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Health services continue to face economic and capacity challenges. Quality improvement (QI) methods that can improve clinical care processes are therefore needed. However, the successful use of current QI methods within hospital settings remains a challenge. There is considerable scope for improvement of elective clinical pathways, such as hip and knee replacement, and so the use and study of QI methods in such settings is warranted.

A model to manage variability was adapted for use as a QI method and deployed to improve a hip and knee replacement surgical pathway. A prospective observational study, with a mixed-methods sequential explanatory design (quantitative emphasised) that consisted of two distinct phases, was used to assess its effectiveness.

Following the use of the novel QI method and the subsequent changes to care processes, the length of hospital stay was reduced by 18%. However, the interventions to improve care process highlighted by the QI method were not fully implemented. The qualitative data revealed that staff thought the new QI method (the model to manage variability) was simple, effective, offered advantages over other QI methods and had highlighted the correct changes to make. However, they felt that contextual factors around leadership, staffing and organisational issues had prevented changes being implemented and a greater improvement being made.

The quality of QI reporting in surgery has previously been highlighted as poor and lacking in prospective and comprehensively reported mixed-methods evaluations. This study therefore not only describes and presents the results of using a novel QI method but also provides new insights in regard to important contextual factors that may influence the success of QI methods and efforts.

This study examines the case of an initial training, called “Dojo”, invented and implemented at a production site in the Czech Republic. It clarifies the initial training program implementation process and offers a conceptual framework for cooperative management of subsidiary activities at the site and firm.

This study conducts an in-depth analysis of qualitative data from the Czech production site over a five-year period. The theoretical base is the theorization and labeling phase of management innovation (MI), the final phase of which legitimizes a new management practice. Interview data, archival data, pictures and financial data are used for the analysis.

To legitimize the Dojo in the operational flow controlled by the site and firm, the Czech production site acquires validation of the Dojo from employees and board members of the Japanese and European headquarters, helping the site build trustful relationships with them. Training programs, process standardization and skills standardization of the workers offer benefits to the trainees, production site and firm.

The authors offer theoretical insights into MI at the subsidiary-level, which past studies have not differentiated at the firm-level. The authors also provide details of the implementation and management of initial training for newly hired blue-collar workers at the production site. The findings complement related literature on human resource management and operational management.

In the present study, we assessed how school improvement consultants, as part of a six-year model project conducted in North Rhine-Westphalia, Germany, were perceived by school leaders and how they defined their role(s), tasks and working methods as external consultants at the beginning of the project.

Our analyses are based on a mixed-methods approach, involving a standardized online survey of school leaders and 18 guideline-based interviews with school improvement consultants, which were conducted at the beginning of the model project. The interviews were analyzed using qualitative content analysis and typifying structuring of the interview material.

Our results based on the quantitative survey data showed that the school administrators generally rated the collaboration with the external consultants as not very positive. Furthermore, our qualitative findings showed that the school improvement consultants in the model project faced resistance to their coaching efforts, which may be attributed to the obligatory nature of their work on the project. In general, the consulting process appeared to be little differentiated according to the school principals' perceptions of the school needs, with the consultants mainly proceeding as they also do in other coaching processes.

This study contributes to our understanding of coaching in improvement activities among schools serving disadvantaged communities by offering insights into the role(s) and working methods of external school improvement consultants.

This paper aims to examine the key challenges experienced and lessons learned when organizations undergo large-scale agile transformations and seeks to answer the question of how incumbent firms achieve agility at scale.

Building on a case study of a multinational corporation seeking to scale up agility, the authors combined 36 semistructured interviews with secondary data from the organization to analyze its transformation since the early planning period.

The results show how incumbent firms develop and successfully integrate agility-enhancing capabilities to sense, seize and transform in times of digital transformation and rapid change. The findings highlight how agility can be established initially at the divisional level, namely with a key accelerator in the form of a center of competence, and later prepared to be scaled up across the organization. Moreover, the authors abstract and organize the findings according to the dynamic capabilities framework and offer propositions of how companies can achieve organizational agility by scaling up agility from a divisional to an organizational level.

Along with in-depth insights into agile transformations, this article provides practitioners with guidance for developing agility-enhancing capabilities within incumbent organizations and creating, scaling and managing agility across them.

Examining the case of a multinational corporation's exceptional, pioneering effort to scale agility, this article addresses the strategic importance of agility and explains how organizational agility can serve incumbent firms in industries characterized by uncertainty and intense competition.

Research was conducted to investigate whether, and how, political accountability might stabilise when agents are faced with profound changes in external structures such as competition laws and austerity policies.

We performed a field study from 2007 to 2015 in a regional hub in Finland and worked with data from document analysis, interviews and meeting observations. We have used embedded research design, where we apply methodological bracketing as well as composite sequence analysis for field research.

