title: Exploring the cross-level impact of market orientation on nursing innovation in hospitals.
abstract: BACKGROUND
  Recently, many hospitals have been enthusiastically encouraging nurses to pursue nursing innovation to improve health care quality and increase nursing productivity by proposing innovative training methods, products, services, care skills, and care methods.
  
  
  OBJECTIVE
  This study tried to explore the cross-level impact of market orientation on nursing innovation.
  
  
  METHODS
  In our study, 3 to 7 nurses and 1 manager were selected from each nursing team to act as respondents. The questionnaire survey began after the managers of each nursing team and the nurses had been anonymously coded and paired up in Taiwan in 2009-2010. A total of 808 valid questionnaires were collected, including 172 valid teams. Hierarchical linear modeling was used for the analysis.
  
  
  RESULTS
  Nursing innovation is the sum of knowledge creation, innovation behavior, and innovation diffusion displayed by the nurses during nursing care. The level of knowledge creation, as perceived by the nurses, was the highest, whereas the level of innovation diffusion was the lowest. Results of hierarchical linear modeling showed that only competitor orientation yielded a significant positive influence on knowledge creation, innovation behavior, or innovation diffusion. The r values were 0.53, 0.49, and 0.61, respectively. Customer orientation and interfunctional coordination did not have significant effects on nursing innovation.
  
  
  CONCLUSIONS
  Hospital nurses exhibited better performance in knowledge creation than in innovation behavior and diffusion. Only competitor orientation had a significantly positive and cross-level influence on nursing innovation. However, competitor orientation was observed to be the lowest dimension of market orientation, which indicates that this factor should be the focus when improving nursing innovations in the future. Therefore, managers should continually understand the strategies, advantages, and methods of their competitors.
authors.affiliation: Department of Hospital and Health Care Administration, Chia Nan University of Pharmacy and Science, Tainan, Taiwan, ROC. wonhon@mail2000.com.tw
authors.forename: Rhay-Hung
authors.initials: RH
authors.lastname: Weng
authors.forename: Ching-Yuan
authors.initials: CY
authors.lastname: Huang
authors.forename: Tzu-En
authors.initials: TE
authors.lastname: Lin
mesh_terms: D001291:Attitude of Health Personnel; D003163:Competitive Behavior; D003430:Cross-Sectional Studies; D004059:Diffusion of Innovation; D006301:Health Services Needs and Demand; D006761:Hospitals / Q000592:standards; D006801:Humans; D008389:Marketing of Health Services; D009732:Nursing Care / Q000523:psychology / Q000592:standards*; D009741:Nursing Staff, Hospital / Q000523:psychology / Q000592:standards*; D015279:Organizational Culture; D009936:Organizational Innovation; D017060:Patient Satisfaction; D013624:Taiwan