Leadership and Innovation in Healthcare Governance

Abstract

Healthcare systems in high-income countries are once again under pressure to develop major reforms to achieve cost control and high standards of qual- ity and safety (Birnbaum, 2012; Maynard, 2013; Saltman and Cahn, 2013). Yet the reform models of the past --- system restructuring and severe budget cuts --- are no longer a viable option (Denis et al., 1999), and alternative routes are necessary (Institute of Medicine, 2012; McQueen et al., 2012; Nasmith et al., 2010; Starfield, 2011). For example, the political scientist Carolyn Tuohy (2012) argues that institutional entrepreneurs at the me so and operational levels increasingly play a key role in the design and implementation of innovative healthcare delivery. Due to their in-depth knowledge of the healthcare needs and organizational practices, these entrepreneurs may be in a better position to test new ideas about the organization and delivery of healthcare, and consequently bring more appropriate solutions to broad policy dilemmas.