Clinician Participation in Innovation Labs at University Hospitals: Mixed-Methods Study (Preprint)

BACKGROUND Innovation labs (ILs) are increasingly implemented in hospital settings to propel collaboration and experimentation against the backdrop of digital transformation. While these labs offer substantial potential for healthcare innovation, the sustainable participation of hospital staff remains a challenge. OBJECTIVE This study aims to explore how hospital staff can be effectively engaged in ILs within a university hospital setting. Specific objectives are to (1) identify organizational, structural, and cultural conditions that enable or hinder participation; (2) understand enablers and barriers from the perspective of staff; and (3) derive practical recommendations for the design and implementation of ILs. METHODS A mixed methods exploratory sequential design was employed. In Phase 1, semi-structured interviews were conducted with innovation leaders from non-hospital sectors and clinical leaders from a large university hospital in Germany. Themes derived from qualitative analysis informed the development of an online survey. In Phase 2, this survey was distributed to hospital staff. Quantitative data were analyzed using descriptive and non-parametric comparative statistics. RESULTS In the qualitative phase, n=13 interviews were conducted, with eight emergent themes that were organized into three typological categories: strategic alignment of ILs, design principles, and staff motivation. In the quantitative phase, n=532 responses were collected in the structured 44-item online survey. Findings revealed strong staff support for ILs that align with institutional priorities (e.g., patient care, digital transformation), prioritize workflow improvements, and are embedded within hospital structures. Key enablers for participation included protected time, funding, and access to expertise. Differences between professional groups (physicians vs. nurses) were observed in motivation, perceptions of innovation outcomes, and structural needs. Participants expressed interest in contributing to innovation but preferred flexible, time-limited roles over long-term commitments or spin-off participation. CONCLUSIONS Clinical staff perspectives indicate that engaging them in university hospital-based ILs requires structural support, visible strategic alignment, and attention to differing professional motivations. Internal IL models, resource allocation, and tailored participation formats appear essential for clinician engagement. While investment is required, this approach may yield substantial returns through enhanced care delivery and organizational adaptability. We present actionable recommendations for IL implementation in university hospitals.