Stakeholder Conflicts during Digital Innovation Projects in Hospitals

Topic

This Master's thesis investigates the conflicts that arise among diverse stakeholders during digital innovation projects within hospitals and explores how these conflicts can be effectively understood and addressed. It argues that digital transformation in healthcare frequently faces obstacles not from technological deficiencies, but from unresolved tensions between different organizational rationalities such as medical, technical, and economic logics. Understanding these inherent conflicts is crucial for enabling sustainable digital transformation in healthcare settings.

Relevance

This thesis is highly relevant for practitioners, including hospital leaders and project managers, as it provides concrete insights into the common stakeholder conflicts that impede digital innovation in healthcare. By identifying eight recurring conflict types and analyzing strategies that have proven successful, it offers actionable guidance to anticipate, mitigate, and resolve these human and organizational frictions. This understanding is essential for translating promising digital solutions into successful, adopted practices and avoiding costly project delays or failures.

Results

The study identified eight recurring conflict types in hospital digital innovation projects, including resource limitations, misaligned expectations, role ambiguity, and siloed communication. These conflicts stem from competing rationalities (clinical, technical, economic, political, scientific). While some projects failed due to unresolved tensions, others succeeded by implementing strategies such as cross-functional roles, inclusive governance, and iterative implementation approaches. The findings emphasize that successful digital innovation in hospitals depends on navigating institutional complexity and strategically aligning around shared public value.

Implications for Practitioners

• Lead with a Grand Vision Framed by Public Value: Frame digital innovation projects around their contribution to broader public value, such as improved patient outcomes and enhanced system efficiency, to unify diverse stakeholder interests and gain buy-in.
• Invest in Bridging Capacities and Translation: Strategically invest in roles like CMIOs and CNIOs and foster cross-functional teams to translate between different rationalities (e.g., clinical and IT), addressing communication barriers and role ambiguities.
• Practice Adaptive and Iterative Implementation: Adopt iterative approaches and pilot phases for projects to demonstrate early value, gather real-world evidence, and adapt strategies based on feedback, thereby managing expectations and building trust.
• Foster Inclusive Governance and Ensure Fair Distribution of Burdens: Implement transparent decision-making pathways and actively involve diverse stakeholders. Proactively address and mitigate perceived losses or increased burdens for certain groups through open communication and compensatory mechanisms.
• Cultivate a Culture of Continuous Learning: Establish rigorous evaluation processes during and after projects to objectively analyze what hindered or stopped progress, identifying patterns of unrecognized omissions to prevent recurrence and foster organizational learning.

Methods

This study employed a qualitative research design with an exploratory and descriptive approach to understand stakeholder perceptions and experiences during digital innovation projects in hospitals. Data was collected through 18 semi-structured interviews with key stakeholders from clinical, IT, administrative, research, and vendor domains in Swiss and Austrian hospitals. The sampling strategy was purposive, focusing on individuals with direct project involvement. Data analysis utilized qualitative content analysis, combining deductive coding based on Multirationality Theory with inductive open coding to identify both theory-driven and emergent themes, facilitated by MAXQDA software.