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This paper presents a systematic literature review aiming at analysing how research has addressed performance measurement systems’ (PMSs) ambiguities in the public sector. This paper embraces the ambiguity perspective that PMSs in public sector coexist with and cope with existing ambiguities.

The authors conducted a literature review in Scopus and ScienceDirect, considering articles published since 1985, and the authors selected articles published in the journals included in the Association of Business Schools' Academic Journal Guide (Chartered ABS, 2018). Of the 1,278 abstracts that matched the study’s search criteria, the authors selected 131 articles for full reading and 37 articles for the final discussion.

The study's key findings concern the elements of ambiguity in PMSs discussed in the literature. The study’s results suggest that ambiguity is still a relevant problem in performance measurement, as a problem that is impossible to be solved and therefore needs to be better understood by researchers and public managers. The analysis allows us to summarize the antecedents and consequences of ambiguity in the public sector.

The key findings of the study concern the main sources of ambiguity in PMSs discussed in the literature, their antecedents and their consequences. The study results suggest that ambiguity exists in performance measurement and that is an issue to be handled with various strategies that can be implemented by managers and employees.

Managers and researchers may benefit from this research as it may represent a guideline to understand ambiguities in their organizations or in field research. Researchers may also benefit from a summary list of the key issues that have been analysed in the empirical cases provided by this research.

This research may provide insights to limit ambiguity and thus contribute to improve performance measurement in the public sector.

This research presents a comprehensive review on the topic. It provides insight that suggests what future research should attend to in helping to interpret ambiguity, considering also what should be done to influence ambiguity.

The extent to which sustainability is integrated into conventional accounting practices, in the light of a more integrated thinking perspective, requires further exploration. This paper aims to investigate how management control systems (MCSs) and sustainability-specific control systems (SCSs) are mobilised and how they interact to support the environmental sustainability strategy of a small- and medium-sized entity (SME).

Through a case study in a waste disposal firm, this paper examines the influence of cognitive, organisational and technical factors on the interaction and integration of MCSs and SCSs to bolster an environmental sustainability strategy.

The MCSs that are mobilised vary according to the type of strategy that is pursued. Even though the technical integration of MCSs with SCSs was not achieved, interaction between them supported strategic decision-making and the pursuit of environmental performance in the light of a more integrated thinking perspective. The role of multidisciplinary teams formed by accountants and environmental scientists to support sustainability management control at the SME also enabled interaction and provided steps for integrated thinking.

Although based on single case study, this research offers practitioners useful knowledge about the potential levers and obstacles relating to the mobilisation of MCSs when a sustainability strategy is conceived and its impact on the development of integrated thinking.

The paper provides insight into how SMEs can mobilise their MCSs to support an environmental sustainability strategy, shedding light on the factors that enhance interaction among MCSs and SCSs.

Exploring how to enhance innovative work behaviour (IWB) has been the main concern of top managers and researchers, particularly in knowledge-intensive and public organizations. Yet, studies investigating factors that shape innovative behaviour at work are scarce. Focussing on the healthcare setting, the purpose of this paper is to hypothesize a direct relationship between individuals’ perceived creative self-efficacy (CSE), creative collective efficacy (CCE) and IWB.

The research used survey data from 446 clinical managers working in public healthcare organizations in six different Italian regions and a set of previously validated questionnaires to measure the study variables.

Findings suggest that clinical managers’ perceptions of their CSE and their perceived CCE significantly influence their self-reported IWB.

Findings highlight the importance of constructing and developing clinical managers’ efficacy in creativity at both an individual and team level in order to incentivize the emergence of innovation behaviour. Further research is needed to assess the existence of mediating and/or moderating mechanisms underlying the relationships emerging from this study in order to support decision makers in diffusing innovation and creativity in healthcare organizations.

The research adds to the debate on improving IWB by introducing perceived individual and team creative efficacy as determinants of IWB in healthcare organizations. The research is among the first attempts to contribute to healthcare organizations’ management through exploring clinical managers’ characteristics that influence their IWB.

This paper aims to investigate the consequences of the coercive regulations for performance measurement and comparability that strengthened regional health authority’s control over organizations’ activities on management accountants’ relationship with clinician managers, who are the recipients of accounting information for decisional processes in health-care organizations. To achieve this aim, the research focuses on management accountants’ perception of their role and whether they perceive role conflict and role ambiguity.

A case study was undertaken in a public university hospital in the Emilia-Romagna region, Italy; 9 management accountants and 11 clinician managers were interviewed and secondary data analyzed.

Management accountants show low capabilities to support clinician managers’ decisional processes. Following the enactment of regulations, management accountants perform their role with a primary focus on functional responsibility. The focus on the provision of information to address regulations influenced management accountants’ capability to act as business partners in the organization. Because of the conflicting information needs from regulations and clinician managers, management accountants experience role conflict and ambiguity.

The paper has implications for policymakers, underlining the consequences of strict regulations on management accountants’ role. It also emphasizes the importance of revising accounting techniques to satisfy both regional requirements and clinician managers’ needs for decision-making.

The article contributes to knowledge related to the role of management accountants in health care. It explores, in particular, the consequences of coercive regulations in health-care organizations, adding knowledge to a field that remains quite unexplored.

The purpose of this paper is to report on an action research project carried out in an Italian university hospital that was facing a strategic challenge. The role of intellectual capital (IC) for university hospital strategic management is discussed after developing and applying an IC framework to enhance the visualisation of strategic IC elements.

An action research process has been applied in the studied setting based on Susman and Evered’s (1978) definition of the engaged research cycle.

The action research process allowed a gap between theory and practice to be bridged; the strategic control process resulted supported by new measures; a different approach to strategy management was launched, and other organisations perceived the relevance of the IC representation and wished to import it.

Research limitations are related to those recognised for the interventionist research approach.

The paper contributes to the improvement of managerial and accounting technologies for practitioners managing university hospitals and discusses a university hospital’s strategic goals.

The paper represents a methodological contribution related to the interventionist research stream of literature, and enriches the limited studies focused on IC in health care organisations. Furthermore, the paper enables appreciation of the role of academics in the convergence of theory and practice.