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The purpose of this paper is to describe and analyze nurses’ perceptions and evaluations of healthcare developmental work after the introduction of Lean and Six Sigma and, how nurses aspire to maintain a high reliability organization (HRO).

Nurses’ roles and the way they respond to new efficiency and quality working methods are crucial. Underlying themes were analyzed from in-depth, semi-structured interviews with (n=17) nurses at two Swedish hospitals.

The nurses perceived that Lean worked better than Six Sigma, because of its bottom-up approach, and its similarities with nurses’ well-known work qualities. Nurses coordinate patients care, collaborate in teams and take leadership roles. To maintain high reliability and to become quality developers, nurses need stable resources. However, professional’s logic collides with management’s logic. Expert knowledge (top-down approach) without nurses’ local knowledge (bottom-up approach) can lead to problems. Healthcare quality methods are standardized but must be used with flexibility. However, HROs ensue not only from method quality but also from work attitudes, commitment and continuous work-improvement.

Management can support personnel in developmental work with: continuous education, training, teamwork, knowledge sharing and cooperation. Authoritarian method structures that limit the healthcare professionals’ autonomy should be softened or abandoned.

The study uses theoretical concepts from HROs, which were developed for unexpected events, to explain the consequences of implementing Lean and Six Sigma in healthcare.

Recent lapses in the management of high hazard organizations, such as the Fukushima event or the Deepwater Horizon blast, add considerable urgency to better understand the complicated and complex phenomena of leading and managing high reliability organizations (HRO). The purpose of this paper is to offer both theoretical and practical insight to further strengthen reliability in high hazard organizations.

Phenomenological study based on over three years of research and thousands of hours of study in HROs conducted through a scholar-practitioner partnership.

The findings indicate that the identification and the management of competing tensions arising from misalignment within and between public policy, organizational strategy, communication, decision-making, organizational learning, and leadership is the critical factor in explaining improved reliability and safety of HROs.

Stops short of full-blown grounded theory. Steps were made to ensure validity; however, generalizability may be limited due to sample.

Provides insight into reliably operating organizations that are crucial to society where errors would cause significant damage or loss.

Extends high reliability research by investigating more fully the competing tensions present in these complex, societally crucial organizations.

This paper aims to offer an innovative and original solution methodology proposal to the problem of arbitrary complex multiscale (ACM) ontological uncertainty management (OUM). The solution is based on the postulate that society is an ACM system of purposive actors within continuous change. Present social problems are multiscale-order deficiencies, which cannot be fixed by the traditional hierarchical approach alone, by doing what one does better or more intensely, but rather by changing the way one does it.

This paper treasures several past guidelines, from McCulloch, Wiener, Conant, Ashby and von Foerster to Bateson, Beer and Rosen’s concept of a non-trivial system to arrive to an indispensable and key anticipatory learning system (ALS) component for managing unexpected perturbations by an antifragility approach as defined by Taleb. This ALS component is the key part of our new methodology called “computational information conservation theory (CICT) OUM” approach, based on brand new numeric system behavior awareness from CICT.

To achieve an antifragility behavior, next generation system must use new CICT OUM-like approach to face the problem of multiscale OUM effectively and successfully. In this manner, homeodynamic operating equilibria can emerge out of a self-organizing landscape of self-structuring attractor points in a natural way.

This paper presents a relevant contribution toward a new post-Bertalanffy Extended Theory of Systems. Due to its intrinsic self-scaling properties, this system approach can be applied at any system scale: from single quantum system application development to full system governance strategic assessment policies and beyond.

The new post-Bertalanffy Extended Theory of Systems Framework allows, for the first time, social, biological and biomedical engineering ideal system categorization levels, from an operational perspective, to be matched exactly to practical system modeling interaction styles, with no paradigmatic operational ambiguity and information loss.

Even new social and advanced health and wellbeing information application can successfully and reliably manage higher system complexity than contemporary ones, with a minimum of design specification and less system final operative environment knowledge at design level. The present paper offers for discussion an innovative solution proposal for the complex society and big government modeling and management approach.

Specifically, advanced wellbeing applications, high reliability organization, mission critical project system, very low technological risk and crisis management system can benefit highly from our new methodology called CICT OUM approach and related techniques. This paper presents a relevant contribution toward a new post-Bertalanffy Extended Theory of Systems. Due to its intrinsic self-scaling properties, this system approach can be applied at any system scale: from a single quantum system application development to full system governance strategic assessment policies and beyond.

Weick and Sutcliffe identified five principles that enable high-reliability organizations (HROs) to address environmental complexity and manage unexpected events. The current study aims to adopt this sensemaking perspective to analyze accidents within a typical HRO sector, namely maritime transport.

Through a retrospective case study analysis, this study focused on seven oil tanker accidents, using them as illustrative examples.

