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The traditional construction delivery method is challenged by low trust and collaboration issues, resulting in increased project costs. The integrated project delivery (IPD) method is developed, through a contractual agreement, to overcome these challenges by creating a common set of terms, expectations and project goals.

A singular construction case was followed during a four-month period. Data collection consisted of contract documents and a series of semi-structured interviews with representatives from the owner, design-group and contractors.

The IPD contract was found to have a number of positive effects; it improved project behavior (e.g. trust, collaboration and communication), increased ownership among project participants and improved buildability of the design, leading to fewer surprises and interruptions in the construction phase. The study also revealed a number of challenges including contractual and legal challenges and involving too many participants in the early phases. Moreover, co-location was identified as a particular important supporting element, to build relations and improve collaboration.

This research identified lessons learned from the application, as well as initial barriers and persistent barriers for implementing IPD. To improve IPD application the top three lessons were as follows: 1) the contractual documents should be adapted and signed at an early stage as this increases financial transparency, 2) cost estimates should be carried as an iterative process and project main concept be freezed at an early stage to increase understanding and minimize risks, 3) only the most important project developers should be involved in the early phases, to avoid going into detailed design issues before the main concept is completed.

Emergency care delivery is a process requiring input from various healthcare professionals within the hospital. To deliver efficient and effective emergency care, professionals must integrate rapidly at multiple interfaces, working across functional, spatial and professional boundaries. Yet, the interdisciplinary nature of emergency care presents a challenge to the optimization of patient flow, as specialization and functional differentiation restrict integration efforts. This study aims to question what boundaries exist at the level of professionals and explores how these boundaries may come to influence integration and operational performance.

To provide a more holistic understanding of the inherent challenges to integration at the level of professionals and in contexts where professionals play a key role in determining operational performance, the authors carried out an in-depth case study at a busy, Level 1 trauma center in The Netherlands. In total, 28 interviews were conducted over an 18-month period.

The authors reveal the existence of structural, relational and cultural barriers between (medical) professionals from different disciplines. The study findings demonstrate how relational and cultural boundaries between professionals interrupt flows and delay service processes.

This study highlights the importance of interpersonal and cultural dynamics for internal integration and operational performance in emergency care processes. The authors unveil how the presence of professional boundaries creates opportunity for conflict and delays at important interfaces within the emergency care process, and can ultimately accumulate, disrupting patient flow and increasing lead times.

MASH has been a feature of safeguarding practices in England and Wales since 2011, bringing safeguarding agencies together to effectively share information and prevent organizational silos. Core agencies include the police, social care, and health, with key features of co-location, joint decision-making and co-ordination. A standardised definition for MASH implementation does not exist, and this lack of a clear definition has meant various structures have emerged, impacting on safeguarding practices. This policy brief draws on workshops with a range of safeguarding practitioners between May and July 2022, about the challenges of collaborative working practices and how MASH can become more standardised. Whilst national standardisation is required, there needs to be flexibility when implementing guidelines, so that practices and processes reflect regional needs and resources.

The purpose of this paper was to develop deeper insights into the practices enacted by entrepreneurial healthcare managers to enhance the implementation of a partnership logic in integrated care models for older adults.

A multiple case study design in two urban centres in two jurisdictions in Canada, Ontario and Quebec. Data collection included 65 semi-structured interviews with policymakers, managers and providers and analysis of key policy documents. The institutional entrepreneur theory provided the theoretical lens and informed a reflexive iterative data analysis.

While each case faced unique challenges, there were similarities and differences in how managers enhanced a partnership’s institutional logic. In both cases, entrepreneurial healthcare managers created new roles, negotiated mutually beneficial agreements and co-located staff to foster inter-organisational partnerships between public, private and community organisations in the continuum of care for older adults. In addition, managers in Ontario secured additional funding, while managers in Quebec organised biannual meetings and joint training to enhance inter-organisational partnerships.

