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In this viewpoint article, the authors recognize the increased focus in health systems on co-design for innovation and change. This article explores the role of leaders and mangers in developing and enhancing a culture of trust in their organizations to enable co-design, with the potential to drive innovation and change in healthcare.

Using social science analyses, the authors argue that current co-design literature has limited focus on interactions between senior leaders and managers, and healthcare staff and service users in supporting co-designed innovation and change. The authors draw on social and health science studies of trust to highlight how the value-based co-design process needs to be supported and enhanced. We outline what co-design innovation and change involve in a health system, conceptualize trust and reflect on its importance within the health system, and finally note the role of senior leaders and managers in supporting trust and responsiveness for co-designed innovation and change.

Healthcare needs leaders and managers to embrace co-design that drives innovation now and in the future through people – leading to better healthcare for society at large. As authors we argue that it is now the time to shift our focus on the role of senior managers and leaders to embed co-design into health and social care structures, through creating and nurturing a culture of trust.

Building public trust in the health system and interpersonal trust within the health system is an ongoing process that relies upon personal behavior of managers and senior leaders, organizational practices within the system, as well as political processes that underpin these practices. By implementing managerial, leadership and individual practices on all levels, senior managers and leaders provide a mechanism to increase both trust and responsiveness for co-design that supports innovation and change in the health system.

Drawing on organizational design theory and organizational learning theory, this paper aims to examine component technology (CT) and the interaction between CT and experiential learning (EL) effects on the degree of integration (DI) of cross-border technological acquisitions.

Using a sample of 267 firms consisting of 229 acquirer firms who started cross-border technological acquisitions from developed economies and 38 acquirer firms who initiated cross-border technological acquisitions from emerging economies over the period of 1993–2016, this study adopts a value chain framework to measure the acquirers’ acquisition integration degree for the investigation of the effects of CT and the interaction between CT and EL.

First, this paper finds CT in cross-border technological acquisitions exerting a positive influence on the acquirer firm’s likelihood of the DI implementation, in line with the organizational design theory. Second, in view of organizational learning theory, this study finds EL and the combined effect of CT and EL to have an inverse influence on the DI.

The results imply that the moderating role of EL significantly optimizes decision choices for an acquirer firm for integration implementation strategies in the form of DI, such as full integration (structural integration), partial integration and no integration (structural separation), which appears to be crucial for cross-border technological acquisitions.

This study contributed to international business strategies by shedding light on the importance of the DI for an acquirer firm that undertakes a cross-border technological acquisition with a CT target firm. This study explains why structural integration might be necessary in cross-border technological acquisitions regardless of the costs of disruption it imposes, as well as the contexts in which it becomes less important or unnecessary. The study disclosed that the increase in the likelihood of DI because of CT depends on the EL of the acquisition company in the host country environment and fluctuates with the prior acquisition knowledge and EL of the host country. Combining two cross-border technological acquisition’s literature streams, such as CT and EL, this study enlightens the importance of organizational learning theory and theory of organization design strategic direction making on acquisition integration implementation strategies.