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In analyzing the field of strategic management in public organizations, scholars have noted a lack of studies that investigate how public organizations actually apply strategic management tools (Hansen, 2011) as well as studies that investigate how strategic knowledge is developed and used in practice in public organizations (Bryson et al., 2010). Voicing similar concerns, the 2013 World Health Report pointed out the challenges facing many governments in providing universal health coverage and the importance of conducting new studies that focus on practical approaches using the existing knowledge rather than only investing in research related to new technologies. The purpose of this paper is to analyze how Telemedicine System of Santa Catarina (TSSC)’s strategy has resulted in significant improvements as seen through the lens of structuration theory (ST).

The authors support the analysis using the strategy as practice (SAP) framework of practice, praxis and practitioners and the ST of Giddens (1984), using Orlikowski’s (2000) technology in practice framework. The authors have applied a qualitative methodology using a single case study which analyzes a healthcare system that has resulted from a successful cooperation agreement between two public organizations in Brazil. This research is based on the analysis and identification of the structural aspects (interpretative schemes, facilities, norms and stock of knowledge) that are enacted by the practitioners through their practices and praxis.

The authors have identified five strategic practitioners that perform six strategic practices and praxis, and have analyzed the structures they enact during their praxis. The authors have also identified the interpretative schemes, norms and facilities that motivate these social practices and how they influence the results of the TSSC.

As limitations of this study, the authors highlight the focus given to the service provider practitioners, leaving aside the political practitioners and patients. The researcher perception and possible biases must be considered also as a limitation, despite of the efforts to minimize them with the rigor of the methodology and the use of mixed data collection techniques to enable data triangulation.

This research contributes to a better understanding of the benefits that the practice perspective offers and provides insights into the possible management cooperation between institutions. It also provides substantial evidence of the relationship between SAP and ST as it contributes to the reinforcement of empirical studies using ST. In addition to academic advances, this study contributes to the field by highlighting how the relationship between practices, praxis, practitioners and the existing structures has positively influenced the results of a public healthcare system and by presenting a successful initiative that has helped to improve the public healthcare system.

The authors believe that this paper will contribute to the field by highlighting how the relationship between practices, praxis, practitioners and existing structures has positively influenced the results of a public healthcare system and the roles played by the human agents involved.

The purpose of this paper is to examine the bases of positive relations between suppliers and purchasers of healthcare services. In doing so, it examines the nature of cooperation between the providers of healthcare services (hospitals) and those who commission and purchase healthcare on behalf of patients (regional health authorities) and makes specific recommendations as to how cooperation can be better realized.

The paper employs a qualitative interview approach for gathering and analyzing major stakeholder (provider and purchaser) perceptions of their interorganizational relations and how these interactions impact on the quest of the healthcare provider to meet the needs of the community they serve.

The paper identifies and groups relevant variables into four major themes or “core categories” that characterize purchaser‐provider stakeholder cooperation. These themes represent provider and purchaser views on those factors characterising stakeholder relationships within the purchaser‐provider dyad. This is followed by a number of suggestions as to how to improve the nature of cooperation between these stakeholders.

Extending practitioners' understanding of the nature of these inter‐related factors may lead to better insights of how interorganizational relations and partnerships might be managed more proactively throughout the healthcare value chain. Strategies to foster stakeholder cooperation are also suggested.

In the extant literature, there is a paucity of research that has illustrated multi‐stakeholder perspectives in the public sector. This paper explores the perceptions of two main stakeholders in public healthcare to map and assess management issues influencing purchaser‐provider cooperation.

The purpose is to examine the bases of positive relations between suppliers and purchasers of healthcare services. In doing so, the paper examines the nature of cooperation between the providers of healthcare services (hospitals) and those who commission and purchase healthcare on behalf of patients (regional health authorities).

The paper employs a qualitative interview approach for gathering and analysing major stakeholder (provider and purchaser) perceptions of their interorganisational relations and how these interactions impact on the quest of the healthcare provider to meet the needs of the community they serve.

The paper identifies group relevant variables into four major themes or “core categories” that characterise purchaser‐provider stakeholder cooperation. These themes represent provider and purchaser views on those factors characterising stakeholder relationships within the purchaser‐provider dyad.

The paper suggests that extending practitioners' understanding of the nature of these interrelated factors may lead to better insights of how interorganisational relations and partnerships might be managed more proactively throughout the healthcare value chain.

In the extant literature, there is a paucity of research that has illustrated multi‐stakeholder perspectives in the public sector. This paper explores the perceptions of two main stakeholders in public healthcare to map and assess management issues influencing purchaser‐provider cooperation.

The purpose of this paper is to describe the competences needed for managing competitive bidding in the Finnish healthcare and to understand the management of competitive bidding holistically, considering the challenges the management faces from being embedded in focal nets and the wider network.

The phenomenon is examined from the perspective of networks. This focus acknowledges the fact that competitive bidding changes the dynamics of the network and therefore requires new competences from the actors. The study applies qualitative methods.

Competitive bidding connects effects, interests, resources and actors together. It changes the dynamics of the net and the network. Thus, new competences are required. Three major competence areas were detected: relationship management competences, net management competences and purchasing competences.

The conclusions shed light on the combination of competences needed in managing competitive bidding in healthcare networks.

Many countries struggled to respond to the pandemic burden; in fact, most suffer from healthcare incapacity generally. Therefore, they need to find innovative systems to compensate for their deficiencies in dealing with current and future problems. One such goes down the public-private partnership (PPP) route. It is important to note, however, that PPP is not a magic wand, and some of these projects have been criticized for overruns that exceed the value created. Aiming to promote the value created in healthcare PPP projects, this study aims to identify factors and critical points related to their implementation.

