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The purpose of this paper is to analyse ethical competence related to healthcare governance and management tasks at the county/regional level in Sweden. The paper also discusses conditions that support or constrain the development and application of such competence.

The study is based on original qualitative data from 13 interviews and 6 meeting observations. Three key groups of actors were included: politicians, civil servants and CEOs in publicly financed health-provider organizations. An abductive analysis was carried out by a stepwise method guided by thematic research questions.

The informants viewed themselves as having a high degree of ethical responsibility for healthcare practice. However, they did not integrate ethical reflection and dialogue into their work decisions (e.g. regarding budgets, reforms and care agreements). The current organization, control systems and underlying business principles, along with the individuals’ understanding of their own and others’ roles, tended to constrain the development and use of ethical competence.

Qualities of an appropriate ethical competence related to healthcare governance and management, and conditions to develop and use such competence, are suggested.

Hardly any empirical research has examined ethical competence related to healthcare governance and management tasks. The paper integrates ethics and theories on learning in organizations and contributes knowledge about ethical competence and the conditions necessary to develop and practise ethical competence in an organizational and inter-organizational context.

The paper aims to compare and discuss the findings of discursive constructions of patients in legal texts from the three Scandinavian countries. Since traditional welfare state systems in Scandinavia are being challenged by new governance systems, new questions are being raised about patient positions and agency, carrying with them potential ethical dilemmas for healthcare professionals.

The methodology of the paper is inspired by critical discourse analysis. Comprehensively analysing the findings of previous discourse studies on how “the patient” is constructed in central policy texts, this study compares the position of the patient in Norway, Sweden and Denmark.

The paper reveals ideological struggles across the Scandinavian countries, operating at a political level, a legislative level and a healthcare level. It is shown that national governance systems still exert hegemonic power by strongly influencing patients' degree of choice and autonomy. The discursive struggle between welfare state governance and other governance systems in Scandinavia indicates a shift towards a commercial healthcare market although a traditional welfare model is advocated by professionals and researchers.

Because of the specific conditions of Scandinavian healthcare policy, the findings lack generalisability. The research approach should therefore be explored further in additional contexts.

The findings of this study can inform policymakers, professionals and patients of the ideological values underlying seemingly objective shifts in national policy.

A comparative critical discourse analysis can expose patterns in the Scandinavian approaches to patient rights.

The importance of hospital board engagement in the work of governing healthcare quality has been demonstrated in the literature. Research into influences on effective corporate governance has traditionally focused on board architecture. Emerging research is bringing to light the importance of governance dynamics. This paper contributes to emerging research through highlighting how communication and leadership underpin effective engagement in governing healthcare quality.

A comparative case study of eight Australian public hospitals was undertaken involving document review, interviews and observations. Case studies were allocated into high- or low-engagement categories based on evidence of governance processes being undertaken, in order to compare and contrast influencing factors. Thematic analysis was undertaken to explore how communication and leadership influence healthcare governance.

Several key components of communication and leadership are shown to influence healthcare quality governance. Clear logical narratives in reporting, open communication, effective questioning and challenge from board members are important elements of communication found to influence engagement. Leadership that has a focus on healthcare excellence and quality improvement are aligned and promote effective meeting processes is also found to foster governance engagement. Effective engagement in these communication and leadership processes facilitate valuable reflexivity at the governance level.

The findings highlight the way in which boards and senior managers can strengthen governance effectiveness through attention to key aspects of communication and leadership.

The case study approach allows the exploration of communication and leadership in greater depth than previously undertaken at the corporate governance level in the healthcare setting.

This research explores the subjective health experiences of women incarcerated in a provincial detention center in Ottawa, Canada.

Narrative interviews conducted with 16 previously incarcerated women were analyzed to explore how health issues shaped their experiences in detention.

Women identified a set of practices and conditions that negatively impacted health, including the denial of medication, medical treatment, and healthcare, limited prenatal healthcare, and damaged health caused by poor living conditions.

Findings suggest that structural health problems emerge in penal environments where healthcare is provided by the same agency responsible for incarceration. The incompatibility between the mandates of incarceration and healthcare suggests that responsibility for institutional healthcare should be transferred to provincial healthcare bodies.

This research responds to the lack of research on carceral health experiences within both penal scholarship and medical sociology, particularly in relation to women and those confined in jails.

This paper aims to examine how the customer can be better integrated into case-mix systems for primary healthcare. Case-mix is an established performance management tool in hospitals, and there is growing interest in its extensions into out-of-hospital healthcare.

Interviews with academics and clinicians are used to explore conceptual foundations for this area. A service-dominant logic perspective is used to problematize the roles of accounting in this complex setting.

The findings identify that a customer focus is embedded in current primary healthcare thinking, contrasting with the goods-dominant focus in hospitals. This paper identifies diverse objectives and coordinating networks of care as challenges for case-mix.

