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Given the complex nature of integrated care systems (ICSs), the geographical spread and the large number of organisations involved in partnership delivery, the importance of leadership cannot be overstated. This paper aims to present novel findings from a rapid realist review of ICS leadership in England. The overall review question was: how does leadership in ICSs work, for whom and in what circumstances?

Development of initial programme theories and associated context–mechanism–outcome configurations (CMOCs) were supported by the theory-gleaning activities of a review of ICS strategies and guidance documents, a scoping review of the literature and interviews with key informants. A refined programme theory was then developed by testing these CMOCs against empirical data published in academic literature. Following screening and testing, six CMOCs were extracted from 18 documents. The study design, conduct and reporting were informed by the Realist And Metanarrative Evidence Syntheses: Evolving Standards (RAMESES) training materials (Wong et al., 2013).

The review informed four programme theories explaining that leadership in ICSs works when ICS leaders hold themselves and others to account for improving population health, a sense of purpose is fostered through a clear vision, partners across the system are engaged in problem ownership and relationships are built at all levels of the system.

Despite being a rigorous and comprehensive investigation, stakeholder input was limited to one ICS, potentially restricting insights from varied geographical contexts. In addition, the recent establishment of ICSs meant limited literature availability, with few empirical studies conducted. Although this emphasises the importance and originality of the research, this scarcity posed challenges in extracting and applying certain programme theory elements, particularly context.

This review will be of relevance to academics and health-care leaders within ICSs in England, offering critical insights into ICS leadership, integrating diverse evidence to develop new evidence-based recommendations, filling a gap in the current literature and informing leadership practice and health-care systems.

The aim of this paper is to investigate the effects of environmental dynamism on different EO dimensions in family firms. The authors also examine the moderating role of national culture (uncertainty avoidance and in-group collectivism) and the level of family control and influence in fostering/hindering this relationship.

A survey was conducted among 1,143 family firms from twenty-eight countries. The authors developed and tested hypotheses through a fixed-effects regression analysis.

The findings suggest that environmental dynamism has a positive effect on all three EO dimensions. Analysis reveals a positive moderating role of family control and influence and negative moderating roles of in-group collectivism and uncertainty avoidance.

The findings imply that family firm managers should carefully interpret the influence of their national culture on family firm behavior. More specifically, family firms in dynamic environments should consider the importance of the national culture in which they are embedded. Those operating in high uncertainty avoidant and highly collectivist cultures should take proactive steps to cultivate a corporate entrepreneurial culture. On the other hand, the family should not undermine the effect of its control and influence. In dynamic environments, family control and influence may be a competitive advantage in reinforcing entrepreneurial orientation.

The study contributes to the literature on EO in family firms by expanding the previous research on the antecedents of EO and examining moderation effects of culture and family control and influence across a broad multi-country sample. In contrast with the common findings regarding the effect of family logic on EO, the study shows the strengthening role of family control and influence in the relationship between environmental dynamism and EO. The authors show that culture as an informal institution may also play a critical role in hindering/strengthening the relationship between environmental dynamism and EO.

In this study, we develop understanding of factors that shape the propensity of market incumbents to collaborate in response to the threat posed by new market entrants. We are particularly interested in instances when a market's competitive structure becomes unsettled by new entrants who engage in nonconforming strategic tactics. In such situations, we propose two factors – strategic similarity among competitors and market-share instability – will systematically shape competitors' collaborative response to new entrants. To test our theory, we use data on strategic tactics and collaborative dynamics in the US airline industry from 1989 to 2010. We demonstrate that greater strategic similarity among a market's incumbents increases the likelihood of cooperation in response to the threat of a nonconforming new entrant, while greater market-share instability reduces cooperative response. Through this study, we extend existing understanding of the contextual circumstances under which established competitors recognize their mutual interests and band together.

This paper seeks to explore the effect of performance duration (rather than intensity) on the subsequent initiation of strategic change by firms. Specifically, the effect of outperformance and underperformance duration on strategic change, as well as the moderating effect of environmental dynamism, is studied.

Using a fixed-effects model, analyzing a sample of 34,907 firm-year observations from 1980 to 2018 across 112 industries mostly supported proposed hypotheses.

Results revealed a U-shaped relationship between outperformance duration and strategic change and an inverted U-shaped relationship between underperformance duration and strategic change. The moderation role of environmental dynamism was only partially supported.

This study examines a new dimension of performance feedback, namely duration, rather than the widely used intensity of performance feedback, to enhance our understanding of the behavioral theory of the firm.

Strategic decisions leaders make involving organizational changes such as mergers and acquisitions (M&A), divestitures, and downsizing, which can influence and/or interact with other organizational factors. For example, within the context of M&A, changes impact financial performance, firm behaviors, and organizational culture. In addition, strategic decisions for these types of change can also interrelate with other more intrapersonal factors, including both leaders’ and employees’ health and well-being. Employee stress, also referred to as “merger syndrome,” outlines individual negative impacts of the changes including, but not limited to, cynicism and distrust, change wariness, and burnout, all accumulating to psychological effects including increases in detachment to work, stress, and sick leave. In this chapter, the authors outline the different impacts M&A phases have on stress and well-being and how they interrelate with the strategic decisions leaders make. The authors also outline future research opportunities and practical implications for how leaders and employees could better manage future major changes such as M&A activities.