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During the 1990s, Italian healthcare organisations (HOs) underwent a process of corporatisation, and the most innovative HOs introduced the balanced scorecard (BSC) to address the need for broader accountability. Currently, there is a limited understanding of the dynamics and outcomes of such a process. Therefore, this study aims to explore whether the BSC is still considered an effective performance management tool and analyse the factors driving and hindering its evolution and endurance in public and non-profit HOs.

We conducted a retrospective longitudinal analysis of two pioneering cases in the adoption of the BSC: one in a public hospital and the other in a non-profit hospital. Data collection relied on accessing institutional documents and reports from the early 2000s to the present, as well as conducting semi-structured interviews with the internal sponsors of the BSC.

We found evidence of three main categories of factors that trigger or hinder the adoption and development of the BSC: (1) the role of the internal sponsor and professionals’ commitment; (2) information technology and the controller’s technological skills; and (3) the relationship between the management and professionalism logics during the implementation process. At the same time, there is no evidence to suggest that specific technical features of the BSC influence its endurance.

The paper contributes to the debate on the key factors for implementing and sustaining multidimensional control systems in professional organisations. It emphasises the importance of knowledge-based assets and distinctive internal capabilities for the success of the business. The implications of the BSC legacy are discussed, along with future developments of multidimensional control tools aimed at supporting strategy execution.

Business models (BMs) are becoming increasingly crucial for value creation in the healthcare sector. The study explores the conceptualization and application of BM concepts within the healthcare sector and investigates their evolution in emerging economies (EEs) and developed economies (DEs). This study aims to uncover these two contexts' shared characteristics and unique variances through a comparative analysis.

The paper systematically investigates and consolidates the literature on healthcare by employing the antecedents, decisions and outcomes (ADO) framework and finally examines 71 shortlisted articles published between 2003 and 2022.

The recognition of the BM within healthcare is increasing, both in EEs and DEs. EEs prioritize value creation and capture through cost efficiency, while DEs focus on innovation. Key theories employed include a resource-based view, the network theory and the theory of innovation. Case studies are commonly used as a methodology. Further research is needed to explore the decisions and outcomes of BMs.

The study adopts stringent filtration and keyword criteria, potentially excluding relevant research. Future researchers are encouraged to broaden their selection criteria to encompass a more extensive range of relevant studies.

Beyond comparing and highlighting gaps in BMs between EEs and DEs, benchmarking DE's healthcare business models (HBMs) helps healthcare organizations in EEs align their practices, mitigate risks and establish efficient healthcare systems tailored to their specific contexts. The study adopts stringent filtration and keyword criteria, potentially excluding relevant research. Future researchers are encouraged to broaden their selection criteria to encompass a more extensive range of relevant studies.

The study analyzes HBMs using an SLR framework perspective and provides practical implications for academicians and practitioners to enhance their decision-making.

The purpose of this study is to solve the problem of healthcare waste management in developing countries. The buildup of medical waste has attracted the attention of all spheres of society due to the expanding population and developing economy. Timely collection and processing of medical waste are extremely important due to its potential hazards. Although the problem of planning medical waste management has been addressed in developed countries, it persists in several developing countries. This research is motivated by an example of a city in India characterized by a dense population, abundant health-care facilities and a lack of planning for managing large medical waste generated daily.

The authors address the problem of designing the network of collection and processing facilities for medical waste and optimizing the vehicle route that collects and transfers the waste between facilities. Due to distinct topographic restrictions in the considered city, the collection and transfer process needs to be conducted in two echelons – from hospitals to collection centers using smaller vehicles and then to the processing facilities using trucks. This work addresses these two problems as a two-echelon location-routing problem.

A mixed-integer programming model is developed to minimize the cost of opening the facilities and transporting medical waste. Several managerial insights are drawn up to assist planners and decision-makers.

This study follows a case study approach to provide a descriptive and prescriptive approach to hospital waste management in the ancient city of Varanasi. The city has witnessed unplanned growth over the years and is densely populated. The health-care facilities in the city have a large catchment area and attract patients from neighboring districts. The situation analysis based on secondary data and unstructured interviews of the stakeholders suggests that the ad hoc approach prevails in present hospital waste management in the city.

The various quality improvement (QI) frameworks and maturity models described in the health services literature consider some aspects of QI while excluding others. This paper aims to present a concerted attempt to create a quality improvement maturity model (QIMM) derived from holistic principles underlying the successful implementation of system-wide QI programmes.

A hybrid methodology involving a systematic review (Phase 1) of over 270 empirical research articles and books developed the basis for the proposed QIMM. It was followed by expert interviews to refine the core constructs and ground the proposed QIMM in contemporary QI practice (Phase 2). The experts included academics in two academic conferences and 59 QI managers from the New Zealand health-care system. In-depth interviews were conducted with QI managers to ascertain their views on the QIMM and its applicability in their respective health organisations (HOs).

