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been created, and rules for its implementation have been defined, the only
problem is to make firms aware of it. Prescriptions about ‘Six-Sigma’ or
‘Customer Relationship Management’ or even ‘Knowledge Management’
as ‘must have’ ‘best’ practices are good examples. Research shows, how-
ever, that this is a misleading and potentially dangerous view (Ettlie and
Bridges, 1987) that greatly downplays the problems of implementation and
the knowledge requirements of innovation. Most innovation is simply not
like that. Box 9.2 summarizes the key limitations of this traditional view.
In Medico, for example, the creation of knowledge went hand in hand with
its use in practice. Indeed the clinical data on the brachytherapy technique
would not be available unless the technique had actually been applied by
medical professionals. In short, knowledge was produced through use, not
before it.

BOX 9.2 Limits of traditional views on innovation
• The innovation process is not linear – pivotal modifi cations in the inno-
vation introduced during its implementation, for example, feed back
into its design (Scarbrough, 2008a).
• The innovation process is not rational (in the traditional sense) – choices
about innovation are based as much on claims made about their effi-
ciency (e.g. by consultants, experts or different players within firms) as
evidence of efficiency per se (Abrahamson, 1996).
• Innovation is not a ‘thing’ or entity with fixed and definable param-
eters that can be simply inserted into different organizational con-
texts. Implementation of technological innovation, for example, often
involves significant reworking of the initial idea or technology so that
it is blended and adapted together with features of the organization
(Clark, 2003).
• Most innovation cannot, therefore, be introduced as a ‘technical fix’
with predictable outcomes.
• Innovation is not discrete but has an impact on many different areas
of the organization and on many individuals and social groups within
it. Effective implementation depends, then, on changes in knowledge,
skills and organizational practices that lie outside the remit of the tech-
nical expert.
• The notion of a universally applicable ‘best practice’ is, in any case,
misleading. Innovation is highly context-specifi c – what works in
one context may not be applicable in another because of the differ-
ent knowledge, skills and understandings of the social groups involved
(Swan et al., 1999b).

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