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Opera houses have been traditionally publicly financed in many western countries. However, today many opera houses are facing serious financial troubles, due to the recent financial crisis. There is thus a widespread public debate on measures to ensure agency efficiency for performing arts organizations. Focusing on the reform implemented recently in Italy, which submitted opera houses that had severe financial difficulties to a recovery plan and encouraged forms of collaborative governance (CG), the purpose of this paper is to investigate the impact of CG on the performance of the arts sector.

Multiple case studies are used, on longitudinal data from multiple sources over a period of up to five years, in order to triangulate the narrative of financial and artistic performance and ensure trustworthiness. The study thus spans the period before the Bray Law came into force (2013) and covers the entire period in which recovery plans were implemented.

The analysis explores how opera houses are building sustainability for themselves and the community in terms of financial and artistic performance through CG. Various forms of CG adopted yielded positive results. Furthermore, more robust forms of CG generated better performance, especially from a financial point of view.

This paper adds to the limited knowledge of CG in the non-profit sector by bridging the fields of agency performance and CG. It discusses how the introduction of forms of CG can build up long-term sustainability, solving the dilemma of how to achieve financial equilibrium without compromising artistic quality, focusing on the case of opera houses, which are notably affected by Baumol’s cost disease.

The purpose of this paper is to describe the design and construction of a privilege mapping system (clinical and organizational competences) of the medical staff of the Niguarda Hospital in Milan, Italy. The second aim is to measure and assess the impact of implementing an evaluation process of clinical competences at the same hospital.

The paper retraces the development and implementation of the evaluation of the privilege system, highlighting the subjects involved, the phases and outputs. Moreover, a questionnaire was distributed to 50 heads of unit involved in the planning, building and implementation of competences mapping. Five areas were investigated: competences evaluation for professional development; the impact on work organization and professional roles; professional collaboration; its impact according to context (hospital or unit) and time scale (short or long term); and ability to evaluate clinical outcome.

Results reveal success factors for the development and implementation of a privilege mapping system. Furthermore, the survey revealed that clinical leaders are aware of the importance of competences evaluation. In particular, they consider it as a management tool useful for professional development, for identifying excellence and planning operational activities.

Literature and practical evidence recognize the need to assess the clinical and organizational competences in order to assign tasks and responsibilities. However, there are no studies that describe the construction of systems of evaluation of privileges, as it has never been investigated as professionals perceive these tools.

Despite the advent of New Public Management theories over three decades ago, doubts persist regarding the practical implementation of these principles in the public health-care context. Challenges arise particularly from the type of system where this phenomenon is analyzed. In the Italian context, for instance, it can be arduous to define universally applicable organizational behaviors, given the interregional disparity that characterizes such a system. Furthermore, the professional identity of clinician-managers influences the perception of what “being a manager” means. This paper, thus, using the Italian context as a reference, aims to delineate what is the perception of Italian public hospitals clinician-middle-managers in terms of their responsibilities and tasks.

A survey-questionnaire was distributed to 6,011 Chief Medical Officers (CMOs) in Italian public hospitals, representing 100% of such role holders in the country. With a response rate of 16.7%, 1,005 responses were obtained. The questionnaire assessed CMOs' attitudes toward specific activities relevant to clinician-management, ranked from most to least important. Activities were derived from literature and categorized to discern management styles. Subgroups based on geographical location and professional orientation were also identified to isolate regional effects and professional identity influences.

Results suggested that activities associated with a collaborative approach are perceived as most important. Furthermore, it clearly emerges the difference based on professional orientation of CMOs. However, it could not be appreciated the same level of difference basing the analysis on regional disparities.

The interest in the role of middle management in healthcare organizations has increased over the years. Nevertheless, currently the authors believe that not many studies are focused on defining what “being a manager” means for clinician-managers themselves, rather than explaining what clinician-managers shall do.

This study aims to provide a picture of the current state of art in the use of big data for decision-making processes for the management of health-care organizations.

