Overlooking the front line: Impacts of front‐line worker inclusion on implementation and outcomes of collaborative innovation
| Published date | 01 September 2023 |
| Author | Riley V. Livingstone |
| Date | 01 September 2023 |
| DOI | http://doi.org/10.1111/padm.12838 |
ORIGINAL ARTICLE
Overlooking the front line: Impacts of front-line
worker inclusion on implementation and
outcomes of collaborative innovation
Riley V. Livingstone
Strathclyde Business School, University of
Strathclyde, Glasgow, UK
Correspondence
Riley V. Livingstone, 88 Old Lake Trail, Saint
John, NB E2J 0J9, Canada.
Email: riley.livingstone@strath.ac.uk
Funding information
Capita plc
Abstract
Policymakers acknowledge the need to drive innovation in
health and social care, given the complex, “wicked”prob-
lems that such services are tasked with solving and the con-
cept of collaborative innovation is proposed as a tool in
which to reach solutions to these problems. Prior case stud-
ies have overlooked the element of front-line worker inclu-
sion on processes of collaborative innovation. This research
explores this element through a case study of an intermedi-
ate care facility in Scotland. This collaboration produced
innovation, but the strength of the innovative solution was
diluted by the omission of front-line workers in key phases
of the innovation process. This paper contributes to the
broader public administration literature by operationalizing
a novel conceptual framework of collaborative innovation
and by exploring the problematic implications of neglecting
to include front line worker perspectives throughout the
process of collaborative innovation.
1|INTRODUCTION
Policymakers recognize a growing demand for innovation in public services, including in the domain of health and
social care. Interest in public service innovation has risen in response to a series of mounting pressures: society's
increasing demand for high-quality personalized public services (Alves, 2013; Windrum, 2008); budgetary constraints
due to financial instability and/or crisis, such that innovation is seen as a superior alternative to broad cuts to ser-
vices (Sørensen & Torfing, 2017); and the call to respond to “wicked problems”—which in health and social care have
Received: 5 May 2021 Revised: 13 January 2022 Accepted: 26 January 2022
DOI: 10.1111/padm.12838
This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and
reproduction in any medium, provided the original work is properly cited.
© 2022 The Authors. Public Administration published by John Wiley & Sons Ltd.
788 Public Admin. 2023;101:788–803.
wileyonlinelibrary.com/journal/padm
in recent times been the aging of populations and the exacerbation of service gaps by the COVID-19 pandemic
(Bekkers & Tummers, 2018; Coen et al., 2020). This paper employs the concept of collaborative innovation to ana-
lyze the case of the journey to implementing the Bellfield Centre, an integrative intermediate care facility in Stirling,
a city in central Scotland, designed to bridge the gaps in service delivery between hospital and community for older
adults, with an approach focusing on rehabilitation and reablement. Collaborative innovation is defined here as the
processes that result from diverse, interdependent, and relevant actors that commit to collectively solve a “wicked”
shared problem and take joint ownership over its implementation and outcomes (Torfing, 2016). Innovation, in this
context, entails a discontinuous, clear break from what preceded it including how services are delivered and their
impacts (van Acker, 2018). Through this case study research, the authors seek answers to the following research
questions: (1) How effectively do collaborative innovation processes support innovative changes in organizations and ser-
vices?? (2) How does the role of front-line workers in the different stages of a collaborative innovation process affect the
outcome and impact of collaborative innovation processes?
Following this introduction, the background of collaborative innovation in public services is considered along
with its components and the argument it presents for superior public innovation. The context for the research is then
discussed followed by a description of research methods informing the analysis of this case. Next, the findings of the
case are presented through the lens of a conceptual framework of collaborative innovation. The article concludes
with a discussion of how this case contributes to the larger theoretical literature of public administration through its
operationalization of a novel conceptual framework of collaborative innovation and through its exploration of how
institutional power imbalances in these processes are reflected in workers' experiences and in the implementation of
collaborative innovations.
2|BACKGROUND
Collaborative innovation arose out of a relatively recently developed public administration paradigm known as New
Public Governance (NPG), based out of dissatisfaction with the previous paradigm, New Public Management (NPM)
which was itself borne out of critiques of the preceding paradigm (Liddle, 2018; Torfing, 2016). Although collabora-
tion as a means to innovation has become more accepted in the public sector discourse, the stickiness of NPM's leg-
acy has left several barriers to collaborative innovation (Torfing, 2013). In contrast to NPM's more transactional
approach to public sector management, NPG emphasizes collaborative governance, relationships, negotiation and
trust and promotes innovation through collaboration (Eriksson, 2019; Osborne et al., 2015; Torfing, 2016). It is
within the paradigm of NPG that the concept of collaborative innovation began to gain acceptance, through an
emerging evidence base of successful case studies. Case studies in fields such as urban development (Dente
et al., 2005), crime prevention (Aagaard, 2012), public schools (Roberts & King, 1996), pharmacy services (Lindsay
et al., 2018), and digital government (Kattel et al., 2020) have shown that collaborative innovation processes can
have a positive impact.
In this era of widespread public austerity and reduced public trust in government, there is an argument to be
made that collaboration is the better vehicle for producing innovative solutions to complex, “wicked”problems
(Sørensen & Torfing, 2011; Torfing, 2016). Collaborative innovation describes the process of creating innovative
solutions to complex “wicked”problems through multi-actor collaboration (Torfing, 2016). Collaborative innovation
has an emerged as an important framework for trying to understand how public services can best respond to wicked
problems and provides practical guidance for collaborative actors on the ground (Krogh & Torfing, 2015; Lindsay
et al., 2018). It is rooted within the paradigm of NPG and draws on institutional and network theory to suggest that
collaboration networking is required to overcome institutional logics and biases and develop holistic solutions com-
plex policy problems (Hartley et al., 2013; Peters, 2011; Torfing, 2016). While some of the theoretical literature
touches on the impact of actors' power relations on collaborative innovation (Lindsay et al., 2018; Torfing, 2016) and
calls for the inclusion of front-line workers in the processes of collaborative innovation to maximize the strength of
LIVINGSTONE 789
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