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As part of a national plan to govern professional and organizational development in Norwegian specialist healthcare, the country’s hospital clinics are tasked with constructing development plans. Using the development plan as a case, the paper analyzes how managers navigate and legitimize the planning process among central actors and deals with the contingency of decisions in such strategy work.

This study applies a qualitative research design using a case study method. The material consists of public documents, observations and single interviews, covering the process of constructing a development plan at the clinical level.

The findings suggest that the development plan was shaped through a multilevel translation process consisting of different contending rationalities. At the clinical level, the management had difficulties in legitimizing the process. The underlying tension between top-down and bottom-up steering challenged involvement and made it difficult to manage the contingency of decisions.

The findings are relevant to public sector managers working on strategy documents and policymakers identifying challenges that might hinder the fulfillment of political intentions.

This paper draws on a case from Norway; however, the findings are of general interest. The study contributes to the academic discussion on how to consider both the health authorities’ perspective and the organizational perspective to understand the manager’s role in handling the contingency of decisions and managing paradoxes in the decision-making process.

The Covid-19 pandemic generated significant changes in the operating methods of hospital logistics departments. The objective of this research is to understand how these changes took place, what collaboration mechanisms were developed with clinical authorities and, to what extent, logistics and clinical care activities should be decoupled to maximize each area's contribution?

The case study is selected to investigate practices implemented during the COVID-19 pandemic in hospitals in Canada. The pandemic presented an opportunity to contrast practices implemented in response to this crisis with those historically used in this environment.

The strategy of decoupling logistical tasks of an operational nature from clinical activities is well-founded and helps free clinical staff from tasks for which they are not trained. However, the decoupling of operational tasks should be combined with an integration of the clinical information flow to the logistics hub players. With this clinical information, the logistics hub can generate its full potential enabling better inventory management decisions to be made.

The concept of decoupling is studied to identify configurations that offer the best benefits for clinical staff.

Value-based healthcare suggested using patient-reported information to complement the information available in the medical records and administrative healthcare data to provide insights into patients' perceptions of satisfaction, experience and self-reported outcomes. However, little attention has been devoted to questions about factors fostering the use of patient-reported information to create value at the system level.

Action research design is carried out to elicit possible triggers using the case of patient-reported experience and outcome data for breast cancer women along their clinical pathway in the clinical breast network of Tuscany (Italy).

The case shows that communication and engagement of multi-stakeholder representation are needed for making information actionable in a multi-level, multispecialty care pathway organized in a clinical network; moreover, political and managerial support from higher level governance is a stimulus for legitimizing the use for quality improvement. At the organizational level, an external facilitator disclosing and discussing real-world uses of collected data is a trigger to link measures to action. Also, clinical champion(s) and clear goals are key success factors. Nonetheless, resource munificent and dedicated information support tools together with education and learning routines are enabling factors.

Current literature focuses on key factors that impact performance information use often considering unidimensional performance and internal sources of information. The use of patient/user-reported information is not yet well-studied especially in supporting quality improvement in multi-stakeholder governance. The work appears relevant for the implications it carries, especially for policymakers and public sector managers when confronting the gap in patient-reported measures for quality improvement.

Despite much attention being devoted to shared leadership, the negotiation of such arrangements remains underexplored. In parallel, the revival of interest in matrix structures reveals their challenges but neglects the dynamics of shared leadership. In this case study, the author analyzes the tensions experienced by senior managers of a healthcare organization transitioning from a hierarchical to matrix structure as they negotiate their leadership roles in this new arrangement.

The author interviewed 16 senior managers, observed their meetings and analyzed documents. These data were combined with secondary data including previous interviews and observations of this top leadership team. The author then conducted an inductive data analysis.

The author's analysis reveals that the tensions experienced by senior managers as they negotiate their roles reflect the co-existence of leadership surpluses (too much leadership) and deficits (too little leadership) in matrix organizations. The author argues that surpluses and deficits are not mutually exclusive but are interrelated and shows how leadership surpluses can create leadership deficits.

The author’s findings suggest that in contexts of leader abundance, actors should explore leadership voids. Particular attention should be paid to incidents of intrusion and exclusion, moments of transition and intense role negotiation, as those contexts are particularly conducive to leadership deficits.

While previous work on matrix structures focuses on leadership surpluses, the author discusses leadership deficits. The author explores how more leaders do not necessarily mean more leadership, but instead how more leaders may result in leadership voids.

Adoption of Clinical Decision Support Systems (CDSS) is a crucial step towards the digital transition of the healthcare sector. This review aims to determine and synthesise the influential factors in CDSS adoption in inpatient healthcare settings in order to grasp an understanding of the phenomenon and identify future research gaps.

A systematic literature search of five databases (Medline, EMBASE, PsycINFO, Web of Science and Scopus) was conducted between January 2010 and June 2023. The search strategy was a combination of the following keywords and their synonyms: clinical decision support, hospital or secondary care and influential factors. The quality of studies was evaluated against a 40-point rating scale.

Thirteen papers were systematically reviewed and synthesised and deductively classified into three main constructs of the Technology–Organisation–Environment theory. Scarcity of papers investigating CDSS adoption and its challenges, especially in developing countries, was evident.

This study offers a summative account of challenges in the CDSS procurement process. Strategies to help adopters proactively address the challenges are: (1) Hospital leaders need a clear digital strategy aligned with stakeholders' consensus; (2) Developing modular IT solutions and conducting situational analysis to achieve IT goals; and (3) Government policies, accreditation standards and procurement guidelines play a crucial role in navigating the complex CDSS market.