A systematic literature review was carried out. The research uses two analyses: descriptive analysis, describing the evolution of citations; keywords; and the ten most influential papers, and bibliometric analysis, for content evaluation, for which a cluster analysis was performed.

A total of 48 articles were selected for bibliographic coupling out of an initial sample of more than 5,000 papers. Of the 48 articles, 29 are linked on the basis of their bibliography. Clustering the 29 articles on the basis of actual content, four research areas emerged: quality of care, quality of service, crisis management and data management.

Health-care organizations believe strongly that big data can become the most effective tool for correctly influencing the decision-making processes. Thus, more and more organizations continue to invest in big data analytics, and the literature on this topic has expanded rapidly. This study seeks to provide a comprehensive picture of the different streams of literature existing, together with gaps in research and future perspectives. The literature is mature enough for an analysis to be made and provide managers with useful insights on opportunities, criticisms and perspectives on the use of big data for health-care organizations. However, to date, there is no comprehensive literature review on the big data analysis in health care. Furthermore, as big data is a “sexy catchphrase,” more clarity on its usage may be needed. It represents an important tool to be investigated and its great potential is often yet to be discovered. This study thus sheds light on emerging issues and suggests further research that may be needed.

Healthcare organizations worldwide were badly hit by the “surprise” of the pandemic. Hospitals in particular are trying hard to manage problems it caused, searching for solutions to protect the health of citizens and reorienting operations. The implementation of resilience solutions in the coping phase and the ability to react promptly and redefine activities is essential. Integrating crisis management and resiliency literature, this paper discusses how health organizations were able to cope with adversity during the crisis.

The research is conducted through a case study of a large Italian hospital, the Gemelli Polyclinic Foundation, which was one of the leading hospitals in the Italian response to the pandemic.

The case reports actions taken in order to continue functioning and to maintain core activities despite severe adversity. The overall response of the Gemelli was the result of the three types of response: behavioral (effective leadership), cognitive (rapid resource reallocation) and the contextual reinforcement (multiagency network response). The authors highlight how an integrative framework of crisis management and resiliency could be applied to healthcare organizations in the coping phase of the pandemic. The experience of the Gemelli can thus be useful for other hospitals and organizations facing external crises and for overall improvement of crisis management and resilience. Responding to crisis brings the opportunity to make innovations introduced during emergencies structural, and embed them moving forward.

The paper focuses only on the coping phase of the response to the pandemic, whereas building long-term resilience requires understanding how organizations accumulate knowledge from crises and adapt to the “new normal.”

The paper responds to the call for empirical studies to advance knowledge of an integrative framework of crisis management and resiliency theories with reference to complex organizations such as healthcare.

The purpose of this paper is to understand whether and how the Environmental, Social and Governance (ESG) paradigm can be useful in social reporting in the context of nonprofit healthcare organizations. In other words, the study deals with non-financial reporting and information, allowing external stakeholders to comprehensively evaluate the organization’s performance and behavior, investigating internal stakeholder perception over ESG paradigm application.

The authors used a case study approach investigating four cases among nonprofit healthcare organizations in Italy. Analyses of available primary sources have been conducted, followed by semi-structured interviews. Interviews were then transcribed and coded in a joint blinded process by all authors. More specifically, three areas have been investigated: (1) factors motivating the development of non-financial disclosure practices; (2) the rationale behind the organization’s decision to include specific topics; and (3) the future perspective on the future of non-financial disclosure within the specific sector.

ESG may serve as a suitable framework to create comparable documents that can act as benchmarks for similar institutions. However, while nonprofit organizations (NPOs) can draw inspiration from ESG, the utility of these criteria should be thoughtfully tailored to align with the organization’s mission. The ESG using as a general guide, instead of implementing it as a real tool to assess performances, emerges as a positive practice. NPOs should not focus on fulfilling ESG requirements bur rather take inspiration from them. Otherwise, the risk is an excess of focus on the formal aspect rather than on its content.

The study contributes to a better understanding of social and ESG’ reporting activities and approaches in the healthcare sector by describing some case studies and the effect of sustainability in the social reporting of nonprofit healthcare organizations.