This study has two main implications. First, efforts to enhance inter-organisational partnerships should strategically include institutional entrepreneurs. Second, successful institutional changes may be supported by investing in integrated implementation strategies that target roles of staff, co-location and inter-organisational agreements.

There is more to primary care than solely medical and nursing services. Models of Child Health Appraised (MOCHA) explored the role of the professions of pharmacy, dental health and social care as examples of affiliate contributors to primary care in providing health advice and treatment to children and young people. Pharmacies are much used, but their value as a resource for children seems to be insufficiently recognised in most European Union (EU) and European Economic Area (EEA) countries. Advice from a pharmacist is invaluable, particularly because many medicines for children are only available off-label, or not available in the correct dose, access to a pharmacist for simple queries around certain health issues is often easier and quicker than access to a primary care physician or nursing service. Preventive dentistry is available throughout the EU and EEA, but there are few targeted incentives to ensure all children receive the service, and accessibility to dental treatment is variable, particularly for disabled children or those with specific health needs. Social care services are an essential part of health care for many extremely vulnerable children, for example those with complex care needs. Mapping social care services and the interaction with health services is challenging due to their fragmented provision and the variability of access across the EU and EEA. A lack of coherent structure of the health and social care interface requires parents or other family members to navigate complex systems with little assistance. The needs of pharmacy, dentistry and social care are varied and interwoven with needs from each other and from the healthcare system. Yet, because this inter-connectivity is not sufficiently recognised in the EU and EEA countries, there is a need for improvement of coordination and with the need for these services to focus more fully on children and young people.

Economic integration of refugees remains a challenge for developed countries. Although refugees differ greatly from labor migrants in available resources and motivation toward self-employment, prevailing studies on minority and ethnic entrepreneurship tend to lump these different categories of migrants together. Based on theories of migrants’ economic embeddedness, the purpose of this paper is to analyze the extent to which family- and kinship-based resources affect self-employment duration among refugees and labor migrants.

Based on Cox regression models, this longitudinal study estimates the self-employment duration of 10,519 refugees and 2,503 labor migrants starting businesses in Sweden in the period 2006–2012.

Results reveal that while refugees are at a disadvantage to labor migrants in terms of self-employment duration, their higher level of family embeddedness in part helps them overcome these disadvantages. For refugees but not for labor migrants, co-location in an ethnic enclave also lowers the risk of them becoming unemployed after a spell in entrepreneurship.

This original paper provides empirical and theoretical contributions to research on migrants’ self-employment success. It also discusses contributions for research on entrepreneurs’ social embeddedness and refugees’ entrepreneurship.

The purpose of this paper is to present a case study tracking the development and engagement of a group of experts by experience (The Independent Futures (IF) Group) who provided a lived experience voice to the Bristol Golden Key (GK) partnership within the Fulfilling Lives programme. The case study reports the genesis and impact of the group, as well as the facilitators of impact and experiences of the group members and those they worked in partnership with.

The research adopted an iterative approach drawing on multiple data sources over an eight-year period. An inductive ethnographic analysis of stakeholder and partnership meetings was combined with documentary analysis and thematic analysis of interviews with experts by experience and service providers.

The voice of lived experience provided by the IF group contributed to the GK partnership through various channels. Evidence of this contribution and its impact was found at programme, city-wide and national levels of the service ecosystem. Furthermore, IF members recognised the value of the group in contributing to systems change and service improvement, but also for themselves.

This case study serves to illustrate the impact of the lived experience voice on services and systems change, specifically the provision of that voice from a formalised advisory group. The successes and challenges of the group and the experiences of its members are reported with a view to sharing learning that may influence future co-production initiatives with experts by experience and service provision for those experiencing multiple disadvantage.

The insights provided by the longitudinal observation of the group as it was formed and evolved, coupled with insights provided by the experts by experience, have important implications for facilitating and supporting sustainable lived experience input.