title: Innovative culture in long-term care settings: the influence of organizational characteristics.
abstract: BACKGROUND
  Innovative cultures have been reported to enhance the creation and implementation of new ideas and working methods in organizations. Although there is considerable research on the impact of organizational context on the innovativeness of organizations, the same is not the case for research on the organizational characteristics responsible for an innovative culture in (long-term) care settings.
  
  
  OBJECTIVE
  The aim of this study was to identify organizational characteristics that explain innovative culture in the (long-term) care sector.
  
  
  METHODS
  A large cross-sectional study in Dutch long-term care-nursing homes and/or elderly homes, care organizations for the handicapped, and long-term mental health care organizations-was conducted. A total of 432 managers and care professionals in 37 organizations participated. The Group Innovation Inventory was used to measure innovative culture in long-term care organizations. Structural characteristics of the organization were centralization and formalization, environmental dynamism and competitiveness, internal and external exchange of information, leadership style, commitment to quality improvement, and the organization's innovative strategy.
  
  
  RESULTS
  The determinants of an innovative culture were estimated with a two-level random-intercepts and fixed-slopes model. Multilevel regression models were used to account for the organizational clustering of individuals within the 37 care organizations. Environmental dynamism, job codification, formal external exchange of information, transformational leadership, commitment to quality, and an exploratory and exploitative innovation strategy were all significantly correlated with an innovative culture in the multivariate multilevel analysis; the other characteristics were not. The explained organizational- and individual-level variance was 52.5% and 49.2%, respectively.
  
  
  CONCLUSIONS
  The results point to substantial differences in innovative cultures between and within care organizations that can, in part, be explained by organizational characteristics. Efforts must be made to ensure that organizational characteristics such as environmental dynamism do not hamper the development of innovative cultures in long-term care organizations. Organizations' human resource practices and knowledge management are particularly promising in strengthening innovative cultures.
authors: Institute of Health Policy & Management, Erasmus University Rotterdam, the Netherlands. nieboer@bmg.eur.nl
authors: Anna P
authors: AP
authors: Nieboer
authors: Mathilde M H
authors: MM
authors: Strating
mesh_terms: D000288:Administrative Personnel / Q000523:psychology; D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006284:Health Plan Implementation / Q000458:organization & administration*; D006801:Humans; D033181:Information Dissemination; D007857:Leadership; D008134:Long-Term Care / Q000458:organization & administration* / Q000592:standards / Q000639:trends; D008297:Male; D008875:Middle Aged; D017146:Models, Organizational; D009426:Netherlands; D015279:Organizational Culture; D009936:Organizational Innovation; D058996:Quality Improvement; D012931:Social Environment