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The outbreak of the COVID-19 pandemic has significantly impacted healthcare systems, presenting unforeseen challenges that necessitated the implementation of change management strategies to adapt to the new contextual conditions. This study aims to analyze organizational changes within the total hip replacement (THR) surgery pathway at multiple levels, including macro, meso and micro. It employs data triangulation from various sources to gauge the complexity of the change process and comprehend how multi-level decision-making influenced an unexpected shift.

A multicentric, single in-depth case study was conducted using a mixed-methods approach. Data sources included patient-reported outcome measures specific to the THR pathway and carefully structured in-depth interviews administered to managers and clinicians in two healthcare organizations serving the same population.

Decisions made at the macro level resulted in an overall reduction in surgical activities. Organizational changes at the meso level led to a complete cessation or partial reorganization of activities. Micro-level actions for change and adaptation revealed diverse and fragmented change management strategies.

Organizations with segmented structures may require a robust and structured department for coordinating change management responses to prevent the entire system from becoming stuck in the absorptive phase of change. However, it is important to recognize that absorptive solutions can serve as a starting point for genuine innovations in change management.

The utilization of data triangulation enables the authors to visualize how specific changes implemented in response to the pandemic have influenced the observed outcomes. From a managerial perspective, it provides insights into how future innovations could be introduced.

The purpose of this study is to examine the role of artificial intelligence (AI) in transforming the healthcare sector, with a focus on how AI contributes to entrepreneurship and value creation. This study also aims to explore the potential of combining AI with other technologies, such as cloud computing, blockchain, IoMT, additive manufacturing and 5G, in the healthcare industry.

Exploratory qualitative methodology was chosen to analyze 22 case studies from the USA, EU, Asia and South America. The data source was public and specialized podcast platforms.

The findings show that combining technologies can create a competitive advantage for technology entrepreneurs and bring about transitions from simple consumer devices to actionable healthcare applications. The results of this research identified three main entrepreneurship areas: 1. Analytics, including staff reduction, patient prediction and decision support; 2. Security, including protection against cyberattacks and detection of atypical cases; 3. Performance optimization, which, in addition to reducing the time and costs of medical procedures, includes staff training, reducing capital costs and working with new markets.

This study demonstrates how AI can be used with other technologies to cocreate value in the healthcare industry. This study provides a conceptual framework, “AI facilitators – AI achievers,” based on the findings and offer several theoretical contributions to academic literature in technology entrepreneurship and technology management and industry recommendations for practical implication.

Many healthcare institutions, such as hospitals, have recently implemented quality improvement initiatives such as Lean Six Sigma (LSS). However, only a few have sustained the initiatives and remained successful. One of the main reasons for the failure of LSS implementation is that managers tend to view LSS as individual projects. Managers lack a Change Management (CM) focus during the implementation. The primary purpose of this study is to document the implementation of LSS through a CM approach to improve sustainability.

Define-Measure-Analyse-Improve-Control (DMAIC) and the Awareness-Desire-Knowledge-Ability-Reinforcement (ADKAR), a popular CM approach, are combined to propose a new framework. The usefulness of the proposed framework is demonstrated using a case study in a multispeciality hospital located in southern India.

The study found that several factors are responsible for the high Length of Stay (LOS) for patients in the Emergency Department (ED). By implementing this proposed model to implement LSS and taking corrective actions, the average LOS was reduced from 267 to 158 min (a 40% reduction approximately).

The complete step-by-step approach is explained, and the LOS was considerably reduced during the pilot project. The findings will provide valuable insights for healthcare practitioners to understand the steps involved in the combined DMAIC-ADKAR model. The findings would also give healthcare practitioners the confidence to identify suitable tools and implement LSS in organisations where the practitioners work.

According to the authors' knowledge, this is the first study that synergises two models (DMAIC and ADKAR) into a single framework to implement in a hospital.

This paper aims to provide a history of graduate healthcare management education in the USA with an emphasis on the comparison of business schools and health science settings. It seeks to explain why different organizational cultures exist and how this affects education.

The approach relies on literature review and descriptive analysis using secondary data. Institutional economics helps provide perspective on different academic cultures and orientations.

