Developing Organizational Ambidexterity: Enabling Service Innovation in a Hospital Setting

  • Thomas Hoholm
  • Fred Strønen
  • Kari J. Kværner
  • Linn Nathalie Støme


In Chapter 13, Hoholm et al. discuss controversies in the healthcare sector by studying the nature of innovation projects at the Clinic of Innovation at Oslo University Hospital and its efforts to improve organizational ambidexterity in the area of service innovation. This includes more room for exploration, and improving their capacity to translate and exploit service innovations in use. Using the notions of ‘exploration’ and ‘exploitation’ (March, Organization Science 2:71–87,1991) the authors show how successful innovation requires two different organizational capacities and discuss how a complex knowledge organization like a hospital may increase its ability to handle both, often referred to as ‘organizational ambidexterity’ (Junni et al., The Academy of Management Perspectives 27:299–312, 2013). The authors propose three conditions for driving ambidexterity: organizational responsibilities and roles, provisional evaluation methods, and systematic cross-case learning.


  1. Bahemia, H., & Squire, B. (2010). A contingent perspective of open innovation in new product development projects. International Journal of Innovation Management, 14(4), 603–627.CrossRefGoogle Scholar
  2. Birkinshaw, J., & Gupta, K. (2013). Clarifying the distinctive contribution of ambidexterity to the field of organization studies. The Academy of Management Perspectives, 27(4), 287–298.CrossRefGoogle Scholar
  3. Burgelman, R. A. (2002). Strategy as vector and the inertia of coevolutionary lock-in. Administrative Science Quarterly, 47(2), 325–357.CrossRefGoogle Scholar
  4. Criscuolo, P., Salter, A., & Ter Wal, A. L. (2013). Going underground: Bootlegging and individual innovative performance. Organization Science, 25(5), 1287–1305.CrossRefGoogle Scholar
  5. Dubois, A., & Gadde, L. E. (2002). Systematic combining: An abductive approach to case research. Journal of Business Research, 55(7), 553–560.CrossRefGoogle Scholar
  6. Dubois, A., & Gadde, L. E. (2014). “Systematic combining” – A decade later. Journal of Business Research, 67(6), 1277–1284.CrossRefGoogle Scholar
  7. Erik Mørk, B., Hoholm, T., & Aanestad, M. (2006). Constructing, enacting and packaging innovations. European Journal of Innovation Management, 9(4), 444–465.CrossRefGoogle Scholar
  8. Fjeldstad, Ø. D., Snow, C. C., Miles, R. E., & Lettl, C. (2012). The architecture of collaboration. Strategic Management Journal, 33(6), 734–750.CrossRefGoogle Scholar
  9. Garud, R., & Karnoe, P. (Eds.) (2001). Path dependence and creation. East Sussex: Psychology Press.Google Scholar
  10. Gioia, D. A., & Chittipeddi, K. (1991). Sensemaking and sensegiving in strategic change initiation. Strategic Management Journal, 12(6), 433–448.CrossRefGoogle Scholar
  11. Gupta, A. K., Smith, K. G., & Shalley, C. E. (2006). The interplay between exploration and exploitation. Academy of Management Journal, 49(4), 693–706.CrossRefGoogle Scholar
  12. Håkansson, H., & Waluszewski, A. (Eds.) (2007). Knowledge and innovation in business and industry: The importance of using others. London: Routledge.Google Scholar
  13. Hoholm, T. (2011). The contrary forces of innovation: An ethnography of innovation in the food industry. Basingstoke: Palgrave Macmillan.CrossRefGoogle Scholar
  14. Hoholm, T., & Araujo, L. (2011). Studying innovation processes in real-time: The promises and challenges of ethnography. Industrial Marketing Management, 40(6), 933–939.CrossRefGoogle Scholar
  15. Hoholm, T., & Olsen, P. I. (2012). The contrary forces of innovation: A conceptual model for studying networked innovation processes. Industrial Marketing Management, 41(2), 344–356.CrossRefGoogle Scholar
  16. Jasmand, C., Blazevic, V., & De Ruyter, K. (2012). Generating sales while providing service: A study of customer service representatives’ ambidextrous behavior. Journal of Marketing, 76(1), 20–37.CrossRefGoogle Scholar
  17. Junni, P., Sarala, R. M., Taras, V., & Tarba, S. Y. (2013). Organizational ambidexterity and performance: A meta-analysis. The Academy of Management Perspectives, 27(4), 299–312.CrossRefGoogle Scholar
  18. Levinthal, D., & March, J. G. (1981). A model of adaptive organizational search. Journal of Economic Behavior & Organization, 2(4), 307–333.CrossRefGoogle Scholar
  19. March, J. G. (1991). Exploration and exploitation in organizational learning. Organization Science, 2(1), 71–87.CrossRefGoogle Scholar
  20. May, C., & Finch, T. (2009). Implementing, embedding, and integrating practices: An outline of normalization process theory. Sociology, 43(3), 535–554.CrossRefGoogle Scholar
  21. McGrath, R. G., & MacMillan, I. C. (1995). Discovery driven planning. Philadelphia: Wharton School, Snider Entrepreneurial Center.Google Scholar
  22. Moreira, T. (2013). The transformation of contemporary health care: The market, the laboratory, and the forum. London: Routledge.Google Scholar
  23. Mørk, B. E., Hoholm, T., Maaninen-Olsson, E., & Aanestad, M. (2012). Changing practice through boundary organizing: A case from medical R&D. Human Relations, 65(2), 263–288.CrossRefGoogle Scholar
  24. Quinn, J. B. (1978). Strategic change. Sloan Management Review, 20(1), 7–19.Google Scholar
  25. Ries, E. (2011). The lean startup: How today’s entrepreneurs use continuous innovation to create radically successful businesses. Crown Books.Google Scholar
  26. Stark, D. (2009). The sense of dissonance. In Accounts of worth in economic life. Princeton: Princeton.Google Scholar
  27. Sullivan, S. D., Mauskopf, J. A., Augustovski, F., Caro, J. J., Lee, K. M., Minchin, M., Orlewska, E., Penna, P., Barrios, J.-M. R., & Shau, W. Y. (2014). Budget impact analysis – principles of good practice: Report of the ISPOR 2012 budget impact analysis good practice II task force. Value in Health, 17(1), 5–14.CrossRefGoogle Scholar
  28. Tushman, M. L., & O’Reilly, C. A. (1996). The ambidextrous organizations: Managing evolutionary and revolutionary change. California Management Review, 38(4), 8–30.CrossRefGoogle Scholar
  29. Van De Ven, A. H., Polley, D., Garud, R., & Venkatraman, S. (1999). The innovation journey. Oxford: Oxford University Press.Google Scholar
  30. Zimmermann, A., Raisch, S., & Birkinshaw, J. (2015). How is ambidexterity initiated? The emergent charter definition process. Organization Science, 26(4), 1119–1139.CrossRefGoogle Scholar

Copyright information

© The Author(s) 2018

Authors and Affiliations

  • Thomas Hoholm
    • 1
  • Fred Strønen
    • 2
  • Kari J. Kværner
    • 1
    • 3
  • Linn Nathalie Støme
    • 4
  1. 1.Department of StrategyBI Norwegian Business SchoolOsloNorway
  2. 2.Oslo Business SchoolOslo and Akershus University College of Applied SciencesOsloNorway
  3. 3.Centre for Connected CareOslo University HospitalOsloNorway
  4. 4.Centre for Connected CareOslo University HospitalOsloNorway

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