Findings show how the five principles contributed to the accidents' occurrence, explaining how failures in sensemaking affected the crew's capability to both prevent errors and cope with their consequences, thus leading to disasters.

Overall, the study offers an applicative contribution showing how this model may provide a reliable framework for analyzing the psychosocial factors affecting an accident. This approach deepens the understanding of how latent factors are enacted and how the prevention and error management phases interrelate within a comprehensive flow of the entire accident sequence. Furthermore, the study emphasizes consistent patterns that emerge across multiple accidents within the same sector, in order to learn valuable lessons to improve safety measures in the future.

This study constitutes an exemplary application in support of how Weick and Sutcliffe’s model is valuable for investigating HROs. It offers a second-order interpretative framework to understand accidents and underscores the interplay among these factors during the dynamic development of an accident.

In this chapter the authors present a field study investigating the adoption of information communications technology innovation at a UK-based University hospital. The authors have followed the implementation of electronic medicine chart technology (EMEDs) designed to replace “traditional” paper-based systems used by doctors, nurses, and pharmacists teams in the hospital. Having studied the interactions between the “user” and “implementer” groups, the findings of this chapter offer a socio-cognitive model of innovation adoption which accounts for the intra- and inter-team idiosyncrasies that underpin the processes of implementation. Using the concept of interactive framing as the analytical lens, findings of this chapter illustrate that the adoption and diffusion process of innovation is a social process resulting from the interaction of organizational team members. The cycles constituting the adoption and implementation of EMEDs in this research encapsulate the conflicting experience of different groups and their transition from implementation to acceptance. The authors have adopted a socio-cognitive perspective to explain the asymmetrical experience of different groups in a complex, high reliable organization.

Based on the belief that it is behaviour which constitutes risk rather than procedures, the paper focuses on the awareness of behavioural aspects in risk management techniques and the consequences that arise out of this awareness. It questions the traditional thinking that risk management is predominantly a set of procedures in the control of risk. The paper also considers the part played by public policy in managing risk and changing behaviour. The paper concludes that it is behaviour, and not the set of procedures, which is the risky factor; therefore in risk management there is need to focus on developing human behaviour that is capable of being flexible in an event.

The ideas expressed in this work are based on those put into practice at the Okuma Corporation of Japan, one of the world′s leading machine tool manufacturers. In common with many other large organizations, Okuma Corporation has to meet the new challenges posed by globalization, keener domestic and international competition, shorter business cycles and an increasingly volatile environment. Intelligent corporate strategy (ICS), as practised at Okuma, is a unified theory of strategic corporate management based on five levels of win‐win relationships for profit/market share, namely: ,1. Loyalty from customers (value for money) – right focus., 2. Commitment from workers (meeting hierarchy of needs) – right attitude., 3. Co‐operation from suppliers (expanding and reliable business) – right connections., 4. Co‐operation from distributors (expanding and reliable business) – right channels., 5. Respect from competitors (setting standards for business excellence) – right strategies. The aim is to create values for all stakeholders. This holistic people‐oriented approach recognizes that, although the world is increasingly driven by high technology, it continues to be influenced and managed by people (customers, workers, suppliers, distributors, competitors). The philosophical core of ICS is action learning and teamwork based on principle‐centred relationships of sincerity, trust and integrity. In the real world, these are the roots of success in relationships and in the bottom‐line results of business. ICS is, in essence, relationship management for synergy. It is based on the premiss that domestic and international commerce is a positive sum game: in the long run everyone wins. Finally, ICS is a paradigm for manufacturing companies coping with change and uncertainty in their search for profit/market share. Time‐honoured values give definition to corporate character; circumstances change, values remain. Poor business operations generally result from human frailty. ICS is predicated on the belief that the quality of human relationships determines the bottom‐line results. ICS attempts to make manifest and explicit the intangible psychological factors for value‐added partnerships. ICS is a dynamic, living, and heuristic‐learning model. There is intelligence in the corporate strategy because it applies commonsense, wisdom, creative systems thinking and synergy to ensure longevity in its corporate life for sustainable competitive advantage.

Addresses the standardization of the measurements and the labels for concepts commonly used in the study of work organizations. As a reference handbook and research tool, seeks to improve measurement in the study of work organizations and to facilitate the teaching of introductory courses in this subject. Focuses solely on work organizations, that is, social systems in which members work for money. Defines measurement and distinguishes four levels: nominal, ordinal, interval and ratio. Selects specific measures on the basis of quality, diversity, simplicity and availability and evaluates each measure for its validity and reliability. Employs a set of 38 concepts ‐ ranging from “absenteeism” to “turnover” as the handbook’s frame of reference. Concludes by reviewing organizational measurement over the past 30 years and recommending future measurement reseach.

