Identifying the Barriers to Innovation in Public Sector Organizations: A Case Study of Healthcare Policy Implementation
Keywords:
Public sector innovation, healthcare policy, qualitative research, bureaucratic barriers, organizational culture, policy implementation, IranAbstract
This study aims to identify and analyze the key barriers to innovation in public sector organizations, with a specific focus on healthcare policy implementation within Iran’s centralized public health system. A qualitative research design was employed using a case study approach centered in Tehran. Data were collected through semi-structured interviews with 23 purposively selected participants, including healthcare policymakers, administrators, and frontline managers actively involved in policy implementation. Interviews continued until theoretical saturation was achieved. All interviews were audio-recorded, transcribed verbatim, and analyzed thematically using NVivo 12 software. Thematic analysis followed an inductive approach to coding and categorization, and peer debriefing and member checking were used to enhance validity and credibility. Three overarching themes emerged: (1) Structural and Bureaucratic Barriers, including centralized decision-making, rigid hierarchies, and inflexible procedures; (2) Cultural and Human Resource Challenges, such as risk-averse organizational culture, lack of innovation mindset, and leadership resistance; and (3) Policy and Systemic Constraints, including political interference, fragmented accountability, and underutilization of data. Participants emphasized the implementation gap between policy design and practice, the lack of innovation-related performance metrics, and limited stakeholder engagement. The barriers were found to be interrelated, reinforcing a cycle of stagnation that undermines innovative efforts. Innovation in public healthcare policy implementation is hindered by entrenched structural, cultural, and systemic constraints. Addressing these barriers requires decentralizing authority, fostering a supportive innovation culture, enhancing employee skills, and reforming policy processes to be more inclusive, data-informed, and adaptive. The findings offer actionable insights for policymakers, managers, and reform advocates seeking to foster innovation in similar public sector contexts.
Downloads
References
Ansell, C., & Gash, A. (2008). Collaborative governance in theory and practice. Journal of Public Administration Research and Theory, 18(4), 543–571. https://doi.org/10.1093/jopart/mum032
Arundel, A., Bloch, C., & Ferguson, B. (2015). Advancing innovation in the public sector: Aligning demand, procurement, and implementation. Public Money & Management, 35(1), 37–44. https://doi.org/10.1080/09540962.2015.986944
Bason, C. (2018). Leading public sector innovation: Co-creating for a better society (2nd ed.). Policy Press.
Bekkers, V., Tummers, L., & Voorberg, W. (2011). From public innovation to social innovation in the public sector: A literature review of relevant drivers and barriers. Erasmus University.
Borins, S. (2001). Encouraging innovation in the public sector. Journal of Intellectual Capital, 2(3), 310–319. https://doi.org/10.1108/EUM0000000005660
Brown, K., & Osborne, S. P. (2013). Risk and innovation: Towards a framework for risk governance in public services. Public Management Review, 15(2), 186–208. https://doi.org/10.1080/14719037.2012.707681
Cinar, E., Trott, P., & Simms, C. (2019). A systematic review of barriers to public sector innovation process. Public Management Review, 21(2), 264–290. https://doi.org/10.1080/14719037.2018.1473477
De Vries, H., Bekkers, V., & Tummers, L. (2016). Innovation in the public sector: A systematic review and future research agenda. Public Administration, 94(1), 146–166. https://doi.org/10.1111/padm.12209
Dunleavy, P., Margetts, H., Bastow, S., & Tinkler, J. (2006). New public management is dead: Long live digital-era governance. Journal of Public Administration Research and Theory, 16(3), 467–494. https://doi.org/10.1093/jopart/mui057
Ferlie, E., Ashburner, L., Fitzgerald, L., & Pettigrew, A. (2005). The new public management in action. Oxford University Press.
Gault, F. (2018). Defining innovation in the context of public sector services. Handbook of Innovation in Public Services, 31–43. https://doi.org/10.4337/9781783479947.00009
Greenhalgh, T., Robert, G., Macfarlane, F., Bate, P., & Kyriakidou, O. (2004). Diffusion of innovations in service organizations: Systematic review and recommendations. The Milbank Quarterly, 82(4), 581–629. https://doi.org/10.1111/j.0887-378X.2004.00325.x
Hartley, J. (2005). Innovation in governance and public services: Past and present. Public Money & Management, 25(1), 27–34. https://doi.org/10.1111/j.1467-9302.2005.00447.x
Hartley, J., Sørensen, E., & Torfing, J. (2013). Collaborative innovation: A viable alternative to market competition and organizational entrepreneurship. Public Administration Review, 73(6), 821–830. https://doi.org/10.1111/puar.12136
Hill, M., & Hupe, P. (2014). Implementing public policy: An introduction to the study of operational governance (3rd ed.). Sage.
Khodaveisi, M., Ghofranipour, F., & Ramezankhani, A. (2018). Challenges to policy implementation in Iranian health system. Iranian Journal of Public Health, 47(7), 1012–1020.
Lægreid, P., & Christensen, T. (2011). The Ashgate research companion to new public management. Ashgate.
Lewis, J. M., Considine, M., & Alexander, D. (2018). Innovation in public sector human services: The case of personal budgets in disability care. Public Management Review, 20(8), 1226–1244. https://doi.org/10.1080/14719037.2017.1383777
Morris, J. C., & Farrell, C. (2007). The determinants of innovation in local government. State and Local Government Review, 39(1), 19–30. https://doi.org/10.1177/0160323X0703900103
OECD. (2015). The innovation imperative in the public sector: Setting an agenda for action. OECD Publishing.
Sørensen, E., & Torfing, J. (2012). Enhancing collaborative innovation in the public sector. Administration & Society, 43(8), 842–868. https://doi.org/10.1177/0095399711418768
Torfing, J., & Triantafillou, P. (2016). Enhancing public innovation by transforming public governance. Cambridge University Press.
Walker, R. M. (2006). Innovation type and diffusion: An empirical analysis of local government. Public Administration, 84(2), 311–335. https://doi.org/10.1111/j.1467-9299.2006.00004.x
Downloads
Published
Submitted
Revised
Accepted
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
