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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.

China’s population is ageing. Continuing care retirement communities (CCRCs) are an emerging living arrangement of older Chinese. Incorporating social sustainability features into CCRCs helps to create age-friendly residential environments for residents. However, it is still unclear what kinds of social sustainability features are incorporated into the residential environments of CCRCs in China. Therefore, this study aims to address this research gap.

Qualitative content analysis is adopted to analyse the retrieved business information of representative CCRC developers in China.

This study revealed 36 social sustainability features in CCRCs, with the top-ranked ones being health care and management, social connection and engagement, high-quality and diverse services and daily life support and assistance. Additionally, a preliminary social sustainability framework of CCRCs was proposed, and this framework includes the five components of care and health, environment and management, service and facility, age-friendly life philosophy and social support and inclusion.

In theory, this research’s findings clarify the meaning of social sustainability within the context of CCRCs, which supports future relevant explorations in the CCRC research community. In practice, these findings enhance stakeholders’ understanding of the social sustainability in CCRCs, which promotes the development of age-friendly living environments for older people in an ageing society.

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.

This study focuses on the reasons leading health organisations to adopt a cooperation strategy and the benefits they can draw from that inter-organisational relation.

To this end, a mixed research approach – qualitative and quantitative – was adopted, taking a real case between a Health Centre Group in inland Portugal (ACeS-CB) and the Faculty of Health Sciences at a university situated in the same region (FCS-UBI). To gather information, a questionnaire survey was directed to medical students in this faculty, together with semi-structured interviews with those in charge of both types of organisation in the inter-organisational cooperation studied here.

After content analysis of the interviews and descriptive analysis of the questionnaires, it was concluded that this cooperation is based on a relation of a formal nature, as each organisation is independent from the other, as are their administrative and management organs. The benefits obtained from this cooperative relation regard mainly the share of human resources, particularly elements of the clinical staff in ACeS-CB who have taken on teaching duties at FCS-UBI.

Articulation of theoretical training with clinical practice and the exchange of knowledge were other benefits identified. The study also reveals that students perceive this inter-organisational cooperation as satisfactory, corresponding to what was defined by those in charge of the institutions as its main objectives.

This study focuses on the reasons leading health organisations to adopt a strategy of cooperation with other organisations in the same sector and the benefits they can obtain from that relation. It represents a tool to support managers in health organisations and other stakeholders in an inter-organisational cooperation relation, in planning strategies and understanding the impact of this type of cooperation.

This chapter identifies the serious issue of the mental health and wellbeing of English paramedics working in the emergency ambulance service. It identifies the case of the extant top-down performance measurement regime and the absence of indicators of wellbeing in ambulance performance reporting. The impact of such measures on frontline staff and the implications for their motivation and commitment are also documented. More decentralised, open and discursive approaches to performance management in the public sector are advocated as key methods for re-imagining ambulance and wider public services in a global context.

Drawing on relevant literature, the chapter provides the context of the English ambulance service and the challenges it faces with reference to the New Public Management (NPM) and New Public Governance (NPG). Key issues concerning performance metrics and staff wellbeing and welfare are then identified and discussed. The notions of communicative rationality, deliberative democracy and agonistic pluralism are introduced as a framework for analysing the state of both wellbeing and resilience and the performance regime within the English ambulance service. The chapter relates these themes to the re-imagining of public services internationally, proposing a more participative and discursive approach.

It is desirable for the evaluation of public services to include the wellbeing of the healthcare provider, as well as the public service recipient. Additionally, there is a case for greater participative and dialogic engagement to address the intertwined relationship of ambulance staff wellbeing and the performance management regime of the service. The process should be revised, therefore, to take into account the wellbeing of ambulance staff as an integral and intrinsic part of the delivery of the service, and it is recommended that deliberative methods of participation are deployed in reimagining ambulance services and public services more generally.

The challenges facing ambulance services and, more generally, health services globally continue to proliferate and intensify. They are exacerbated by foreseeable contextual challenges such as the demographic profile of patients and service users and budgetary cuts. Traditional and more recent NPM approaches are proving inadequate for this challenge and appear unsustainable in practice. The lack of acknowledgement of welfare indicators in the performance metrics make them unfit for purpose. Our suggested discursive approach would help to re-imagine the service by improving its sustainability and resilience in parallel with the improved wellbeing and personal resilience of the people who provide the service.

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.