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Open source software (OSS) communities devoted to the development of electronic medical records (EMRs) have grown in recent years. The purpose of this paper is to focus on the challenge the leaders of these communities face in terms of building perceptions of psychological ownership among community members.

Surveys (n = 50) and brief interviews (n = 56) with individual members of an open source EMR community (most of whom are based in African nations) were used.

Among community members, normative commitment (in comparison to extrinsic motivation and affective commitment) was the strongest predictor of psychological ownership. Interviews revealed that community members tended to feel a greater sense of ownership toward the end user (i.e. hospitals and clinics) than toward the community itself.

To foster engagement and retention – and enhance the worldwide impact of their community on healthcare practices – leaders of open source EMR communities can offer incentives related to certifications and status-based rewards, hold annual meetings to allow members to develop a better understanding of the community and encourage members to “pay it forward” by involving end users (i.e. hospital and clinic employees) within the community, thus furthering public health initiatives.

OSS communities experience unique challenges compared to traditional organizations. This necessitates a reconsideration of the applicability of commonly accepted principles, tenets and recommendations from the management literature.

For decades, organizational research has primarily considered instrumental technology perceptions (ITP) – emphasizing how technology impacts the personal interests of end users themselves – to understand technology acceptance. The authors offer a complementary paradigm by introducing deontic technology perceptions (DTP), defined as the degree to which individuals believe that the technology they use is beneficial to other individuals beyond themselves (e.g. beneficial to customers).

The authors collected quantitative survey-based data from three different hospitals located in the United States. On the basis of conservation of resources theory, the authors investigated whether both DTP and ITP were associated with improved work-related well-being.

Two pilot studies (n = 161 and n = 311 nurses) substantiated our DTP conceptualization. Our primary study (n = 346 nurses) found support for the association between DTP and improved work-related well-being. Evidence for the relationship between ITP and work-related well-being was mixed and the authors did not find a statistically significant interaction between DTP and ITP.

The authors build on decades of research on technology acceptance by complementing it with our deontic perspective. Our work demonstrates that technology users pay attention and react meaningfully to how their use of technology impacts not only themselves but also external parties like patients, customers and members of the general public.

Workarounds represent informal modifications to rules and procedures that individuals will engage into navigate around a process block in order to make their job easier. Although workarounds have been primarily studied from an individual-level perspective, this chapter argues that workarounds are a socially constructed, multilevel phenomenon, meaning that they are influenced by others (e.g., group norms and coworkers) and can result in the emergence of workaround climates. We find empirical support for the view that workarounds are shaped by a variety of social influences. Moreover, based on an inductive exploratory study, we suggest that workarounds are related to informal training and troubleshooting behaviors. We conclude by outlining several theory-based directions for understanding how workarounds spread throughout all levels of an organization as an incubator for future research.

This study used dominance analysis to examine the relative importance of psychological versus pecuniary approaches to the development of employee ownership attitudes and behaviors. In a sample of 409 non-unionized employees from a commercial real estate firm, we found that perceptions of information and control (i.e., psychological ownership) had a much stronger impact on ownership-related outcomes than did voluntary investment in company stock (i.e., pecuniary ownership), as hypothesized. These findings are consistent with the predictions of the employee ownership literature, suggesting that ownership culture initiatives should be directed at increasing employees’ perceptions of information and control.

To explore identity dynamics in the lived experience of a strategic change over time.

Qualitative data were collected through a longitudinal engagement with the focal organisation. Narrative analysis was used to trace the identity dynamics of senior figures in an organisation as it went through strategic change. This entailed a change of CEO and chairman, alterations to the composition of the board and the executive team and, in association with these changes in personnel, alterations to the strategy and direction of the company.

The identity dynamics were at times comfortable and uncomfortable fits for the individuals involved, and over time expectations and realisations impacted on the processes of change in ways that were unexpected and unintentional for the actors. The outcome of the analysis shows the disruptive impact of identity dynamics on the practice of strategic change.

The nature of the research undertaken does not seek to represent a holistic case study but, rather, is focused on a depth analysis of selected interactional data.

A critique of traditional views of resistance to change is presented and an alternative approach to analysing reactions to change is proposed.

The paper contributes a narrative approach to the discursive analysis of strategic change. It also elaborates the significance of “identity work” in such settings.

This chapter presents a framework for an action research based intervention to develop and transform sustainable healthcare in a regional context. The framework is illustrated by the case of the Regional Cancer Centre (RCC) West in western Sweden.

The framework draws upon and develops Pettigrew’s context–content–process model of strategic change and applies it to the unfolding narrative of the change effort. The empirical focus is the activities of a learning platform consisting of the RCC leadership, senior cancer physicians designated as process owners and an action research team. Data were collected from documents, observations of the learning platform, notes from meetings and interviews. Outcome data were obtained via the self-reporting of the physicians.

The learning platform established the capability for wide ranging development and quality improvement on the 23 cancer pathways as well as some support activities around principles of patient-centred care. A clear result is greater inter-organisational collaboration between care professionals as well as the introduction of new medicines, clinical methods, joint learning activities and new forms of measurement and monitoring of care practices. All of the improved measures are sustained.

Whilst there is no shortage of rhetoric on patient-centred care, the reality is that in complex healthcare systems solutions such as process-oriented approaches often fail. This case presents a model and an approach that eschews clear visions for change and instead places an emphasis on dialogue, participation, professional autonomy and collaborative communities as means for achieving the patient-centred ideal. The case also shows the value of seeing sustainable health systems as being grounded on practitioner–scholar collaboration that combines practical knowing with scientific knowledge.