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The purpose of this paper is to explore the way “hybrid” clinical managers in Kenyan public hospitals interpret and enact hybrid clinical managerial roles in complex healthcare settings affected by professional, managerial and practical norms.

The authors conducted a case study of two Kenyan district hospitals, involving repeated interviews with eight mid-level clinical managers complemented by interviews with 51 frontline workers and 6 senior managers, and 480 h of ethnographic field observations. The authors analysed and theorised data by combining inductive and deductive approaches in an iterative cycle.

Kenyan hybrid clinical managers were unprepared for managerial roles and mostly reluctant to do them. Therefore, hybrids’ understandings and enactment of their roles was determined by strong professional norms, official hospital management norms (perceived to be dysfunctional and unsupportive) and local practical norms developed in response to this context. To navigate the tensions between managerial and clinical roles in the absence of management skills and effective structures, hybrids drew meaning from clinical roles, navigating tensions using prevailing routines and unofficial practical norms.

Understanding hybrids’ interpretation and enactment of their roles is shaped by context and social norms and this is vital in determining the future development of health system’s leadership and governance. Thus, healthcare reforms or efforts aimed towards increasing compliance of public servants have little influence on behaviour of key actors because they fail to address or acknowledge the norms affecting behaviours in practice. The authors suggest that a key skill for clinical managers in managers in low- and middle-income country (LMIC) is learning how to read, navigate and when opportune use local practical norms to improve service delivery when possible and to help them operate in these new roles.

The authors believe that this paper is the first to empirically examine and discuss hybrid clinical healthcare in the LMICs context. The authors make a novel theoretical contribution by describing the important role of practical norms in LMIC healthcare contexts, alongside managerial and professional norms, and ways in which these provide hybrids with considerable agency which has not been previously discussed in the relevant literature.

Healthcare regulation is one means to address quality challenges in healthcare systems and is carried out using compliance, deterrence and/or improvement approaches. The four countries of the UK provide an opportunity to explore and compare different regulatory architecture and models. The purpose of this paper is to understand emerging regulatory models and associated tensions.

This paper uses qualitative methods to compare the regulatory architecture and models. Data were collected from documents, including board papers, inspection guidelines and from 48 interviewees representing a cross-section of roles from six organisational regulatory agencies. The data were analysed thematically using an a priori coding framework developed from the literature.

The findings show that regulatory agencies in the four countries of the UK have different approaches and methods of delivering their missions. This study finds that new hybrid regulatory models are developing which use improvement support interventions in parallel with deterrence and compliance approaches. The analysis highlights that effective regulatory oversight of quality is contingent on the ability of regulatory agencies to balance their requirements to assure and improve care. Nevertheless, they face common tensions in sustaining the balance in their requirements connected to their roles, relationships and resources.

The paper shows through its comparison of UK regulatory agencies that the development and implementation of hybrid models is complex. The paper contributes to research by identifying three tensions related to hybrid regulatory models; roles, resources and relationships which need to be managed to sustain hybrid regulatory models.

Drawing upon theoretical insights on value creation perspectives, the authors aim to advance the understanding of performance and accountability in different hybrid organisations.

The authors conceptualise common theoretical origins of hybrid organisations and how they create and enact value, by reflecting on the Accounting, Auditing and Accountability Journal (AAAJ) special issue articles. Furthermore, the authors propose an agenda for future research into accounting, performance and accountability for hybrid organisations.

Hybrid organisations can be conceptualised through their approaches to value creation (mixing, compromising and legitimising). This article provides a more detailed understanding of accounting, performance and accountability changes in hybrid organisations.

This contribution also has relevant practical implications for actors, such as politicians, managers, professionals, auditors, controllers and accountants, encased in various hybrid organisations, policy contexts and multi-faceted interfaces between public, private and civil society.

Hybridity lenses reveal novel connections between different types of hybrid organisations and how they create and enact multiple values.

The purpose of this paper is to explain how public sector accounting has changed and is changing due to public governance development.

