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Despite agreement on the importance of adopting governance structures for developing competitive advantage, we still know little about why or how governance mechanisms are adopted in the first place. We also acknowledge that family businesses with formal governance mechanisms in place still resort to informal means to make decisions, and we lack knowledge about why certain governance mechanisms are sometimes, but not always, effective and functional. Given these research gaps, and drawing on institutional theory, we aim to explore: How are governance structures adopted and developed in family firms? Once adopted, how do family businesses perceive these governance structures?

Using Mokken Scale Analysis, a method suitable to uncover patterns/sequences of adoption/acquisition over time, we analyze a dataset of 1,488 Spanish family firms to explore if there is a specific pattern in the implementation of governance structures. We complement the analysis with descriptive data about perceived usefulness of such structures.

Our findings highlight two important issues. Family businesses follow a specific process implementing first business governance (board of directors, then executive committee), followed by family governance (family council then family constitution). We suggest they do so in response to institutional pressures, given the exposure they have to business practices, and their need to appear legitimate. Despite formal adoption of governance structures, family businesses do not necessarily consider them useful. We suggest that their perception about the usefulness of the implemented governance structures may lead to their ceremonial adoption, resulting in a gap between the implementation and functionality of such structures.

Our article contributes to the family business literature by bringing novel insights about implementation of governance structures. We take a step back to explain why these governance mechanisms were adopted in the first place. Using institutional theory we enrich governance and family business literatures, by offering a lens that explains why family businesses follow a specific process in adopting governance structures. We also offer a plausible explanation as to why governance structures are ineffective in achieving their theorized role in the context of family businesses, based on the family's perception of the unusefulness of such structures, and the concept of ceremonial adoption.

There is no single recipe that can serve the multiple needs of different family businesses. This indicates that family businesses may need diverse levels of development and order when setting up their governance structures. Accordingly, this study constitutes an important point of demarcation for practitioners interested in examining the effectiveness of governance structures in family firms. We show that an important pre-requisite for examining the effectiveness of governance structures is to start by investigating whether these structures are actually being used or are only adopted ceremonially.

Our paper expands current knowledge on governance in family firms by taking a step back hinting at why are governance structures adopted in the first place. Focusing on how governance is implemented in terms of sequence is novel and relevant for researcher and practitioners to understand how this process unfolds. Our study uses institutional theory, which is a strong theory to support the results. Our paper also uses a novel method to study governance structures in family firms.

The purpose of this paper is to argue for an improved conceptualisation of health service research, using Stengers' (2018) metaphor of “slow science” as a critical yardstick.

The paper is structured in three parts. It first reviews the field of health services research and the approaches that dominate it. It then considers the healthcare research approaches whose principles and methodologies are more aligned with “slow science” before presenting a description of a “slow science” project in which the authors are currently engaged.

Current approaches to health service research struggle to offer adequate resources for resolving frontline complexity, principally because they set more store by knowledge generalisation, disciplinary continuity and integrity and the consolidation of expertise, than by engaging with frontline complexity on its terms, negotiating issues with frontline staff and patients on their terms and framing findings and solutions in ways that key in to the in situ dynamics and complexities that define health service delivery.

There is a need to engage in a paradigm shift that engages health services as co-researchers, prioritising practical change and local involvement over knowledge production. Economics is a research field where the products are of natural appeal to powerful health service managers. A “slow science” approach adopted by the embedded Economist Program with its emphasis on pre-implementation, knowledge mobilisation and parallel site capacity development sets out how research can be flexibly produced to improve health services.