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Describes how the National Health Service management has responded to pressure for change as a “critical case site” for investigation of the importance of innovativeness. What factors help or hinder innovation? What distinguishes highly innovative teams? How does the process of innovation develop over time? What practical recommendations can be made to facilitate innovation? Identifies four significant factors: vision, participative safety, a climate for excellence, and support for innovation. Describes a programme of recommended practical interventions.

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