The QIMM consists of four dimensions of organisational maturity, namely, strategic, process, supply chain and philosophical maturity. These dimensions progress through six stages, namely, identification, ad-hoc, formal, process-driven, optimised enterprise and finally a way of life. The application of the QIMM by the QI managers revealed that the scope of QI and the breadth of the principles adopted by the QI managers and their HOs in New Zealand is limited.

The importance of QI in health systems cannot be overstated. The proposed QIMM can help HOs diagnose their current state and provide a guide to action achieving a desirable state of quality improvement maturity. This QIMM avoids reliance on any single QI methodology. HOs – using the QIMM – should retain full control over the process of selecting any QI methodology or may even cherry-pick principles to suit their needs as long as they understand and appreciate the true nature and scope of quality overstated. The proposed QIMM can help HOs diagnose their current state and provide a guide to action achieving a desirable state of quality improvement maturity. This QIMM avoids reliance on any single QI methodology. HOs – using the QIMM – should retain full control over the process of selecting any QI methodology or may even cherry-pick principles to suit their needs as long as they understand and appreciate the true nature and scope of quality.

This paper contributes new knowledge by presenting a maturity model with an integrated set of quality principles for HOs and their extended supply networks.

The purpose of this research is to explore how one unsanctioned community sport organization (CSO), AM Hockey, sought to acquire legitimacy in a highly institutionalized minor hockey marketplace at various points in its organizational life cycle.

This study was guided by instrumental case study methodology. Twenty (20) AM Hockey stakeholders from a variety of roles (e.g. executives, program directors and coaches) were interviewed. Document analysis was also utilized to supplement the interviewees. Internal and public documents reflective of the CSO's creation and growth were obtained.

Findings revealed that the CSO had to navigate distinct phases of evolution including the Building, Growth, Competition and Stabilization phases. Although the four life cycle phases identified in this study share similarities with the phases identified by Lester et al. (2003), findings indicated that institutional work mechanisms must be understood in their context as they can vary over the life cycle of an organization. Therefore, start-up sports organizations must approach the pursuit of legitimacy as a continual process rather than something acquired and defended through maintenance work.

Developing legitimacy remains a central challenge for CSOs that seek to deliver alternative sport programming, yet it continues to be understudied. Ultimately, the long-term viability of an unsanctioned CSO in a federated sports system relies, in part, on its ability to continually determine the actions needed to achieve legitimacy within its environment.

This study aims to understand the utility of personas and illustrate, through a case study, how a persona-building exercise in a Community Based Prevention Marketing (CBPM) training of community leaders elicited important insights that complemented findings from ongoing formative research on vaccine hesitancy in the Hispanic/Latino population in the USA during COVID-19 pandemic.

An exploratory concurrent parallel qualitative study design compared three personas created by community-based organization members (n = 37) to transcripts from five formative research focus groups (n = 30) from the same project. All participants in this study were recruited by the National COVID-19 Resiliency Network as part of their capacity-building and formative research activities. Grounded theory guided the content analysis.

This study found personas and focus groups to be complementary. A high degree of co-occurrence was observed when investigating the uptake of the COVID-19 vaccine under the categories of barriers, culture and communication. Between the two methods, the authors found strong associations between fear, disruption to the value system, work-related barriers, inaccessibility to health care and information sources and misinformation. Areas of divergence were negligible.

While personas provided background information about the population and sharing “how” to reach the priority population, focus groups provided the “why” behind the behavior, followed by “how”.

A community-driven persona-building process built on cultural community knowledge and existing data can build community capacity, provide rich information to assist in the creation of tailored messages, strategies and overall interventions during a public health crisis and provide user-centered, evidence-based information about a priority population while researchers and practitioners wait on the results from formative research.

This case study provided a unique opportunity to analyze the complementary effectiveness of two methods acting in tandem to understand the priority population: stakeholder-informed persona-building and participant-informed focus group interviews. Understanding their complementary nature addresses a time gap that often exists between researchers and practitioners during times of crises and builds on recommendations associated with bringing rigor into practice, promoting academic contribution to real-world issues and building collaborative partnerships. Finally, it supports the utility of a nimble tool that improves social marketers’ ability to know more about their audience for intervention design when time is of the essence and formative research is ongoing.

