In Pillar I, the highest scores were seen in ages 36 to 45 (mean of 4.48) compared to other age groups across all four pillars. Pillar I focuses on generating ideas, Pillar II on taking calculated risks and being entrepreneurial, Pillar III on developing and maintaining interpersonal relationships, and Pillar IV on turning ideas into products, processes, and services. One of the reasons for the higher scores in this age group may be that these individuals have relatively more organizational work experience (in the 5 to 10-year range). They tend to be in the middle management cadre, hence likely to understand organizational dynamics and have played key managerial roles over their tenures. This does not hold true for employees between the ages of 25 to 35 years and certainly not for those below 25 years. Literature in this regard suggests that age is not a limiting factor but rather a benefit for innovation, as individuals in this age group can take more risks, have more contacts, and possess more valid experiences compared to younger age groups (16, 17).
In LMICs, barriers cited in the literature include resource constraints such as time, human, financial, and physical infrastructure. These constraints have substantial implications for healthcare institutions, especially hospitals and clinical domains, hampering their ability to explore innovative approaches to healthcare delivery, technology adoption, and patient care (18). Innovation dashboards for LMICs, particularly for hospitals and clinical domains, can significantly enhance healthcare delivery despite the resource limitations. A mixed-method study found that partnership in the form of donor funding was not conducive to innovation. Only 13% of respondents strongly agreed that learning about innovations and models was a primary mission of their partnership. This opinion was also shared by international partners, indicating that this partnership very rarely leads to reverse innovation (19).
HICs healthcare institutions are exposed to innovative approaches developed and used by global communities to advance care despite resource constraints in the LMIC contexts. Interestingly, the concept of "reverse innovation" gains prominence when considering HICs healthcare institutions. Despite resource constraints prevalent in LMICs, HICs can benefit from the innovative approaches developed in LMIC contexts, offering potential solutions to enhance care delivery, lower costs, and improve quality within their own resource-constrained settings. This is primarily attributed to limited evidence of reverse innovation, perceptions of poor quality, or irrelevance regarding solutions developed in LMICs, and a complicated regulatory and policy environment in HICs(20).
The lowest scores were seen in ages less than 25 years. This could be primarily due to employees in this age group not being in positions of authority to exercise innovation in the modern workplace. Furthermore, this group also has the limitation of exposure and experience due to fewer years of experience. Similar results have been found in the literature where youth require the necessary environment to flourish as innovators; this is especially true for healthcare (21, 22).
Regarding gender, male employees had higher scores compared to female employees. There could be multiple factors contributing to this, including a higher number of male employees leading to more competition. Additionally, male employees tend to seek leadership positions and are not involved in childbearing, giving them more exposure and opportunities to flourish, which is also reflected in their innovation potential(23-25).
In terms of educational level, the highest innovation scores were seen for people who had intermediate (12th grade) education for Pillar I (4.36), Pillar II (4.2), and Pillar IV (4.4). For Pillar III, the highest scores were seen in the postgraduate group (4.5). This is supported by literature as well; higher qualifications do not necessarily correlate with creativity and innovation.
Conformity is a key ingredient of education systems, while rebellion is the key to innovation and entrepreneurial spirit (26-29).
Looking at years of experience, the highest scores were seen for 2 to 3 years of experience in Pillar I (4.34), Pillar II had the highest score for 3 or more years of experience, Pillar III had the highest score for less than 1 year (4.52), and the same was observed for Pillar IV with the highest score in less than 1-year experience (4.52). This could be because the differences in experience years were very close and did not have significant variations for different groups. An experience difference of 5 years or more would have an additional advantage in innovation potential, but we were unable to observe that difference due to the close nature of years of experience in this cohort.
Regarding job designation, doctors had higher scores compared to nursing staff for all four pillars, with scores of 4.5, 4.2, 4.58, and 4.6, respectively. This could be due to doctors having higher domain knowledge and more liberty at the facility to implement and practice innovation compared to nursing staff (30, 31). This highlights the necessity to incorporate healthcare professionals’ perspectives in building innovation dashboards and benchmarks.
The ISA identifies strengths and gaps in individuals' skills; this customized dashboard provides a structured approach for healthcare institutions to identify innovation strengths and areas needing improvement. It enables hospital leaders and administrators to make data-driven decisions, allocate resources strategically, foster collaborations that align with innovation objectives, and improve patient care and healthcare delivery within the constraints of LMICs. Just as the ISA provides a tailored path for individuals to excl, the LMIC-focused innovation dashboard offers a targeted route for healthcare institutions to navigate challenges, unlock latent potential, and drive impactful innovation in clinical settings, ensuring the well-being of patients while leveraging local contexts and global innovation trends(32).
Who is needed to function as an innovator? And who is expected to bring other skills to the team’s performance? Where does the team have an abundance of innovation skills? And where does it lack? Who is most confident in acting and contributing? And who excels at managing others? More data is needed to answer such questions, and at the end of the day, this assessment might be too subjective to hold value in empirical sciences.