Trajectories of Innovation in the Health Care Sector: The Case of Belgian Nursing Homes

Nursing homes are a fast-growing sector facing huge and sometimes barely reconcilable challenges. They are constantly seeking compromise solutions and are thereby forced to innovate in numerous fields. The aim of this paper is to explore the nature and diversity of innovations in the nursing home sector and investigate their emergence and trajectories. Under the light of the French Convention Theory, three in-depth qualitative case studies were conducted in three different organization types: a nonprofit, for-profit and state owned nursing homes, all coexisting in the sector. This longitudinal qualitative study involved face-to-face interviews with 47 internal and external actors, collection of internal documents and observations. The findings suggest that innovation in nursing homes is far from being limited to ‘medical’ and ‘technological’ fields but exist in a wide range and diversity of forms. Our results show the importance of the legal status as a determinant of innovation trajectories; the non-profit nursing home being also more predisposed to innovate. This research also shows the important role played by internal actors such as nurses and directors as well as external influence such as legislation in facilitating or impeding efforts made to implement innovations