This paper conducts a traditional literature review based on selected studies in the fields of accounting, public administration and management. The aim of the review is to explain how diverse forms of public governance influence the fate of public sector accounting, including accountability, performance measurement, budgeting and reporting practices.

Public governance is developing into more inclusive but also complex forms, resulting in network, collaborative and digital governance. Consequently, the focus and practices of public sector accounting have changed, as reflected in new types of accountability, performance measurement, budgeting and reporting practices.

Drawing upon literature from different fields enables a deeper understanding of the changes in public sector accounting. Nevertheless, the intention is not to execute a systematic literature review but to provide an overview and resolve the scattered body of knowledge generated by previous contributions. The areas of risk management and auditing were not included and deserve further attention.

This paper discusses the need to continually redefine and reassess public sector accounting practices, by recognising the interdependencies between different actors, citizens and digital technologies.

The authors argue that the mainstream scholarly discourse on hybridity and accounting is thus far primarily interested in the use and effects of accounting “in” hybrid organizations. Consequently, the literature has to a lesser extent explored how accounting mediates hybrid settings (while also being mediated), and the role of disentanglements in such processes. In hybrid settings, objects are difficult to define, and measures and tools difficult to agree upon. However, the literature on hybrid accounting is inconclusive and indicates that accounting can potentially both stabilize and de-stabilize relations in a hybrid setting. The authors address the research question of how accounting emerges and manifests itself in a process of entangling and disentangling in a heterogeneous emerging hybrid setting.

The paper is based on a longitudinal qualitative case study of the implementation of social investments, a public sector calculative framework based on the logic of measuring long term and social and economic impact of prevention. Methodologically, the study was guided by actor-network theory. In total, 18 observations and 48 interviews were conducted.

The observation the authors make in their case study is that much effort was spent on both keeping things apart and tying elements together. What the authors add to the literature is an illumination of how the interplay between entanglements and disentanglements facilitated the design idea of social investments to be enacted as multiple semi-integrated and purified hybridizations. The authors describe different translation points, each representing a specific hybridization where elements were added, recombined and disentangled. Still, the translation points were not completely compartmentalized, but rather semi-integrated where associations were facilitated through active mediation, likeness and productiveness for each other.

One limitation is the single case approach. A second limitation arises from the ANT approach to hybridity.

A practical implication of this paper is that in hybrid settings, the semi-integrated character may be interpreted as a strength because it allows the mobilization of heterogenous actors. However, this may also come at the cost of governability and raises further questions of managerial practices in hybrid settings.

The paper suggests the potentially productive role of disentanglements in allowing multiple hybridizations to evolve in hybrid accounting settings.

The paper suggests the potentially productive role of disentanglements in allowing multiple stabilized hybridizations to evolve in hybrid accounting settings.

The purpose of the present study is to investigate travel agencies' social media usage and its perceived effectiveness by small- and micro-Italian travel agencies; the pre-pandemic period is compared to the forecasts for the post-Covid-19 period and different characteristics of firms and entrepreneurs are considered. Furthermore, the study analyses the expected benefits in terms of marketing objectives, such as improving brand image and/or personalizing the offer.

The research was developed through a questionnaire administered electronically to travel agents (282 respondents). The resulting data was analyzed by applying the McNemar test, a pairwise t-test and the multivariate analysis of variance.

The results show that social media are strategically significant for travel agents, even though their adoption is influenced by different agency aims; the perceived effectiveness results are diversified according to varying agency typologies.

The two main limitations of the study are its focus on the Italian context only and the missing consideration of the consumer's point of view. The latter prevents an exhaustive assessment of future trends regarding the use of social media in the client–agency relationship.

The study, which focuses on a little debated topic concerning the relationship between social media and SMEs, organically explores various dimensions related to the adoption of social media by small agencies, also considering the impact of the Covid-19 on the perception of travel agents. As a further element of originality, the research takes into consideration the main social platforms separately rather than the set of tools as a whole.