Organizing the entrepreneurial hospital: Hybridizing the logics of healthcare and innovation

Contemporary research hospitals occupy a vexed position in the policy landscape. On the one hand, as healthcare providers, they must abide by the logic of healthcare policy, which expects health research to support improved health outcomes and high quality healthcare systems. On the other hand, as research facilities, they are beholden to the logic of innovation policy, which seeks to advance research-driven, science and technology-derived innovations, where industry is the key customer and client. At the intersection of these policy logics, the research hospital must orchestrate a range of interests that may not always coexist harmoniously. Through a detailed case study of a Canadian research hospital, we illustrate organizational efforts to hybridize healthcare and innovation logics. The need to be more 'business like' and the expected financial and reputational rewards encourage acceptance of a mandate for technology transfer and commercialization. As well, there is hope that the entrepreneurial turn can serve the hospital's own mission, by prioritizing the needs of patients and the organization itself as a user of its own innovations. Further, insofar as successful technology transfer and commercialization is a transformative force, it is expected to enable the research hospital to achieve its goal of translational and impactful health research. As we illustrate, there is much optimism that these hybridizing efforts will produce a successful cross. Yet the trajectory of change in the context of mixed logics is necessarily uncertain, and other hybrid futures cannot be foreclosed. More sterile or monstrous outcomes remain possible, with potentially significant implications for the intellectual, economic and health benefits that will arise as a result.