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While digital transformation holds immense promise, organizations often fail to realize its benefits. This study aims to address how policies for digital transformation benefits realization are translated into practice.

The authors apply a qualitative, comparative case study of two large, public-sector health care organizations in Sweden. Through document and interview data, the authors analyze the process of translation.

The study finds that practice variation is primarily caused by two types of decoupling: policy-practice and means-ends. Contrary to previous studies, coercion in policy compliance is not found to decrease practice variation.

The limitations primarily stem from the empirical selection of two large public health-care organizations in Sweden, affecting the study’s generalizability. Reducing practice variation is more effectively achieved through goal alignment than coercion, leading to implications for the design of governance and control.

Policymakers should, instead of focusing on control-related compliance, work to align organizational objectives and policies to decrease practice variation for successful benefits realization.

The study contributes to better benefits realization of digital transformation initiatives in health care. As such, the authors contribute to a better functioning and more transformative health care in times of increased demand and decreased supply of health-care services.

The study challenges conventional wisdom by identifying that coercion is less effective than goal alignment in reducing practice variation, thereby enhancing the understanding of policy implementation dynamics in health-care settings.

This paper conceptualises how managers psychologically experience and respond to crises via metaphor analysis.

This paper uses a discourse dynamics approach to metaphor analysis. Conceptual metaphors were analysed and developed into concept maps through 37 semi-structured interviews with senior managers from different portfolios within 16 public universities in South Africa after #FeesMustFall protests.

Five domains emerged, including (1) looming crisis, (2) crisis onset, (3) crisis triage and containment, (4) (not) taking action and (5) post-crisis reflection. These domains shape a framework for the crisis adaptation cycle.

This study suggests that organisations should pay more attention to understanding emotions in crises and can use the adaptation model to develop their managers. It shows how metaphors can help explain affective and cognitive experiences and how emotions shift and evolve during a crisis. Managers should be aware of early signs of the crisis and its potential impact on their business operation in the looming and recognition stages, analyse the situation and work collectively on possible actions to minimise losses and maximise gains.

This is a rare investigation into the emotions of senior managers in the public sector in a social movement and national crisis via unconventional research methods to advance cognitive appraisal theory in crisis management.