Horizon scanning as a tool in innovation in healthcare services development A qualitative study of two integrated care cases in a Norwegian hospital

Abstract

Background: Due to changing population demands, needs, demographics, technological development, fragmentation problems and increasing costs, the healthcare sector needs to adapt and develop new service delivery models to meet these changes and challenges. Developing new sustainable service models requires innovation. A potential method for systemizing the process in innovation projects is horizon scanning (HS). Objectives: i) Identify potential elements of horizon scanning based on two hospital cases, and ii) Present enabling and constraining factors for using horizon scanning in early project phases. Methods: This study is a qualitative case study of two cases at the same hospital. Two empirical sources were used to gather data; interviews and documents. Semi-structured interviews were conducted with informants (n = 10) who were a part of the two studied cases. The cases and informants were purposefully sampled. The data was analyzed through a concept-driven thematic analysis with two pre-defined frameworks; HS and COM-B (implementation theory). Findings: Findings suggest that neither project followed a systemized method or framework for finding innovative service models through the HS perspective. The processes in the cases studies had some elements similar to those of HS, but did not fulfill the full framework of HS. The analysis of the interviews suggests that enabling factors that could promote the use of HS include; culture for inputs, flexibility, willingness to try HS and more. Constraining factors include; concerns about time and scope, interruptions, different expectations, uneven power-dynamics, competency and more. Conclusions: This study concludes that HS has the potential to be used in innovation projects managed by hospitals. Several existing elements of the projects studied compliment HS activities. Enough time and training in the use of HS can have the potential to promote innovation through the use of HS.