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Challenges and opportunities arise from the significantly different perspectives of context-specific versus context-free researchers and the literatures they contribute to. Reviews of one type or the other or both types of literatures may provide different understandings of the state of the art in a particular area of health care management. Suggestions for writing quality reviews are also included along with suggested topics for future reviews.

Responding to demand fluctuations is a difficult problem in the marketing of services. This problem is particularly difficult in the delivery of health care, as it requires a complex network of facilities, equipment and trained personnel. This paper aims to examine how health care organizations are deploying volume flexible strategies in response to these changing demand patterns.

This research used interviews with hospital administrators and a survey of administrators at academic medical centers in the USA to identify the use of internal and external volume flexible strategies, their impact on the creation of volume flexible capability, and their impact on performance outcomes.

The results show that there is a positive relationship between the use of internal volume flexible strategies, volume flexible capability, patient satisfaction, and organizational performance.

Although the measures used in this study were adequate for this exploratory research study, they require further development to improve their reliability as well as to capture additional dimensions of the constructs examined.

The results validate the impact of these strategies and indicate that internal volume flexible strategies are positively related to patient satisfaction and organizational performance.

Although health care organizations have implemented these strategies, little is known about their use or the impact that they have on satisfaction and performance – this work addresses this gap.

Reducing waste in health care can result in savings that could be used to meet the projected shortfall in NHS funding or to meet the care needs of vulnerable groups. Patients and their families can contribute to the identification and reduction of waste. To do so their understanding of the costs of health care and treatment needs to be increased. The paper aims to discuss these issues.

The approach formed part of the Close Partnering work stream of the NHS Future Focused Finance (FFF) programme. Included in this was a review of the literature relating to waste reduction, patient engagement and reference to experts in the field of public and patient engagement. Engagement of the patient voice in the NHS FFF programme to provide the patient perspective and engage in discussions with patients. Discussions with experts in patient and public involvement and clinicians were also undertaken.

The public and patients have little awareness of NHS finances and generally perceive efforts to reduce costs and achieve efficiencies as impacting on the quality of care. Engaging the public and patients in discussions about the costs of health care is challenging and existing methodologies for patient and public engagement may not be appropriate for what could be termed difficult conversations.

Increasing patient awareness of the costs of health care and treatment may result in patients and the public demanding greater involvement in decisions about health care expenditure and use of resources.

Difficult conversations with patients and the public about the costs of health and their role in reducing waste are rarely invited. This paper brings to the fore the issues and challenges that such discussions engender.

The purpose of this paper is two-fold. First, it sets the context for the special issue by considering conceptions of patients and their roles in service delivery and improvement. Second, it introduces the contributions to the special issue, and identifies thematic resonance.

The paper utilises a literature synthesis and thematic analysis of the special issue submissions. These emanated from the Ninth International Organisational Behaviour in Healthcare Conference, hosted by Copenhagen Business School on behalf of the Learned Society for Studies in Organizing Healthcare.

The articles evidence a range of perspectives on patients’ roles in healthcare. These range from their being subject to, a mobilising focus for, and active participants in service delivery and improvement. Building upon the potential patient roles identified, this editorial develops five “ideal type” patient positions in healthcare delivery and improvement. These recognise that patients’ engagement with health care services is influenced both by personal characteristics and circumstances, which affect patients’ openness to engaging with health services, as well as the opportunities afforded to patients to engage, by organisations and their employees.

The paper explores the relationally embedded nature of patient involvement in healthcare, inherent in the interdependence between patient and providers’ roles. The typology aims to prompt discussion regarding the conceptualisation patients’ roles in healthcare organisations, and the individual, employee, organisational and contextual factors that may help and hinder their involvement in service delivery and improvement. The authors close by noting four areas meriting further research attention, and potentially useful theoretical lenses.

The purpose of this paper is to identify the influential agents that led to the successful acceptance and diffusion of the Concerto clinical workstation at the Northern District Health Board.

The paper draws on Rogers’ diffusion of innovation theory to interpret and analyse the factors that enabled acceptance and successful implementation of the innovative Concerto clinical workstation.

The authors conclude that human factors (clinicians) and non-human factors (the software package) simultaneously influenced the ready acceptance of the innovation. The reason for the positive acceptance and full diffusion of Concerto as compared to iHealth is the increased functionality it offers and its ability to provide clinicians with comprehensive patient records over a period of time, which assists in making informed decisions regarding the treatment, discharge, hospitalisation and recommendations for the future well-being of patients.

The study focused on only one district health board (DHB); therefore, the outcomes may not be representative of all DHBs.

