Innovation in hospitals: a survey of the literature.

The literature on innovation in hospitals is relatively extensive and varied. The purpose of this article is to conduct a critical survey, and in particular to highlight the functional and occupational bias that characterises it, whereby the sole object of innovation is medical care, and that innovation is essentially the work of doctors. In order to achieve this objective, four different (complementary or competing) concepts of the hospital are considered. In the first, the hospital is seen in terms of its production function, in the second, as a set of technical capacities, in the third, as an information system, and in the fourth, as a service provider and a hub in a wider system of healthcare. In the latter approach, hospitals are regarded as combinative providers of diverse and dynamic services, able to go beyond their own institutional boundaries by becoming part of larger networks of healthcare provision, which are themselves diverse and dynamic. This approach makes it possible to extend the model of hospital innovation to incorporate new forms of innovation and new actors in the innovation process, in accordance with the Schumpeterian tradition of openness.