Healthcare management education originated in the early twentieth century. Business schools at the University of Chicago and Northwestern were early pioneers. By mid‐century, schools of public health and medicine entered and came to dominate with strong graduate programs at Berkeley, Michigan and other leading universities. More recently, business schools have differentiated away from the generic MBA and expanded into this market. Advocates of health science settings commonly see healthcare as different from other forms of management. The externally funded model of medical education relying on patient and grant revenues dominates the health sciences. This can lead to preference for faculty who generate funds and a neglect of core academic areas that historically have not relied on grants and contracts.

This history of health management education provides insight for students, researchers, educators and administrators. It underscores comparative advantage of different academic settings.

This paper serves to fill a gap in the management literature. It provides history and perspective about academic settings not readily available.

The purpose of this paper is to examine: the content of radical change by mapping differences between two templates for organizing delivery of healthcare; the enabling and constraining mechanisms underlying major change from one template to another; and the processes implicated in change implementation.

Longitudinal, qualitative case study design allowed the tracking, over a four‐year period, of the transformation of healthcare service in a community from provider‐centered, fragmented delivery to patient‐centered, integrated delivery. The authors conducted 90 interviews at three intervals, observed meetings, and analyzed internal and external documents. Concepts on content, process and mechanisms were used to analyze the data.

Transition from one template to another involves radical change in structures/systems and underlying values. Mechanisms precipitating and enabling change include: powerful stakeholders' dissatisfaction with current template and commitment to a new one, willingness to resource the change, provision of credible leadership, and manipulation of incentive programs. Radical change is underlain by a series of micro change processes that involve emergent, non‐linear dynamics, and that follow their own track with enabling and constraining mechanisms.

The paper describes a case of positive, successful change. Implications include importance of: attention to power dynamics, persistent leadership, elimination of boundaries between collaborating groups, and aligning incentives with desired practice changes; and attending to both variance and process in understanding healthcare change.

Change excessiveness is argued as a critical contextual aspect of change management. The purpose of this paper is to identify three major dimensions to change excessiveness: change frequency, extent, and impact. A three-factor structure is proposed to broaden the emerging study on the contextual aspects of change. Its pertinence is proposed in addressing healthcare employees’ exhaustion, change-related uncertainty, and support for change.

Using questionnaires, a first pilot sample (n=131) was recruited to test the psychometric properties and validity of the three-factor structure, while controlling for affectivity. Structural equation modeling techniques following a two-step approach were used on a second sample (n=363). First a confirmatory assessment of the three-factor structure of excessive change is tested. Second, a full mediation effect of excessive change, as a second-order latent factor, regrouping change frequency, impact and extent as first-order factors, was modeled to predict a tripartite conception of change-related reactions: exhaustion, uncertainty, and support for change.

The excessive change three-factor structure is validated, while showing its superiority over alternative models. The fully mediated model is confirmed. Therefore, the significant added effects of change frequency, impact, and extent are positively related to emotional exhaustion and cognitive uncertainty, while negatively related with behavioral support for change.

This study contributes by proposing a three-factor structure to excessive change assessment based on previous and independent findings in the literature. It also contributes in modeling the added effect of change frequency, extent, and impact in the full mediation relationship of change excessiveness on a tripartite reactions to change in healthcare management settings.

Understanding how individuals respond and adapt to change is essential to assist leaders to manage transformational change effectively. Contemporary health care environments are characterised by frequent and rapid change, often with unrealistic and challenging timeframes. Researchers have employed a range of assessment scales to assess individual readiness for change. Hence, to select the appropriate scale, it is critical to compare the properties of these instruments. A scoping review will be conducted to identify scales that measure an individual's response to change in the healthcare environment.

In this article the authors used the PIC (Population or Problem, Interest, and Context) design and undertook a comprehensive literature search conducted in Eric, MEDLINE, EmCare, CINAHL, PsychINFO and PubMed. Management databases were also searched including Business Source Premium (Ebesco) and Business Collection (InfoRMIT). Reference lists were scrutinized, and citation searches were performed of the included studies. The primary outcome was the quality of the literature searches and the secondary outcome was time spent on the literature search when the PIC model was used as a search strategy tool, compared to the use of another conceptualizing tool or unguided searching.

This scoping review identified eight scales used to measure an individual's response to change. This scoping review did not identify any individual change readiness scales specifically designed for use in the healthcare environment. However, two scales (the Acceptance of Change Scale and the Resistance to Change Scale) had applicability across a wide variety of organisational settings.

