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Neo-liberal “reform” has in many countries shifted services across the boundary between the public and private sector. This policy re-opens the question of what structural and managerial differences, if any, differences of ownership make to healthcare providers. The purpose of this paper is to examine the connections between ownership, organisational structure and managerial regime within an elaboration of Donabedian’s reasoning about organisational structures. Using new data from England, it considers: how do the internal managerial regimes of differently owned healthcare providers differ, or not? In what respects did any such differences arise from differences in ownership or for other reasons?

An observational systematic qualitative comparison of differently owned providers was the strongest feasible research design. The authors systematically compared a maximum variety (by ownership) sample of community health services; out-of-hours primary care; and hospital planned orthopaedics and ophthalmology providers (n=12 cases). The framework of comparison was the ownership theory mentioned above.

The connection between ownership (on the one hand) and organisation structures and managerial regimes (on the other) differed at different organisational levels. Top-level governance structures diverged by organisational ownership and objectives among the case-study organisations. All the case-study organisations irrespective of ownership had hierarchical, bureaucratic structures and managerial regimes for coordinating everyday service production, but to differing extents. In doctor-owned organisations, the doctors’, but not other occupations’, work was controlled and coordinated in a more-or-less democratic, self-governing ways.

This study was empirically limited to just one sector in one country, although within that sector the case-study organisations were typical of their kinds. It focussed on formal structures, omitting to varying extents other technologies of power and the differences in care processes and patient experiences within differently owned organisations.

Type of ownership does appear, overall, to make a difference to at least some important aspects of an organisation’s governance structures and managerial regime. For the broader field of health organisational research, these findings highlight the importance of the owners’ agency in explaining organisational change. The findings also call into question the practice of copying managerial techniques (and “fads”) across the public–private boundary.

Ownership does make important differences to healthcare providers’ top-level governance structures and accountabilities and to work coordination activity, but with different patterns at different organisational levels. These findings have implications for understanding the legitimacy, governance and accountability of healthcare organisations, the distribution and use power within them, and system-wide policy interventions, for instance to improve care coordination and for the correspondingly required foci of healthcare organisational research.

Researchers conducted a qualitative analysis of students’ experiences while enrolled in an interdisciplinary leadership minor with the intent to determine programmatic inputs that spur leadership development. Based on students’ reflections, three domains of programmatic inputs for leadership development within the minor were identified. These domains include leadership development at the individual level, leadership development at the group level, and leadership development through experiential learning. Themes within these three domains are also identified providing additional insight into the participants’ experiences while enrolled in the leadership minor. Based on these findings, researchers proposed a framework for leadership development within an interdisciplinary minor. Recommendations for future research and application of the proposed framework are discussed.

The Voice of the Clinician project commenced during an era when practitioner burnout, dissatisfaction, and turnover became an increasingly global health workforce concern. One key problem is clinical staff not being empowered to voice their concerns to decision-makers, as was found in this case study of an Australian public health organization. The following research question informed the present study: What is a better committee system for clinician engagement in decision-making processes? The paper aims to discuss this issue.

The Mid North Coast Local Health District in New South Wales aspired to improve engagement between frontline clinicians and decision-makers. Social network analysis methods and mathematical modeling were used in the discovery of how committees are connected to each other and subsequently to other committee members.

This effort uncovered a hidden organizational architecture of 323 committees of 926 members which overall cost 84,729 person hours and AUD$2.923 million per annum. Furthermore, frontline clinicians were located far from centers of influence, just 37 percent of committees had terms of reference, and clinicians reported that meeting agendas were not being met.

In response to the findings, a technological platform was created so that the board of directors could visually see all the committees and the connections between them, thus creating ways to further improve communication, transparency of process, and – ultimately – clinician engagement.

The breakthrough idea is that all organizational meetings can be seen as a system of engagement and should be analyzed to determine and describe the points and pathways where clinician voice is blocked.

Leadership development among postsecondary students can occur through a variety of experiences; one such experience is a leadership minor. The purpose of this descriptive interpretive study was to analyze students’ experiences while enrolled in a leadership minor with a focus on exploring evidence of leadership identity development. By exploring the leadership identity development of students enrolled in a leadership minor, we sought to provide valuable information for professionals within postsecondary leadership education offering, or planning to offer a leadership minor. Our analysis revealed changes in the leadership identity and skill development of students involved in the leadership minor. Implications and recommendations for leadership development programs, specifically leadership minors, arediscussed.

To combat climate change, protect biodiversity, maintain water quality, facilitate a just transition for workers and engage citizens and communities, a diversity of stakeholders across multiple levels work together and collaborate to co-create mutually beneficial solutions. This paper aims to illustrate how a 7.5-year collaboration between local communities, researchers, academics, companies, state agencies and policymakers is contributing to the reframing of industrial harvested peatlands to regenerative ecosystems and carbon sinks with impacts on ecological, economic, social and cultural systems.

The European Union LIFE Integrated Project, Peatlands and People, responding to Ireland’s Climate Action Plan, represents Europe’s largest rehabilitation of industrially harvested peatlands. It makes extensive use of marketing research for reframing strategies and actions by partners, collaborators and communities in the evolving context of a just transition to a carbon-neutral future.

The results highlight the ecological, economic, social and cultural reframing of peatlands from fossil fuel and waste lands to regenerative ecosystems bursting with biodiversity and climate solution opportunities. Reframing impacts requires muddling through the ebbs and flows of planned, possible and unanticipated change that can deliver benefits for peatlands and people over time.

At 3 of 7.5 years into a project, the authors are muddling through how ecological reframing impacts economic and social/cultural reframing. Further impacts, planned and unplanned, can be expected.

This paper shows how an impact planning canvas tool and impact taxonomy can be applied for social and systems change. The tools can be used throughout a project to understand, respond to and manage for unplanned events. There is constant learning, constantly going back to the impact planning canvas and checking where we are, what is needed. There is action and reaction to each other and to the diversity of stakeholders affected and being affected by the reframing work.

This paper considers how systemic change through ecological, economic, social and cultural reframing is a perfectly imperfect process of muddling through which holds the promise of environmental, economic, technological, political, social and educational impacts to benefit nature, individuals, communities, organisations and society.

Undergraduate agricultural leadership education opportunities are prevalent and growing. However, additional attention should be placed on the quality of educational leadership experiences. The purpose of this study was to explore how the context of a learning experience impacts student application of team leadership skills. The findings and implications of this study are reported in three themes: (a) contextual dimensions of educational experiences, (b) agricultural disconnect, and (c) team leadership skill application. Recommendations for practitioners include providing students with real-life leadership skill application experiences, regulating assignments to have agricultural connections, and integrating opportunities for student reflection. Future research should consider questions such as: (a) what other educational leadership experiences may have considerable learning impacts? and (b) what other pedagogical methodologies are useful in teaching agricultural and team leadership education?