First-generation college students in the United States are a unique demographic that is often characterized by the institutions that serve them with a risk-laden and deficit-based model. However, our analysis of the transcripts of open-ended, semi-structured interviews with 22 “first-gen” respondents suggests they are actively deft, agentic, self-determining parties to processes of identity construction that are both externally imposed and potentially stigmatizing, as well as exemplars of survivance and determination. We deploy a grounded theory approach to an open-coding process, modeled after the extended case method, while viewing our data through a novel synthesis of the dual theoretical lenses of structural and radical/structural symbolic interactionism and intersectional/standpoint feminist traditions, in order to reveal the complex, unfolding, active strategies students used to make sense of their obstacles, successes, co-created identities, and distinctive institutional encounters. We find that contrary to the dictates of prevailing paradigms, identity-building among first-gens is an incremental and bidirectional process through which students actively perceive and engage existing power structures to persist and even thrive amid incredibly trying, challenging, distressing, and even traumatic circumstances. Our findings suggest that successful institutional interventional strategies designed to serve this functionally unique student population (and particularly those tailored to the COVID-moment) would do well to listen deeply to their voices, consider the secondary consequences of “protectionary” policies as potentially more harmful than helpful, and fundamentally, to reexamine the presumption that such students present just institutional risk and vulnerability, but also present a valuable addition to university environments, due to the unique perspective and broader scale of vision their experiences afford them.

The information used in the case study was obtained from secondary sources, such as internal documents, reports, news, and organization websites. Three of the four authors played a hands-on role in the case.

The COVID-19 pandemic exacerbated the global challenge of hiring and retaining health-care workers. To address its own challenges, Mayo Clinic decided to fundamentally transform its 30-year-old tuition assistance program: from a model centered on the premise that tuition assistance was an employee benefit for professional development purposes, to one that was more driven to meet the business needs of the employer by preparing internal talent for important roles throughout the institution. Herein, this case study first describes how the COVID-19 pandemic impacted health-care organizations like Mayo Clinic. Next, this study provides details on the original employee tuition assistance program, and then, focuses on the reasons for its need to be changed. Afterward, this study introduces the new tuition assistance programs. Finally, this study follows with examples of how both Mayo Clinic and its employees navigated through initial challenges, such as resistance to change and lack of engagement. In sum, this case study provides critical insight into designing workforce education programs that provide professional development for meeting the workforce needs of the organization.

This case can be used as teaching material in relevant undergraduate- and MBA-level courses, such as human resource management, human resource development and compensation and benefits. This case allows students to critically analyze workforce education programs (e.g. tuition assistance programs) and to plan how to strategically align those with the workforce needs of the organization.

Research has examined how new ventures strengthen local economic outcomes; however, limited research examines health-oriented ventures and their impact on social outcomes, including health outcomes. Increased VC investment in healthcare service start-ups signals more activity toward this end, and the need for further academic inquiry. We examine the relationship between these start-ups and county-level health outcomes, health factors, and hospital utilization.

Data on start-ups funded via institutional venture capital from PitchBook were merged with US county-level outcomes from the County Health Rankings and Area Health Resources Files for 2010 to 2019. We investigated how the number of VC-funded healthcare service start-ups, as well as a subset defined as innovative, were associated with county-level health measures. We used panel models with two-way fixed effects and Propensity Score Matched (PSM), controlling for demographics and socioeconomic factors.

Each additional VC-funded healthcare service start-up was related to a significant 0.01 percentage point decrease in diabetes prevalence (p < 0.01), a decrease of 1.54 HIV cases per 100,000 population (p < 0.1), a 0.02 percentage point decrease in obesity rates (p < 0.01), and a 0.03 percentage point decrease in binge drinking (p < 0.01). VC-funded healthcare service start-ups were not related to hospital utilization.

This work expands our understanding of how industry-specific start-ups, in this case healthcare start-ups, relate to positive social outcomes. The results underscore the importance of evidence-based evaluation, the need for expanded outcome measures for VC investment, and the possibilities for integration of healthcare services and entrepreneurship ecosystems.

This paper explores the Adoption of Technological Innovation (ATI) in the healthcare industry. It investigates how the literature has evolved, and what are the emerging innovation dimensions in the healthcare industry adoption studies.

We followed a mixed-method approach combining bibliometric methods and topic modeling, with 57 papers being deeply analyzed.

Our results identify three latent topics. The first one is related to the digitalization in healthcare with a specific focus on the COVID-19 pandemic. The second one groups up the word combinations dealing with the research models and their constructs. The third one refers to the healthcare systems/professionals and their resistance to ATI.

The study’s sample selection focused on scientific journals included in the Academic Journal Guide and in the FT Research Rank. However, the paper identifies trends that offer managerial insights for stakeholders in the healthcare industry.

ATI has the potential to revolutionize the health service delivery system and to decentralize services traditionally provided in hospitals or medical centers. All this would contribute to a reduction in waiting lists and the provision of proximity services.

The originality of the paper lies in the combination of two methods: bibliometric analysis and topic modeling. This approach allowed us to understand the ATI evolutions in the healthcare industry.