hecke","year":"2012","journal-title":"J Stat Manag Syst"},{"key":"2025101813362259000_11.5.e047943.17","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2017-006756"},{"key":"2025101813362259000_11.5.e047943.18","doi-asserted-by":"crossref","unstructured":"Braun V , Clarke V . Thematic analysis. In: APA handbook of research methods in psychology, vol 2: research designs: quantitative, qualitative, neuropsychological, and biological. Washington, DC, US: American Psychological Association, 2012: 57\u2013-71.","DOI":"10.1037\/13620-004"},{"key":"2025101813362259000_11.5.e047943.19","unstructured":"The Health Innovation Network . Health innovation network - our projects, 2021. Available: https:\/\/healthinnovationnetwork.com\/our-projects\/ [Accessed 26 Mar 2021]."},{"key":"2025101813362259000_11.5.e047943.20","unstructured":"The King\u2019s Fund . Key facts and figures about adult social care, 2019. Available: https:\/\/www.kingsfund.org.uk\/audio-video\/key-facts-figures-adult-social-care [Accessed 12 Dec 2020]."},{"key":"2025101813362259000_11.5.e047943.21","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1186\/s12889-017-4122-1","article-title":"Commissioning for health improvement following the 2012 health and social care reforms in England: what has changed?","volume":"17","author":"Gadsby","year":"2017","journal-title":"BMC Public Health"},{"key":"2025101813362259000_11.5.e047943.22","unstructured":"Greenhalgh T , Robert G , Bate P . Diffusion of innovations in health service organisations: a systematic literature review. Wiley, 2008."},{"key":"2025101813362259000_11.5.e047943.23","unstructured":"Rogers EM . Diffusion of innovations. New York: Free Press of Glencoe, 1962."},{"key":"2025101813362259000_11.5.e047943.24","doi-asserted-by":"publisher","DOI":"10.1111\/j.0887-378X.2004.00325.x"},{"key":"2025101813362259000_11.5.e047943.25","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-3-1"},{"key":"2025101813362259000_11.5.e047943.26","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-4-50"},{"key":"2025101813362259000_11.5.e047943.27","doi-asserted-by":"publisher","DOI":"10.1007\/s10488-010-0327-7"},{"key":"2025101813362259000_11.5.e047943.28","unstructured":"Nolte E . How do we ensure that innovation in health service delivery and organization is implemented sustained and spread? World Health Organization, 2018."},{"key":"2025101813362259000_11.5.e047943.29","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-015-0242-0"},{"key":"2025101813362259000_11.5.e047943.30","doi-asserted-by":"publisher","DOI":"10.1186\/s13012-017-0637-1"},{"key":"2025101813362259000_11.5.e047943.31","unstructured":"Fixsen DL , Naoom SF , Blase KA . Implementation research: a synthesis of the literature, 2005."},{"key":"2025101813362259000_11.5.e047943.32","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-7-17"},{"key":"2025101813362259000_11.5.e047943.33","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1080\/14697010802133577","article-title":"Understanding change and innovation in healthcare settings: Reconceptualizing the active role of context","volume":"8","author":"Dopson","year":"2008","journal-title":"J Chang Manag"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2020-047943","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T20:36:37Z","timestamp":1760819797000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2020-047943"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,5]]},"references-count":33,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2021,5,25]]},"published-print":{"date-parts":[[2021,5]]}},"alternative-id":["10.1136\/bmjopen-2020-047943"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2020-047943","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,5]]}}}