Healthcare Innovation Barriers Perceived by Risk Managers: Effects of Hospital Bed Size and Organizational Structure

Medical errors cause significant patient injuries, including deaths. Innovations designed to improve quality and reduce risk are numerous, as are the barriers that prevent innovation implementation. The purpose of this quantitative cross-sectional survey research was to analyze the relationships, if any, between the independent variables (IVs) hospital bed size and organizational structure and the dependent variables (DVs) barriers to three innovations: (a) implementing a surgical safety checklist, (b) preventing catheter- associated urinary tract infections, and (c) adopting patient- and family-centered care. Certified risk managers employed in short-term acute care U.S. hospitals (n = 847) received the Internet survey, and 348 (41.1%) participated. Analysis of the six IV and DV combinations revealed there was no difference in the barrier factor means for five combinations. There was a significant difference in the means for the patient- and family-centered care innovation, based on hospital bed size, F(20, 555) = 1.942, p = .008. Within this combination, there was a significant difference in the communication barrier factor, F(5, 5) = 2.53, p = .03, ηp 2 = 0.038, but not in the adopter, organization, and innovation barrier factors. There was a significant association between hospital bed size and organizational structure, χ2(25, n = 345) = 105.31, p < .001. Diffusion theory research often focuses on organizational culture, but the focus of this research was on three innovations. Each innovation did not have a unique set of perceived barriers. The findings strengthen and expand existing research and serve as the foundation for understanding barriers to implementation of three healthcare innovations. Future research should focus on organizational culture instead of innovation-specific barriers and should incorporate other independent variables such as organizational profitability