A two-stage literature review was conducted to shape semi-structured interviews. Based on this, the questions to be asked in the interviews were prepared. The interviews were conducted with twelve experts. The transcripts of the twelve semi-structured interviews were analyzed using manual thematic analysis to reveal the most critical value-creation factors (VCFs). The VFCs were validated by comparing them with the studies in the literature and by having focus group discussions (FGDs) with the experts. Finally, in an FGD, the experts discussed how these factors affect value creation in healthcare PPP projects.

The findings show that VFCs can be categorized into four dimensions: assets, partnership synergy, cooperation environment and processes. Based on the frequency of codes during the thematic analysis, the most frequently addressed VFCs in each category were identified. These were complementary skills and resources, attitude, early establishment of the operational body and effective design development, respectively.

This research contributes to both society and practice by unveiling VCFs and effective ways to achieve them in healthcare PPP projects. Thus, practitioners can generate more value and bring value to the forefront of healthcare PPPs, which can then enhance the value gained by society.

Studies to date have offered little about VCFs and how to realize value in PPP projects by considering the factors involved in them. Moreover, value creation in PPP healthcare projects has largely remained unexplored, despite PPPs being adopted and investigated quite commonly.

The purpose of this research is to investigate the extent of outsourcing, the decision‐making process, the impact of outsourcing, and the future trend of outsourcing in public hospitals in Greece.

A survey instrument was designed and mailed to a random sample of 100 public hospitals in Greece and 43 usable questionnaires were received, representing a response rate of 43 percent. The survey instrument focused on the extent to which public hospitals outsource services, the decision‐making process for choosing an external service provider, the impact of outsourcing, and the future trend of outsourcing in public healthcare organisations.

Public hospitals in Greece outsource a variety of activities. Cost savings and customer satisfaction are the main factors affecting the outsourcing decision. The cooperation with a contract service provider has led to significant improvement in service quality levels. Most users are satisfied with the performance of these companies and believe that there will be an increase in the usage of these services in the future.

It provides a decision‐making framework regarding outsourcing in public healthcare organisations.

This research fills the gap in the area of outsourcing in public hospitals in Greece.

According to Global Healthcare Security Index 2021, India ranked 66 out of 195 countries, indicating the need and scope for improvement. The Cooperative healthcare system which has been rendering exemplary services is yet to gain visible recognition in India. Given the need for upgrading the health infrastructure in India and providing more affordable health services to the country’s growing population, it would help appreciate the large role that cooperative healthcare can play along with others. This study explores the structure, conduct, and performance of healthcare co-operatives in India, the factors contributing to their success and failure, and the challenges they face. The Health Cooperatives have a strong presence in Kerala and Karnataka and are also coming up in other parts of the country. However, a detailed database of them for public awareness is very limited. The cooperative hospitals can meet the basic requirements of curative treatment in rural and poorly-endowed urban areas. The democratic way in which they function makes them a destination for a financially weaker section. They must retain this feature. The study covers two successful cases which reveal that India needs a more dense healthcare cooperative network. Since cooperative hospitals in tune with the spirit of service run on the principle of being ‘Not-for-Profit’ they need to be supported by the governments more liberally, without however interfering with their governance and administration.

The purpose of this study is to provide a framework useful for identifying the elements that aim for success in the construction of collaborative governance and to investigate how international governance systems have characterized the international collaborative projects developed by the International Division of Gaslini Children Hospital in Genoa (Italy). Critical and successful factors in developing partnerships in the healthcare sector have been identified.

A total of 15 projects implemented by the Gaslini Hospital in collaboration with a global network of low and middle-income countries were examined using a content analysis of the project reports. Later, a conceptual framework proposed by Emerson and colleagues was used to design a theoretical map for investigating elements of international governance systems.

A matrix developed in two categories (health cooperation and training, and exchange of best practices) and three branches of medicine (oncology, paediatrics and cardiology) made it possible to cluster the research projects. However, details of the collaborative process often overlooked by research on public-private partnerships emerged from the framework.

The growing demand for higher quality health services in low- and middle-income countries has led to an increasing number of partnerships with industrialized countries to enable access to wider resources and technologies and develop useful skills to adapt to changes in society. Through the application of collaborative governance’s framework to healthcare collaboration, different elements of the collaborative process emerged which have been previously neglected.

The research aim of this chapter is to understand how different institutional logics affect the day-to-day activities of healthcare providers and whether the cohabitation of professional logics with business-like logics increases medical providers’ effectiveness and gives chance to constrain healthcare costs. This research is based on longitudinal case study about the restructuring of the Canadian healthcare system in Alberta in 1992–2008, described in two papers (Reay & Hinings, 2005, 2009). We identify the situation after encroachment of a new, business-like logic into a healthcare system as more complex than described in the extant literature. We challenge the findings of the case study authors that there are two cohabitating logics in healthcare: the business-like logic supported by the government and the logic of medical professionalism. From our research it appears that there are two other logics: a managerial logic derived from business-like logic, and a hybrid professional logic that is a modification of the logic of medical professionalism. Across the healthcare field in general, business-like logic has been competing with the logic of medical professionalism, but on the medical providers’ level these logics become uncoupled. Within a medical provider, on the external, symbolic layer, physicians follow their professional logic and managers show conformity with governmental principles. But on the backstage layer, where the day-to-day work is actually performed, these two logics are subject to modification, creating a space for compromise and cooperation, leading to a growth of the number of unnecessary medical services preventing cost containments in healthcare.