“ <i>Every idea made life easier</i> :” A critical discourse analysis of creative employee-driven innovation in the Italian healthcare system

Purpose The purpose of this study is to scrutinize the connection between creativity and innovation in the context of public healthcare. This is achieved by applying the theoretical concept of employee-driven innovation (EDI) to explore employees’ perceptions of their creative engagement in innovation processes, as well as to capture the managerial implications of setting up such processes in the sector. Design/methodology/approach A critical discourse analysis (CDA) is applied as a methodological lens to capture the interaction between the macro-level production and meso-level distribution of innovation discourse (top-down), and the micro-level perception of, and response to, the same (bottom-up). This study is based on a qualitative approach and is set in the public healthcare system of the Autonomous Province of Trento, Northeast Italy. In total, 26 semi-structured interviews were conducted with 22 healthcare professionals. For triangulation purposes, observation and document analysis were also performed. Findings The findings of this study reveal that tensions are present between the macro-level discourses and the meso-level strategies around innovation, and the micro-level perceptions of employees’ creative engagement in innovation processes. Healthcare professionals’ creative efforts are not easily recognized and supported by top management, which in turn does not receive a framework of reference in policies acknowledging the importance of human skills and creativity in innovation processes. Research limitations/implications That this is a single case study implies a limitation on the generalizability of its results, but the results may nevertheless be transferable to similar empirical contexts. Therefore, a multiple case study design would be preferable in future studies in order to study EDI strategies and policies across various types of organizations in the public sector. Moreover, apart from CDA, other theoretical and methodological lenses can be applied to investigate the interaction between top-down organizing and bottom-up responses to innovation. Originality/value This study contributes to the EDI literature by providing a more integrative understanding of EDI in the public sector, demonstrating the importance of scrutinizing the interactions between employees and top-level management.