Nurses frequently innovate in response to operational failures, regulations, procedures, and/or other workflow barriers that prevent them from delivering high-quality patient care. Unfortunately, most nurse innovations do not diffuse to a broader audience, depriving other nurses from taking advantage of solutions that have already been developed elsewhere. This under-diffusion is problematic from a societal and welfare point of view. The goal of this paper is to understand how diffusion shortage of nurse innovations can be reduced.
We develop a qualitative case study of a medical makerspace at the largest academic hospital in the Netherlands. This medical makerspace reported unusually high rates of nurse innovation diffusion. Our data collection includes on-site observations, archival data, secondary data, and fifteen in-depth interviews with key informants. Qualitative coding procedures and a combination of deductive and inductive reasoning are used to analyze the data.
Our data show that personal, organizational, regulatory, and market barriers prevent nurses from further developing and diffusion their innovations in an anticipatory manner. That is, because nurses expect that transforming an initial solution into an innovation that can be shared with others will be too time consuming and difficult they do not proceed with the further development. The medical makerspace that we investigated adequately addresses this problem by developing an innovation ecosystem that largely takes over the innovation and diffusion process.
We provide a concrete example of how a medical makerspace, and innovation support systems in a broader sense, can be designed to more adequately address the nurse innovation-diffusion gap. The two main elements of the practical solution that we identified are: (1) Support systems should facilitate that others may lead the development and diffusion of innovations and (2) The support system should promote that actors integrate their functional specializations within an innovation ecosystem. We make two theoretical contributions. First, we contribute to understanding barriers in the nurse innovation-diffusion process from a psychological point. Second, we identified that an ecosystem perspective is beneficial to develop innovation support systems in which diffusion occurs more often.

This study investigates the impact of renewable and non-renewable energy sources on carbon emissions in the context of China\'s 14th Five-Year Plan (2021-2025). The plan emphasises a \"Dual-control\" strategy of simultaneously setting energy consumption limits and reducing energy intensity for GDP (gross domestic product) in order to meet the targets of the five-year plan. Using a comprehensive dataset of Chinese energy and macroeconomic information spanning from 1990 to 2022, we conduct a Granger causality analysis to explore the relationship between energy sources and the level of air pollution. Our findings reveal a unidirectional link, wherein renewable energy contributes to a reduction in air pollution, while non-renewable energy sources lead to an increase. Despite the government\'s investment in renewable energy, our results show that China\'s economy remains heavily reliant on traditional energy sources (e.g., fossil fuels). This research is the first systematic examination of the interplay between energy usage and carbon emissions in the Chinese context. Our findings provide valuable insights for policy and market strategies aimed at promoting carbon neutrality and driving technological advancements in both government and industries.

Standardization is gaining importance for digital platform eco-systems as they try to balance both stability and flexibility of their core as well as their boundary resources. Our knowledge on which factors influence standardization processes in business-to-business (B2B) focused digital platform eco-systems remains limited. Using three B2B platform eco-systems from the cargo transportation and seaport eco-system context, we apply a multiple case study to investigate which factors affect the standardization mode and the standard adoption. Based on 19 interviews and a systematic coding procedure, we identified 24 factors and cluster them into four overarching themes. We show the relatedness between standardization and innovation research, identify standard characteristics as the most important theme of factors and show that standardization has to be seen as a dynamic and interconnected process, as some factors are interdependent but the controllability varies between factors. Lastly, implications of these results and future research directions are discussed.
UNASSIGNED: The online version contains supplementary material available at 10.1007/s12525-022-00551-1.

Health systems are increasingly looking toward the private sector to provide digital solutions to address health care demands. Innovation in digital health is largely driven by small- and medium-sized enterprises (SMEs), yet these companies experience significant barriers to entry, especially in public health systems. Complex and fragmented care models, alongside a myriad of relevant stakeholders (eg, purchasers, providers, and producers of health care products), make developing value propositions for digital solutions highly challenging.
This study aims to identify areas for health system improvement to promote the integration of innovative digital health technologies developed by SMEs.
This paper qualitatively analyzes a series of case studies to identify health system barriers faced by SMEs developing digital health technologies in Canada and proposed solutions to encourage a more innovative ecosystem. The Women\'s College Hospital Institute for Health System Solutions and Virtual Care established a consultation program for SMEs to help them increase their innovation capacity and take their ideas to market. The consultation involved the SME filling out an onboarding form and review of this information by an expert advisory committee using guided considerations, leading to a recommendation report provided to the SME. This paper reports on the characteristics of 25 SMEs who completed the program and qualitatively analyzed their recommendation reports to identify common barriers to digital health innovation.
A total of 2 central themes were identified, each with 3 subthemes. First, a common barrier to system integration was the lack of formal evaluation, with SMEs having limited resources and opportunities to conduct such an evaluation. Second, the health system\'s current structure does not create incentives for clinicians to use digital technologies, which threatens the sustainability of SMEs\' business models. SMEs faced significant challenges in engaging users and payers from the public system due to perverse economic incentives. Physicians are compensated by in-person visits, which actively works against the goals of many digital health solutions of keeping patients out of clinics and hospitals.
There is a significant disconnect between the economic incentives that drive clinical behaviors and the use of digital technologies that would benefit patients\' well-being. To encourage the use of digital health technologies, publicly funded health systems need to dedicate funding for the evaluation of digital solutions and streamlined pathways for clinical integration.