To the best of the authors’ knowledge, this is the first review to address the adoption and procurement of CDSS. Previous literature only addressed challenges and facilitators within the implementation and post-implementation stages. This study focuses on the firm-level adoption phase of CDSS technology with a theory refining lens.

In this paper, the authors examine the strategies used to reduce labour costs in three public hospitals in South Africa, which were effective and why. In the democratic era, after the revelations of large-scale corruption, the authors ask whether their case studies provide lessons for how public service institutions might re-make themselves, under circumstances of austerity.

A comparative qualitative case study approach, collecting data using a combination of interviews with managers, focus group discussions and interviews with shop stewards and staff was used.

Management in two hospitals relied on their financial power, divisions between unions and employees' loyalty. They lacked the insight to manage different actors, and their efforts to outsource services and draw on the Extended Public Works Program failed. They failed to support staff when working beyond their scope of practice, reducing employees' willingness to take on extra responsibilities. In the remaining hospital, while previous management had been removed due to protests by the unions, the new CEO provided stability and union–management relations were collaborative. Her legitimate power enabled unions and management to agree on appropriate cost cutting strategies.

Finding an appropriate balance between the new reality of reduced financial resources and the needs of staff and patients, requires competent unions and management, transparency and trust to develop legitimate power; managing in an authoritarian manner, without legitimate power, reduces organisational capacity. Ensuring a fair and orderly process to replace ineffective management is key, while South Africa grows cohorts of competent managers and builds managerial experience.

The purpose of this paper is to determine whether charismatic leadership strategies can be successfully implemented within structures, systems and tasks for social workers to increase case management successes, particularly client well-being, given that the six key charismatic leadership traits align with presented professionally bound ethical expectations.

A short generic qualitative review was done over fifteen publications, emphasizing the effects of charismatic leadership in domestic and foreign occupational domains.

Methodological, thematic and theoretical analyses show that charismatic leadership strategies are active in relevant social work domains with positive participant impacts.

The paper is intended to primarily investigate whether charismatic leadership is present in social work domains, and does not consider other leadership modalities.

High-quality reviews from the presented methodological investigations suggest that charismatic leadership is an effective leadership modality that should be considered into client-involved structures and systems.

The study aims to drive conceptual clarity around resistance to information technology projects, integrating multiple facets of the phenomenon from earlier studies.

The study conducts a meta-synthesis of qualitative studies on resistance to technology projects; it analyzes those studies at a case-specific level, compares and contrasts emergent concepts against each other, and “translates” those to the rest of the studies. The study uses the seven-step meta-ethnography method by Noblit and Hare to reciprocally translate emergent concepts to construct the conceptual model.

Through meta-synthesis, the study derives a new conceptual model for resistance to information technology projects, exemplifying how the identified antecedents create user resistance and how the phenomenon progresses within organizations.

This study enriches the observations and conclusions of past individual studies while explicating various facets of the mechanisms that generate and progress technology resistance within organizations. It offers fresh insights into the equivocal nature of the phenomenon and the distinctive ways it progresses from individual to group level.

Many ambitious and costly digital transformation efforts do not succeed due to user resistance. Understanding the mechanisms that create user resistance can help organizations manage technology projects better, thereby reducing the technology assimilation gap and protecting returns on related investments.

There have been extensive studies on technology acceptance (enablers) within organizations, while those relating to technology inhibitors are somewhat limited. However, the symmetry of understanding between enablers and inhibitors is vital for organizations to assimilate promising technologies and transform their business models. This model uses a new lens of sensemaking theory to explain how the antecedents trigger perceived threats and resistance behavior; it highlights the nuances around the development of resistance within individuals and its progression to groups. The resultant model offers better generalizability in organizational contexts.

A systematic investigation of postgraduate leadership programs for health and/or human services offered by Australian higher education institutions was undertaken.

Quantitative analysis identified the core characteristics of the programs. A thematic analysis of the course learning outcomes was conducted and six major themes of disciplinary leadership and management knowledge; research and analytical skills; professional practice; communication and collaboration; creativity and innovation; and system knowledge are shared in this study.

The authors conclude that Australian universities have taken an evidence-based approach to leadership education.

More work might need to be undertaken to ensure leadership theories are incorporated into learning outcomes.

Drawing on the conservation of resources theory, this study aims to identify the mediating effects of depersonalization and resilience on the relationship between customer incivility and organizational citizenship behavior (OCB). It further posits that these indirect effects vary depending on the caring climate and achievement orientation.

A field survey among 622 service employees (Study 1) and a three-wave field survey of 315 service employees and their managers (Study 2) from various service organizations were conducted.

This study confirms that depersonalization operates as a negative mediator in the relationship between customer incivility and OCB. Simultaneously, resilience emerges as a positive mediator, underscoring the contrasting pathways through which customer incivility affects OCB. Furthermore, a caring climate plays a pivotal role in mitigating the detrimental impact of depersonalization on OCB and weakening the positive impact of resilience on OCB. Additionally, this study identifies achievement orientation as a significant moderator between customer incivility and resilience.

This study advances theoretical foundations by investigating depersonalization and resilience as critical mediators in the intricate relationship between customer incivility and OCB. It goes beyond the conventional understanding of customer incivility’s impact by shedding light on the dual roles of a caring climate, demonstrating its potential to alleviate both positive and negative consequences of customer incivility. Moreover, its identification of achievement orientation as a moderator adds a novel dimension to the discourse, emphasizing the need for tailored strategies to harness employee resilience in the face of customer incivility.