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This study aims to explore how not-for-profit organisations (NFPs) adopt service innovation and improve their employee resilience capabilities as a response to environmental changes arising from marketisation of public services.

Using a multiple case-study research design, this study involved 32 interviews with frontline employees working in a not-for-profit care-providing organisation.

This study finds that the development of absorptive capacity can facilitate service innovation adoption in NFPs and improve employee resilience in times of transition.

This study offers theoretical insights on service innovation, absorptive capacity and employee resilience in NFPs. It makes practical recommendations that will enable NFPs to help frontline employees better adopt service innovation practices in business models endorsed by the private sector.

Adoption of Clinical Decision Support Systems (CDSS) is a crucial step towards the digital transition of the healthcare sector. This review aims to determine and synthesise the influential factors in CDSS adoption in inpatient healthcare settings in order to grasp an understanding of the phenomenon and identify future research gaps.

A systematic literature search of five databases (Medline, EMBASE, PsycINFO, Web of Science and Scopus) was conducted between January 2010 and June 2023. The search strategy was a combination of the following keywords and their synonyms: clinical decision support, hospital or secondary care and influential factors. The quality of studies was evaluated against a 40-point rating scale.

Thirteen papers were systematically reviewed and synthesised and deductively classified into three main constructs of the Technology–Organisation–Environment theory. Scarcity of papers investigating CDSS adoption and its challenges, especially in developing countries, was evident.

This study offers a summative account of challenges in the CDSS procurement process. Strategies to help adopters proactively address the challenges are: (1) Hospital leaders need a clear digital strategy aligned with stakeholders' consensus; (2) Developing modular IT solutions and conducting situational analysis to achieve IT goals; and (3) Government policies, accreditation standards and procurement guidelines play a crucial role in navigating the complex CDSS market.

To the best of the authors’ knowledge, this is the first review to address the adoption and procurement of CDSS. Previous literature only addressed challenges and facilitators within the implementation and post-implementation stages. This study focuses on the firm-level adoption phase of CDSS technology with a theory refining lens.

This study explores how Lean was deployed in several hospitals in the Apulia region in Italy over 3.5 years.

An exploratory qualitative design was drawn up based on semi-structured interviews.

The drivers of Lean in hospitals were to increase patient satisfaction and improve workplace well-being by eliminating non-value-add waste. The participants highlighted three key elements of the pivotal implementation stages of Lean: introduction, spontaneous and informal dissemination and strategic level implementation and highlighted critical success and failure factors that emerged for each of these stages. During the introduction, training and coaching from an external consultant were among the most impactful factors in the success of pilot projects, while time constraints and the adoption of process analysis tools were the main barriers to implementation. The experiences of the Lean teams strongly influence the process of spontaneous dissemination aided by the celebration of project results and the commitment of the departmental hospital heads.

Lean culture can spread to allow many projects be conducted spontaneously, but the Lean paradigm can struggle to be adopted strategically. Lean in healthcare can fail because of the lack of alignment of Lean with leadership in healthcare and with their strategic vision, a lack of employees' project management skills and crucially the absence of a Lean steering committee.

The absence of managerial expertise and a will to support Lean implementation do not allow for systemic adoption of Lean. This is one of the first and largest long-term case studies on a Lean cross-regional multi-hospital application in healthcare.