Innovation, cultural values, and the management of change in British hospitals

Abstract This paper describes the results of a study of innovation in the management teams of 27 UK hospitals. It is argued that the content of innovations provides an accurate representation of the underlying cultural values of the management teams, and the cultural values which they seek to purvey within the wider organizational settings. The authors propose that values in action (as opposed to espoused values) are manifest in the range of innovations introduced by top management within organizations. Using a typology of organizational culture, they categorize the innovations introduced by the management teams, in order to map their underlying cultural values. The results indicate predominant orientations of hospital management teams towards rational goal and hierarchical values in the current context of health care in Britain. Internal climate and service innovations were relatively infrequent, suggesting that the hospitals were dominated by management concern for control rather than flexibility. The costs of such cultural strategies in health service settings are discussed.