Service Innovation and Hospital Performance: A CIMO-Based Systematic Literature Review

Lisbeth Mariane Siahaan; Hendy Tannady; Mohammad Hamsal; Tantri Yanuar Rahmat Syah

doi:10.59261/inkubis.v8i4.544

Authors

Lisbeth Mariane Siahaan Universitas Esa Unggul, Indonesia
Hendy Tannady Universitas Esa Unggul, Indonesia
Mohammad Hamsal Universitas Bina Nusantara, Indonesia
Tantri Yanuar Rahmat Syah Universitas Esa Unggul, Indonesia

DOI:

https://doi.org/10.59261/inkubis.v8i4.544

Keywords:

CIMO Framework, Hospital Performance, Healthcare Management, Service Innovation, Systematic Literature Review

Abstract

Background: Hospitals face increasing pressure to improve patient experience, quality of care, operational efficiency, and financial sustainability. However, evidence linking service innovation to hospital performance remains fragmented.

Objective: To synthesize reported associations and proposed mechanisms linking service innovation to multidimensional hospital performance using the Context–Intervention–Mechanism–Outcome (CIMO) framework.

Methods: This systematic review searched Scopus, ProQuest, ScienceDirect, and PubMed for English-language, open-access empirical journal articles published between 2020 and 2025. Eligible studies examined service innovation in hospital or healthcare settings and its performance-related outcomes, while selected cross-sector studies were used solely to inform the interpretation of underlying mechanisms. The PRISMA 2020 guidelines informed the reporting process, while CIMO coding supported a narrative thematic synthesis rather than a meta-analysis.

Results: Five pathways were identified: patient value, operational value, digital value, collaborative value, and strategic value. Reported outcomes included patient satisfaction, patient loyalty, financial performance, operational coordination, information quality, innovation performance, and competitiveness. Proposed mechanisms included information quality, workflow redesign, leadership, organizational readiness, absorptive capacity, trust, and strategic alignment. The predominance of cross-sectional research designs limits causal inference. Furthermore, inaccessible full-text reports and incomplete documentation of the search and appraisal processes constrain the interpretation of the findings.

Conclusion: Service innovation is associated with hospital performance through context-dependent pathways rather than producing guaranteed improvements. The CIMO framework provides a structured account of plausible mechanisms that warrant empirical testing.

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