Accountability declined when irresistible external structures were the dominant influence on the unreflective actions of agents-in-focus. With time, however, the agents started acting critically by drawing on structures that could facilitate strategic actions to stabilise political accountability.

The field research and interpretation of the data were limited to the organisation analysed; however, the theoretical arguments allow for analytical generalisations.

The research demonstrates how public officials and political decision-makers can eventually adopt a strategic approach when faced with irresistible change in external structures.

The research demonstrates how public officials and political decision-makers can eventually adopt a strategic approach when faced with irresistible changes in external structures.

The study locates political accountability in the context of strong structuration theory and discusses how it is redefined by external structures.

This study aims to explore how managers exercise agency in strategic investment decisions (SIDs) by drawing on their knowledgeability of the strategic context. Specifically, the authors address the role of position–practice relations and irresistible causal forces in this conduct.

The authors examine SID-making (SIDM) practices in four case organisations operating in highly competitive markets, conducting interviews with managers at various levels and analysing company documents. Drawing on strong structuration theory, the authors show how managerial decision makers draw upon their knowledge of organisational context when exercising agency in SIDs.

The authors provide insights into how SIDM behaviour, specifically agents’ conduct, is shaped by a combination of position–practice relations and the agents’ comprehension of their organisation’s context.

The authors extend the SIDM literature by surfacing the issue of how actors’ conjuncturally-specific knowledge of external structures shapes the general dispositions they draw on in exercising agency in practice.

The authors extend the SIDM literature by surfacing the issue of how actors’ conjuncturally-specific knowledge of external structures shapes the general dispositions they draw on in exercising agency in practice. Particularly, the authors contribute to this literature by identifying irresistible causal forces and illuminating why actors might not resist in SIDM processes, despite having the potential to do so.

Accomplishing the United Nations’ Sustainable Development Goals (SDGs) is imperative for societies to meet their grand challenges. Achieving these goals by 2030 requires sustainability change agents with a can-do-attitude. This study aims to show how institutions of higher education can become partners for social marketing in bringing forward such change agents.

Taking a case study approach, this paper examines a master’s programme to identify factors relevant to educating sustainability change agents that can serve as a basis for a social marketing planning primer to foster the SDGs.

This study presents the social marketing discipline with a viable option for supporting the achievement of the SDGs through higher education. Its contributions are twofold. First, it is shown that when interdisciplinarity and a project-based approach are conceptualized and organized to create a motivating and meaningful learning environment with the SDGs as guiding principles, students, as sustainability change agents, can increase awareness and have the potential to generate impacts regarding the SDGs at the individual, organizational and institutional levels. Second, based on this, the paper provides guidance to social marketers regarding the planning of a campaign targeting higher education institutions. The authors argue that the aim of this campaign should be to promote the implementation of the SDGs as guiding principles above all, as this can facilitate the process of students becoming sustainability change agents who help achieve the goals in a timely manner.

Whilst single case studies are usually limited in drawing generalizations, the present study offers a starting point for investigating the role of universities as a target group for social marketing in fostering further sustainable development. Building on its findings, future research could test the proposed social marketing planning primer and evaluate the impact on the SDGs at a larger scale than only one university.

It is proposed to use the findings of the study to model a social marketing campaign aimed at universities to motivate them to help develop sustainability change agents in all disciplines by integrating the SDGs as guiding principles for study programmes.

Students’ impacts range from leading peers to buy sustainable products and consume less to influencing a company to adopt sustainable packaging, thereby contributing to social change.

This study is among the first to examine the possible effect of a study programme on the SDGs at different societal levels by taking the perspectives of multiple stakeholders into account and combining the theory of higher education with sustainability and social marketing.

Change agents are individuals who can successfully transform aspects of how organisations operate. In education, teachers as change agents are increasingly seen as vital to the successful operation of schools and self-improving school systems. To date, however, there has been no systematic investigation of the nature and role of teacher change agents. To address this knowledge gap, we undertook a systematic review into five key areas regarding teachers as change agents. After reviewing 70 outputs we found that current literature predominantly positions teacher change agents as the deliverers of top-down change, with the possibility of bottom-up educational reform currently neglected.

The Agents of Change program is a two-year, project-based learning program to develop Extension Professionals’ capacity to engage in Adaptive and Transformative Leadership. Its primary goal is to develop the capacity of Extension Professionals to engage in leadership to create more diverse, equitable, inclusive and just Extension programs and community change initiatives. This manuscript describes the program and an initial evaluation and results.

Results of an evaluation of the first year of the program indicate that regular training sessions and support are appropriate for leadership development and that Extension Professionals are using the learning, awareness and tools from this program to address challenges with Adaptive and Transformative Leadership elements. Also, Extension professionals demonstrated commitment to personal growth, community engagement and understanding of their multifaceted roles as change agents.

Participants are sharing resources from the program with colleagues, leading meetings differently, questioning the status quo and pushing others to try new ways forward.