Scoping reviews do not set out to comprehensively source all relevant literature but rather to ascertain the nature and extent of the published literature in the field. Therefore, it is possible that a systematic review might uncover additional relevant papers.

This scoping review will assist change leaders to gain a better understanding of the different scales used to measure individual response to change.

To manage change effectively, change leaders first need to develop an understanding of how individuals respond and adapt to change. Change leaders require the necessary scales to assist them to understand change processes, providing an understanding of where individuals are placed on the change continuum. To the best of the authors' knowledge, this scoping review is the first of its kind to identify and review scales to measure individual response to change.

The purpose of this paper is to present the results from a study that investigates first-line healthcare managers’ views on their role and the conditions that influence their ability to drive improvement work based on Lean.

A questionnaire was sent to all first-line managers in a healthcare organization to investigate their views on their role, conditions and ability to create change according to Lean. The results from four of the questions are presented, which focus on how crucial they consider their role to be for managing improvement work based on Lean, what work tasks their time is spent on, what factors they consider to be important to their ability to drive change and what factors best describe what Lean provides.

The results show that first-line managers claim that their role is crucial in improvement work, but when they defined their work tasks, the time spent on improvements was not frequently described. Time, support from coworkers, and a clear vision and clear goals were the three factors that they considered to be most important to their ability to drive improvement work. Considering their leadership, Lean contributed to the structure with tools and supportive methods.

The questions can be used separately or as part of the entire questionnaire before and along a Lean process to obtain a better understanding of how to create a sustainable Lean approach in healthcare. Understanding the factors that first-line managers consider supporting their ability in improvement work and what they consider Lean provides is important in creating a development force in Swedish healthcare.

The purpose of this paper is to bring the discussion on the relationship between management and medicine a step forward by focussing on: first, how the notion of hybrid and hybridity has been used in the literature on healthcare management. Second, the authors have mapped the alternative ways that the concept have been used in order to conceptualize a more specific set of possible combinations of managerial and professional roles in healthcare management. Hybrid management is a topic that ought to be important for training, communication among researchers and for identifying areas of future research: in management, in healthcare reforms, in sociology of professions and in theory of organizations.

The authors provide a systematic literature review in order to map the various conceptualizations of hybrid management. The authors have searched for “hybrid leadership,” “hybrid management” combined with hospitals and health care in a whole range of journals, identified in Google scholar, Academic Search Premier, Academic Research Library and Sage Publication. The authors have also used already existing literature reviews. The search has resulted in more than 60 articles and book titles that have been classified according to whether they make a fit with three alternative ways of conceptualizing hybrid management. The authors are aware that they might have missed some relevant literature but the literature included is quite comprehensive.

In the literature the authors have found three conceptualizations of management. The clinical manager who combines professional self-governance with a general management logic. The commercialized manager who combines professional self-governance with an enterprise logic. The neo-bureaucratic manager who combines self-governance with a neo-bureaucratic logic.

In most analyses of hybridity in management and organization the notion of hybrid has been used in a rather superficial way. By mapping the various uses of hybrid in the literature and suggest how a professional logic may be combined with a set of alternative logics of management the authors provide a platform for developing the concept of hybrid management into a more useful tool for analyses of changes in healthcare management.

The purpose of this paper is to examine the impact of organisational and structural change on the evolution of quality and safety in health organisations, specifically in mental health services.

Data were gathered through semi-structured interviews. In total, 25 executive management team members in both public and private mental health services were interviewed and data were analysed using Burnard’s framework.

Three overarching themes emerged: organisational characteristics, leadership and accountability; sustaining collaboration and engagement with stakeholders; and challenges to and facilitators of quality and safety. Taken together, the findings speak to the disruptive and disorienting impact of on-going organisational change and restructuring on leaders’ ability to focus on, and advance, the quality and safety agenda.

Typical with qualitative research of this nature, the potentially limited generalisability of the findings must be acknowledged.

There is a need for strategies to implement change that are informed by evidence and theory and informed by decades of research on this topic, rather than introduced ad hoc. Change agents must pair effective change management and implementation science strategies to specific contexts, depending on what is being implemented and ensure appropriate evaluation of organisational change to bolster the evidence base around quality and safety and inform future decision-making.

The study explores an identified gap in the literature on the impact of on-going organisational re-structuring and transformation on the evolution of quality and safety in mental health services.