Clinician Participation in Innovation Labs at University Hospitals: Mixed Methods Study

Innovation labs (ILs) are increasingly being implemented in hospital settings to propel collaboration and experimentation against the backdrop of digital transformation. While these labs offer substantial potential for accelerating the development and testing of novel clinical and operational solutions, the sustainable participation of hospital staff remains a challenge. Frontline clinicians and nurses possess essential contextual knowledge yet face significant structural, cultural, and time-related barriers to meaningful IL engagement. Understanding the conditions under which hospital staff can be effectively integrated into ILs is therefore critical to realizing their transformative potential.

This study aims to explore how hospital staff can be effectively engaged in ILs within a university hospital setting. The specific objectives are to (1) identify organizational, structural, and cultural conditions that enable or hinder participation; (2) understand enablers and barriers from the perspectives of staff across professional groups; (3) characterize differences between physician and nursing perspectives on IL engagement; and (4) derive practical recommendations for the design and implementation of ILs.

An exploratory sequential mixed methods design was used for this study, conducted at Charité - Universitätsmedizin Berlin, a large university hospital in Germany. In phase 1, semistructured interviews were conducted with innovation leaders from nonhospital sectors (group A) and clinical and nonclinical leaders from the study hospital (group B). Themes derived from the qualitative analysis informed the development of a structured online survey. In phase 2, this survey was distributed to all hospital staff across campuses. Quantitative data were analyzed using descriptive and nonparametric comparative methods (Mann-Whitney U test) to assess differences between professional groups.

In the qualitative phase, 13 interviews identified 8 emergent themes across 3 typological categories: strategic alignment of ILs, design principles, and staff motivation. In the quantitative phase, 532 responses were collected via the structured 44-item online survey (226/334, 67.7% physicians; 53/334, 15.9% nurses). Findings reveal strong staff support for ILs that align with institutional priorities (eg, patient care and digital transformation), prioritize workflow improvements, and are embedded within hospital structures. Key enablers include protected time, dedicated funding, and access to methodological expertise. Participants were motivated by opportunities to acquire new skills and address clinical problems, preferring flexible roles over commitments extending beyond clinical hours or participation in spin-offs. Statistically significant differences between professional groups were observed in motivation patterns, perceptions of innovation outcomes, and structural needs.

Staff perspectives indicate that engaging clinicians in university hospital-based ILs requires structural support, visible strategic alignment, and attention to differing professional motivations. Internal IL models, resource allocation, and tailored participation formats appear essential for clinician engagement. While investment is required, this approach may yield substantial returns through enhanced care delivery, staff satisfaction, and organizational adaptability. We present empirically grounded, actionable recommendations for IL design and implementation in university hospitals.