- Visioning
The process of assessing how fit an organisation is to grow and function in the future
- Vision
A clear purpose that expresses a distinct sense of an organisation’s future
Organisations
Creativity and visioning are vital to the success of an organisation. However, it is challenging for many organisations to encourage and foster new ideas and to establish creativity and innovation that can benefit all concerned. Of relevance is that the need to be creative is not confined to commercial and non-health-based organisations. Innovation and creativity have an important place in not-for-profit organisations and in the public and government domains, where the drive has shifted to greater efficiency, effectiveness and productivity. There is increased pressure placed on these latter organisations to find new and improved means of working and innovative solutions to current and future problems.
- Creativity
The act of generating new ideas and thoughts and transforming them into reality
- Innovation
The embodiment, combination or synthesis of knowledge into original, relevant, valued new products, processes or services (Luecke & Katz, 2003)
- Not-for-profit organisation
An organisation that is not operating for the profit or personal gain of its individual members or shareholders
Systems-based approach
In Australia, strong leadership at various levels will be required to enable health reforms to succeed within healthcare organisations (Health Workforce Australia, 2012). Leading organisations use creativity and innovation to address the challenges, building cultures which foster capacity for innovation and change (Agbor, 2008). This is generally undertaken through leadership which adopts a systems-based approach. In such workplaces, there are common elements which characterise the culture. These are critical in ensuring that creativity and change are successfully introduced and maintained within the healthcare organisation setting. They include effective transformational leadership, adoption of a systems-based approach and clear understanding of how to develop organisational cultures which enhance and nurture the workplace environment to embrace creativity and change. These elements are discussed and analysed in this chapter.
- Systems-based approach
A leadership method that assumes an organisation is a convoluted interaction of dynamic parts which work together for a common purpose
Learning organisations
Scott, Mannion, Davies and Marshall (2003) observe that organisational culture is a key factor in healthcare reform. They found that creativity, innovation and organisational change can be achieved only with an organisational culture that encourages adaptability to change. Once such a culture is established, the rate of innovation is dependent on how the norms, social status and hierarchy impact on employee behaviours (Rogers, 1995).
An important aspect in any organisation involves its learning capacity, by which the vision exists to ensure that all activities are aligned (Foster & Akdere, 2007). Learning organisations are founded on uniform engagement and collaboration by all employees, who are committed and accountable to change, each directed towards shared principles. As originally described by Peter Senge (1990) in his book The fifth discipline, in learning organisations employees strive to achieve their target goals, new ideas are enhanced, team aspiration is allowed to reign, and all are inspired to learn to view the whole together. According to Senge, an emphasis on knowledge management is characteristic of learning organisations, which can change continuously, as they learn from experience in order to improve overall performance. This is achieved through continually developing, retaining and leveraging both individual and collective learning. Senge also described learning organisations as encouraging and supporting their workers towards ongoing learning while stressing information-sharing, teamwork and participation as important.
- Learning organisation
An organisation in which employees strive to achieve their target goals, new ideas are enhanced, team aspiration is allowed to reign, and all are inspired to continually learn to view the whole together
Learning organisations are readily adaptable to changes in the external environment (Costanzo & Tzoumpa, 2008). The existence of such a learning environment is fundamental to the development of creativity, and this has been shown to be achieved through a transformational approach to leadership (Gumusluoglu & Ilsev, 2009). The transformation to a learning organisation provides the necessary culture to foster innovation, creativity and change (Aragon-Correa, García-Morales & Cordón-Pozo, 2007; Sarros, Cooper & Santora, 2008).
Employees within an effective learning organisation are valued for their own contributions and are encouraged to improve and develop their individual skills and competencies. They benefit from each other’s experience. Leaders in these organisation tend to respect and treat all equally within the workplace environment. In turn, employees are motivated to work towards achieving the goals set by their leaders. This ultimately provides the appropriate culture for innovative solutions, enhanced creativity and new ideas (Health Workforce Australia, 2012).
The impact on employees within such organisations has been found to be very positive (Andriopoulos, 2001). Individuals tend to acquire skills and knowledge above their position’s described requirements. This allows them to accept and appreciate other roles and activities in the organisation. The use of flexible arrangements in the workplace allows employees the liberty to move freely, while removing the obstacles associated with a rigidly structured organisation. It also ensures that employees are able to cope successfully with a changing environment, as is found in healthcare today.