This paper breaks down the complexity of primary healthcare case-mix into two accounting roles: a “dialogue machine” to understand client objectives and a “learning machine” to understand clients’ networks of resources. The infancy of case-mix for primary healthcare means our interview sample is restricted to a small group of pioneers in the area, within a supply perspective.

Primary healthcare management is a priority area in New Zealand. The findings describe opportunities and challenges for the “dialogue” and “learning” roles of accounting. This paper discusses practical and ideological tensions to be resolved when integrating customers into case-mix systems.

This paper contributes to the limited literature on the use of case-mix accounting outside of hospitals, discussing the role of customers and networks of care. Findings contribute by describing the customer as both a source of, and a means to resolving, complexity.

Despite the fundamental role of culture in an organisational setting, little is known of how organisational culture can be sometimes determined/influenced by professional culture, particularly in the global south. Using Nigeria as a research focus, this article uses critical discuss analysis to examine the link between professional and organisational culture.

This study uses qualitative research approach to establish the significance of professional culture as a determinant of organisational culture among healthcare organisations.

We found that the medical profession in Nigeria is replete with professional duties and responsibilities, such as professional values and beliefs, professional rules and regulations, professional ethics, eagerness to fulfil the Hippocratic Oath, professional language, professional symbols, medicine codes of practice and societal expectations, all of which conflate to form medical professionals' values, beliefs, assumptions and the shared perceptions and practices upon which the medical professional culture is strongly built. This makes the medical professional culture stronger and more dominant than the healthcare organisational culture.

The extent to which the findings of this research can be generalised is constrained by the limited and selected sample of the research.

The primacy of professional culture over organisational culture may have dysfunctional consequences for human resource management (HRM), as medical practitioners are obliged to stick to medical professional culture over human resources practices. Hence, human resources departments may struggle to cope with the behavioural issues that arise due to the dominant position taken by the medical practitioners. This is because the cultural system (professional culture), which is the configuration of beliefs, perceived values, code of ethics, practices and so forth. shared by medical doctors, subverts the operating system. Therefore, in the case of healthcare organisations, HRM should support and enhance the cultural system (the medical professional culture) by offering compatible operating strategies and practices.

This article provides valuable insights into the link between professional culture and organisational culture. It also enriches debates on organisational culture and professional culture. We, therefore, contend that a strong professional culture can overwhelm and eventually become an organisational culture.

The purpose of this paper is to explore the perceived responsibilities of five not‐for‐profit hospitals in Bangalore, India, towards society.

The method used is qualitative design with some quantitative elements. Data were collected through a survey of 79 physicians and 104 managers and other stakeholders of the hospitals.

The analysis reveals the existence of highly significant differences in the perception about workplace responsibilities between the doctors and other stakeholders. It also highlights the importance of top management involvement with various stakeholders in effectively carrying out the overall social responsibilities of the hospitals. It was found that the hospitals must take into account the social, cultural and financial characteristics of the patients while fulfilling societal obligations. Training needs, environmental impact audit and encouragement for employees to join local voluntary organizations are the immediate needs for improving the CSR activities of the hospitals.

The study had a small sample and referred only to the perceptions of physicians/management personnel. Further studies should be done with larger samples, comparing different cohorts of stakeholders and, more importantly, patients/their carers.

The study draws attention to issues that emerge from the social responsibilities of healthcare organizations. Its findings provide new insights into the meaning of social responsibility in the healthcare sector in an Indian context from a stakeholder perspective.

The paper is based on an original study that addresses the current gap in the understanding of issues related to social responsibility by the various stakeholders of hospitals. It is particularly valuable for both the internal and external stakeholders of the healthcare organizations.

Brands can imbue unique meaning to consumers, and such meaning and personal experience with a brand can create an emotional connection and relationship between the consumer and the brand. Just as many service providers have adopted branding strategies, marketers are branding the health care service experience. Health care is an intimate service experience and emotions play an integral role in health care decision making. The purpose of this paper is to examine how emotional or affect-based consumer brand relationships are developed for health care organizations.

Empirical evidence from both depth interviews and data garnered from 322 surveys were integrated into a conceptual model. The model was tested using structural equation modeling.

Results indicate that trust, referent influence and corporate social responsibility are key variables in establishing affective commitment in consumer brand relationships in a health care context. Once affective commitment is achieved, consumers may come to identify with the health care provider's brand and a self-brand connection is formed. When such a phenomenon takes place, consumers can serve as advocates for the brand by actively promoting it via word-of-mouth.

The findings provide insight for marketing managers in developing successful branding strategies for health care organizations.

This research examines the advantages of cultivating meaningful brand connections and relationships with consumers in a health care context.