Information and communications technology (ICT) offers enormous opportunities for individuals, businesses and society. The application of ICT is equally important to economic and non-economic activities. Researchers have increasingly focused on the adoption and use of ICT by small and medium enterprises (SMEs) as the economic development of a country is largely dependent on them. Following the success of ICT utilisation in SMEs in developed countries, many developing countries are looking to utilise the potential of the technology to develop SMEs. Past studies have shown that the contribution of ICT to the performance of SMEs is not clear and certain. Thus, it is crucial to determine the effectiveness of ICT in generating firm performance since this has implications for SMEs’ expenditure on the technology. This research examines the diffusion of ICT among SMEs with respect to the typical stages from innovation adoption to post-adoption, by analysing the actual usage of ICT and value creation. The mediating effects of integration and utilisation on SME performance are also studied. Grounded in the innovation diffusion literature, institutional theory and resource-based theory, this study has developed a comprehensive integrated research model focused on the research objectives. Following a positivist research paradigm, this study employs a mixed-method research approach. A preliminary conceptual framework is developed through an extensive literature review and is refined by results from an in-depth field study. During the field study, a total of 11 SME owners or decision-makers were interviewed. The recorded interviews were transcribed and analysed using NVivo 10 to refine the model to develop the research hypotheses. The final research model is composed of 30 first-order and five higher-order constructs which involve both reflective and formative measures. Partial least squares-based structural equation modelling (PLS-SEM) is employed to test the theoretical model with a cross-sectional data set of 282 SMEs in Bangladesh. Survey data were collected using a structured questionnaire issued to SMEs selected by applying a stratified random sampling technique. The structural equation modelling utilises a two-step procedure of data analysis. Prior to estimating the structural model, the measurement model is examined for construct validity of the study variables (i.e. convergent and discriminant validity).

The estimates show cognitive evaluation as an important antecedent for expectation which is shaped primarily by the entrepreneurs’ beliefs (perception) and also influenced by the owners’ innovativeness and culture. Culture further influences expectation. The study finds that facilitating condition, environmental pressure and country readiness are important antecedents of expectation and ICT use. The results also reveal that integration and the degree of ICT utilisation significantly affect SMEs’ performance. Surprisingly, the findings do not reveal any significant impact of ICT usage on performance which apparently suggests the possibility of the ICT productivity paradox. However, the analysis finally proves the non-existence of the paradox by demonstrating the mediating role of ICT integration and degree of utilisation explain the influence of information technology (IT) usage on firm performance which is consistent with the resource-based theory. The results suggest that the use of ICT can enhance SMEs’ performance if the technology is integrated and properly utilised. SME owners or managers, interested stakeholders and policy makers may follow the study’s outcomes and focus on ICT integration and degree of utilisation with a view to attaining superior organisational performance.

This study urges concerned business enterprises and government to look at the environmental and cultural factors with a view to achieving ICT usage success in terms of enhanced firm performance. In particular, improving organisational practices and procedures by eliminating the traditional power distance inside organisations and implementing necessary rules and regulations are important actions for managing environmental and cultural uncertainties. The application of a Bengali user interface may help to ensure the productivity of ICT use by SMEs in Bangladesh. Establishing a favourable national technology infrastructure and legal environment may contribute positively to improving the overall situation. This study also suggests some changes and modifications in the country’s existing policies and strategies. The government and policy makers should undertake mass promotional programs to disseminate information about the various uses of computers and their contribution in developing better organisational performance. Organising specialised training programs for SME capacity building may succeed in attaining the motivation for SMEs to use ICT. Ensuring easy access to the technology by providing loans, grants and subsidies is important. Various stakeholders, partners and related organisations should come forward to support government policies and priorities in order to ensure the productive use of ICT among SMEs which finally will help to foster Bangladesh’s economic development.

Given the pace of industry change and the rapid diffusion of high reliability organization (HRO) approaches, lags and divergences have arisen between research and practice in healthcare. The purpose of this paper is to explore several of these theory-practice gaps and propose implications for research and practice.

Classic and cutting-edge HRO literature is applied to analyze two industry trends: delivery system integration, and the confluence of patient-as-consumer and patient-centered care.

Highly reliable integrated delivery systems will likely function very differently from classic HRO organizations. Both practitioners and researchers should address conditions such as how a system is bounded, how reliable the system should be and how interdependencies are handled. Additionally, systems should evaluate the added uncertainty and variability introduced by enhanced agency on the part of patients/families in decision making and in processes of care.

Dramatic changes in the sociotechnical environment are influencing the coupling and interactivity of system elements in healthcare. Researchers must address the maintenance of reliability across organizations and the migration of decision-making power toward patients and families.

As healthcare systems integrate, managers attempting to apply HRO principles must recognize how these systems present new and different reliability-related challenges and opportunities.

This paper provides a starting point for the advancement of research and practice in high-reliability healthcare by providing an in-depth exploration of the implications of two major industry trends.