Management and innovation
Creating the required culture
In this context, culture is regarded as the norms and beliefs of an organisation and the ways in which it acts collectively. The culture provides the key catalyst to introducing innovation and change, and together with leadership is a main factor in providing the receptive environment for change (Gumusluoglu & Ilsev, 2009; Masood, Dani, Burns & Backhouse, 2006; Rivenburgh, 2014).
In order for a leader and manager to create a learning organisation, they must be competent in transforming and building an organisation’s culture and understand how to create a culture that supports innovation and change. However, although it is widely recognised that creativity and visioning are key ingredients in a high-performing organisation (Karaman, Kok, Hasilogle & Rivera, 2008), it is often difficult to introduce, manage and sustain the required cultural change. Cummings and Worley (1995) list key activities which provide beneficial outcomes in culture change; these include motivating change, creating a vision, developing political support for change, managing the transition and sustaining momentum. Health Workforce Australia (2012) also identifies elements needed for creating the necessary culture:
- Provide a workplace environment which enables support mechanisms that allow employees to develop and trial new ideas.
- Provide flat structures with flexible teams, incorporating rewards and incentives for creative and innovative actions.
- Develop teams of managers who feel comfortable guiding flexible teams which take acceptable risks.
- Develop and provide open communication channels that build trust.
- Appoint managers to play a significant role with regard to facilitating learning and reusing effectively the knowledge received from experience.
John is the new chief executive officer of Care Line Hospital, a tertiary referral public-funded hospital located in metropolitan Sydney. On commencing employment, John soon uncovers several serious issues in performance and service delivery, with decreased efficiency, low productivity and ineffectiveness throughout the organisation. Specifically, there are poor financial management and performance, a high level of senior management team turnover, great dissatisfaction among the employees and increased demands for services.
After wide consultation and analysis, John determines that the situation requires a new and creative model of organisation, management and service delivery. In consultation with his senior executive team, John’s response is to form the following set of strategies:
- Introduce measures to change the culture so that creativity is fostered throughout the organisation through encouraging and supporting new ideas.
- Make plans to transform the culture to that of a learning organisation.
- Establish a new leadership group for the organisation, including the appointment of designated ‘ideas champions’, whose roles are to develop new and creative initiatives while actively targeting improvements and challenging the existing norms and processes of the organisation.
- Base the new culture on uniform engagement and collaboration by all employees, who are committed and accountable to change, each being directed towards shared principles.
- Include in the implementation plan introducing change, developing the vision, securing political agreement for change, managing the period of change and maintaining the change achieved.
- Establish a process through which all employees will be encouraged to learn from experience in an environment that encourages discussion and disagreement.
- Develop ideas on how best to negotiate change processes.
Challenges
Not all leaders and managers who seek a creative culture are successful in attaining it. Numerous challenges exist along the way which could jeopardise its development at the organisational level. These include difficulty in converting individual creativity to organisational creativity, lack of effective leadership to encourage employees to learn from experience, insufficient stimulus and motivation to generate new ideas, and barriers that impede creativity (Agbor, 2008).
Structure
The type of organisational structure in use has a clear impact on employees’ ability to contribute to ideas and creativity. Vertical organisations tend to be rigid and often result in employees feeling stifled in what they can and cannot undertake. Although horizontal organisations are less efficient, there are fewer rules, and they provide employees with a sense of identification with the organisation. Employees in such work environments normally strive to achieve their target goals; through this, new ideas are fostered, and team and group aspiration flows readily (Borrill, West & Dawson, 2003).
Strategies need to be established by the leader to incorporate in the organisation smaller units with a clear direction and enabling structures that facilitate the development and trialling of new ideas. These are often referred to in the literature as innovation factories. They provide the mechanism by which to enhance innovative thinking in organisations with more traditional norms (Snowdon, Shell & Leitch, 2010).
Organisations having modern norms are generally technologically developed, rational, empathic and change-oriented, whereas those with traditional norms are the direct opposite. Those organisations embracing traditional norms have been found to diffuse creativity and innovations much more slowly within the organisation than those that have incorporated modern norms (Rogers, 1995).