The study has practical implications for clinicians, DHB members and public health regulators. The outcomes illuminate the “agents” that positively influenced the diffusion of Concerto. The regulators and the DHBs can use this as a benchmark to determine how to lead the successful diffusion of information technology (IT) innovation in the public health sector.

The impact on society is evident in the paper, as the use of an innovation, such as Concerto, saves time taken by clinicians to make more informed decisions regarding their patient care.

This study contributes to new knowledge by investigating the diffusion process of IT innovation with an intention of establishing the factors that enabled this process.

Knowledge is a key success factor in achieving competitive advantage. The purpose of this paper is to examine how mobile health technology facilitates knowledge management (KM) practices to enhance a public health service in an emerging economies context. Specifically, the acceptance of a knowledge-resource application by community health workers (CHWs) to deliver breast cancer health care in India, where resources are depleted, is explored.

Fieldwork activity conducted 20 semi-structured interviews with frontline CHWs, which were analysed using an interpretive inductive approach.

The application generates knowledge as a resource that signals quality health care and yields a positive reputation for the public health service. The CHW’s acceptance of technology enables knowledge generation and knowledge capture. The design facilitates knowledge codification and knowledge transfer of breast cancer information to standardise quality patient care.

KM insights are provided for the implementation of mobile health technology for frontline health-care professionals in an emerging economies context. The knowledge-resource application can deliver breast cancer care, in localised areas with the potential for wider contexts. The outcomes are valuable for policymakers, health service managers and KM practitioners in an emerging economies context.

The legacy of the mobile heath technology is the normalisation of breast cancer discourse and the technical up-skilling of CHWs.

First, this paper contributes three propositions to KM scholarship, in a public health care, emerging economies context. Second, via an interdisciplinary theoretical lens (signalling theory and technology acceptance model), this paper offers a novel conceptualisation to illustrate how a knowledge-resource application can shape an organisation’s KM to form a resource-based competitive advantage.

The authors have previously validated a design of the health-care supply chain which treats patients as inventory without loss of respect for the patients. This work continues examination of patients as inventory while addressing the dual objectives of reducing redundancy in services and creating greater efficiency in the health-care supply chain. Historical data is used to forecast health care needs in light of the increasingly specialized health-care professionals, which have resulted in much more flexible and expensive supply chains. The lack of common data storage, or electronic medical records (EMRs), has created a need for redundancy (or rework) in medical testing. The use of EMR will also enhance our ability to forecast needs in the future. We perform simulations using SigmaFlow software to address our goals relative to the resource constraints, monetary constraints, and the overall culture of the medical supply chain. The simulation outcomes lead us to recommendations for data warehousing as well as providing mechanisms, like inventory postponement strategies, to establish structures for more efficiency, and reduced flexibility in the supply chains.

Prior studies have examined the relationship between budgetary slack and short-termism of management within a profit-seeking business environment. The purpose of this paper is to examine the dynamics of slack resources in relation to quality performance of heath care services delivered by a publicly funded organization.

A longitudinal regression analysis of resource utilization, productivity and the quality of health care services delivered is performed to reveal evidence about the underlying dynamics of heterogeneous slack resources. It attempts to study slack resources in the case of a “mega” health care service provider based in Hong Kong.

The results suggest that the organization’s cost containment culture, with a strategic focus on productivity measures, has augmented cost effectiveness; however, not all slack resources would enhance quality performance.

This study of a mega health care service provider complements the prior studies of slack resources and points out the challenges of proactively managing any slack resources toward quality performance beyond productivity.

The purpose of this paper is to gain understanding into the human factors which might impede the change process. Change is inevitable in contemporary organizations and particularly within the healthcare field with respect to information technology (IT). Regardless of the amount of literature surrounding change management process organizational leaders will often ignore the human factors associated with the introduction of new IT.

This study sought to examine physician resistance surrounding the Electronic health record (EHR) change process through the lens of each of these three aspects of the Bovey and Hede (2001a) model through semi-structured interviews with physicians. Semi-structured interviews were conducted with physicians from hospitals within the Midwest.

The findings suggest that physicians have been impacted by the EHR change management system within their hospitals. Though each of the participants experienced different issues; it was clear from the data the change to an EHR system was disruptive to their day-to-day routines and caused various challenges. EHR change management research demonstrates physicians are resisting the change despite recognizing its potential benefits.

This paper contributes to the change management literature by examining how physician resistance can have a negative impact on healthcare organizations during a precipitous technology change. The study also provides a unique understanding of how technology resistance can disrupt an organizational change process.