Leadership
Learning organisations need a designated person to be assigned to a leadership role in developing individuals and teams to produce new and creative initiatives. These people are often called ideas champions. They aim to achieve improvements and challenge current norms and processes.
Poor leadership can result in little or no uptake of innovation or creativity within the organisation. Snowdon et al. (2010) give an account of a perceived lack of leadership in the Canadian health system and the issues that arose as a result. The authors report that innovation is an important aspect in addressing challenges in healthcare. Leadership in healthcare is critical to developing a culture that enhances and supports innovation and change for sustainability.
Converting creativity
One significant challenge for a leader is converting individual creativity into organisational creativity. As organisations aim to become more creative and innovative, the strategies employed can often lead to conditions that encourage the individual effort more than team creativity. This can result in pockets of creativity but not an overall commitment to the organisation’s goals. To attain the appropriate culture, the process must be seen as long term rather than an instant solution (Andriopolous, 2001).
While it is important to commence at the individual level in order to build capacity within an organisation, creativity must then spread across all work functions and teams for the organisation to become more creative and effective. Individual effort needs to be converted across the organisation and in line with the organisation’s mission and vision (Woodman, Sawyer & Griffin, 1993).
Learning from experience
Organisations need a culture in which leaders encourage their employees to learn from failings as well as successes (Hartley & Bennington, 2010). This is backed up by research which found that hospitals tend not to learn from failure, because the traditional professional approach often deters questioning, due to a tendency towards a fast fix rather than a more measured and systematic problem-solving approach (Edmondson, 2004).
Searching for new ideas
Florida and Goodnight (2005) stress that creative capital is not just the result of individual ideas but is also attained through interaction among employees and other stakeholders. The challenge for leaders is that employees need to be intellectually engaged and obstacles removed to enable organisation-wide creativity.
Leaders can sense that creativity and innovation are key components of their organisation (Klemm, 2010), and that they can be generated through extensive interaction throughout the organisation. New ideas through widespread dialogue can lead to programs which fulfil creativity targets. As such, the mission of each leader should be to create ongoing opportunities for innovation and new ideas. The leader generally promotes creativity and innovation through management strategies that create a culture which motivates employees (Sundgren & Styhre, 2007).
Leadership and innovation
Effective leadership
Healthcare leaders appreciate their responsibility in providing clear direction into the future. They need to ensure that their organisation adapts in an environment of limited resources and increased demands for services. In order to operate effectively in the long term, a visioning process should be undertaken (Kachaner & Deimler, 2008; Millett, 2006).
The quality of leadership within an organisation has been shown to affect its culture, which in turn affects creativity, innovation and performance (McGuire, 2003). It ultimately impacts on employees and their commitment and trust, on the overall effectiveness of the team, and therefore on personal and collective performance (Avolio, Walumba & Weber, 2009; Burke et al., 2006; Kouzes & Posner, 2007). In essence, effective leadership requires a vision of the future that inspires employees of the organisation. The vision must be both effective and realistic. Successful leaders are those who work towards a shared and common vision to achieve the organisation’s goals (Foster & Akdere, 2007). In this context, the vision forms the unifying thread and acts as a shared goal for all employees. The leader must consider how to meet employees’ needs for expression in order to encourage innovation and creativity within the workplace (Amabile, Conti, Coon, Lazenby & Herron, 1996).
Many leaders today foster lateral thinking among employees in an attempt to enhance creativity within the organisation. The optimum strategies target employees who work across various levels, including staff and line managers and the planning and strategy units. Such leaders are considered to demonstrate a vision, trustworthiness and the capability to motivate (Bass & Avolio, 1993).
Transformational leadership
The changing role of today’s leaders follows contemporary leadership theories, which account for not only the leader but also the people they lead. In particular, transformational leadership theories focus on the role that leaders play in transforming employees in terms of their personal values and goals so that these are more consistent with those of the organisation (Bass, 1985). Transformational leadership has been found to comprise four key elements: individualised consideration, intellectual stimulation, inspirational motivation and idealised influence (Judge & Piccolo, 2004). This is widely acknowledged as the favoured framework for leadership in several current healthcare organisations (Health Workforce Australia, 2012).
- Transformational leadership
A leadership style that can inspire positive changes in followers
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