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Scalar terms, such as “local” and “global,” “big” and “small” are fundamental in how academics and practitioners make sense of and respond to grand challenges. Yet, scale is so taken-for-granted that we rarely question or critically reflect on the concept and how it is used. The aim of this paper is to identify scale as an important concept in research on grand challenges and to point out why taking scale for granted can be problematic. In particular, I suggest that to date most research on grand challenges sees scale as a fundamental ontological feature of the world. Yet, scalar categories and hierarchies are not as self-evident and given as they may seem. Moreover, taking scale as an ontological fixed category limits our ability to make sense of, theorize and respond to grand challenges. As an alternative, I suggest seeing scale as an epistemological frame that participants employ in their everyday practices to make sense of, navigate and develop solutions to grand challenges. The chapter concludes with a research agenda for studying scale as socially constructed in practice.

Following publication of a new vision for the English National Health Service (NHS) in 2014, known as the NHS Five-Year Forward View, a Vanguard programme was introduced by NHS England charged with the task of designing and delivering a range of new care models (NCMs) aimed at tackling deep-seated problems of a type facing all health systems to a greater or lesser degree. Drawing upon recent theoretical developments on the multilevel nature of context, we explore factors shaping the implementation of five NCM initiatives in the North East of England.

Data collection was based on semi-structured interviews (66 in total) between December 2016 and May 2017 with key informants at each site and a detailed review of Trusts' internal documents and policies related to the implementation of each NCM. Our analysis explores factors shaping the implementation of five NCM pilot sites as they touched on the multiple levels of context ranging from the macro policy level to the micro-level setting of workforce redesign.

It is far too early to conclude with any confidence that a successful outcome for the NCM programme will be forthcoming although the NHS Long-Term Plan seeks to build on the earlier vision set out in the Five-Year Forward View. Early indications show some signs of promise, especially where there is evidence of the ground having been prepared and changes already being put in place prior to the official launch of NCM initiatives. At the same time our findings demonstrate that all five pilot sites experienced, and were subject to, unrealistic pressure placed upon them to deliver outcomes.

Our findings demonstrate the need for a deeper understanding of the multilevel nature of context by exploring factors shaping the implementation of five NCMs in the North East of England. Exploring the wider national policy context is desirable as well as understanding the perceptions of front-line staff and service users in order to establish the degree of alignment or, conversely, to identify where policy and practice are at risk of pushing and pulling against each other.

This paper aims to explore how the time and temporal aspects are managed in a financial accounting outsourcing (FAO) transition process in an international interorganizational context. As a research outcome, the authors identify management interventions of both the service provider (SP) and the outsourcing company (OC) at both the corporate and operational levels.

The framework by Huy (2001a, 2001b) was used to analyze the qualitative data, which draw on observations, participation in 32 official meetings during the outsourcing process, informal discussions with key actors from the SP and the OC, and archival data of a single case company.

The authors illustrate how the time and temporal aspects of planned accelerated change are managed through management interventions during the FAO transition process. All four ideal intervention types (commanding, engineering, teaching and socializing) were used sequentially but also jointly to complement one another. The pacing was mostly rapid, owing to strong commanding interventions initiating almost every stage. When analyzing the FAO transition process, the authors identified four stages: contact, contract, convergence and control. Moreover, the authors focused on the role of the operational-level managers and accounting specialists of both organizations. The findings indicate that management interventions vary with the management level.

This study contributes to the interorganizational control literature by considering the time and temporal aspects in planned organizational change and the role of operational-level managers in managing large-scale changes.

As the world of healthcare changes rapidly, healthcare leaders and managers must hone their leadership competencies in order to remain effective in their organizations. With changes such as the Affordable Care Act, increasing medical school costs, decreased graduation rates, and increased needs for care, how are current and future healthcare leaders adapting? In light of the large-scale changes in the healthcare field in recent years, the purpose of this study was to investigate which National Center for Healthcare Leadership (NCHL) competencies were referenced by exemplary healthcare leaders as most important for success in today’s changing healthcare environment. Interviews were conducted with 26 mid- and upper-level healthcare leaders identified by the C-level executives in their organizations as exemplary performers. Change leadership, self-development, talent development, and team leadership were the top four NCHL competencies most frequently referenced, with thematic analysis revealing additional underlying themes in the exemplary leaders’ dialogue.

Agricultural and food systems in the Mekong Region are undergoing transformations because of increasing engagement in international trade, alongside economic growth, dietary change and urbanisation. Food systems approaches are often used to understand these kinds of transformation processes, with particular strengths in linking social, economic and environmental dimensions of food at multiple scales. We argue that while the food systems approach strives to provide a comprehensive understanding of food production, consumption and environmental drivers, it is less well equipped to shed light on the role of actors, knowledge and power in transformation processes and on the divergent impacts and outcomes of these processes for different actors. We suggest that an approach that uses food systems as heuristics but complements it with attention to actors, knowledge and power improves our understanding of transformations such as those underway in the Mekong Region. The key transformations in the region include the emergence of regional food markets and vertically integrated supply chains that control increasing share of the market, increase in contract farming particularly in the peripheries of the region, replacement of crops cultivated for human consumption with corn grown for animal feed. These transformations are increasingly marginalising small-scale farmers, while at the same time, many other farmers increasingly pursue non-agricultural livelihoods. Food consumption is also changing, with integrated supply chains controlling substantial part of the mass market. Our analysis highlights that theoretical innovations grounded in political economy, agrarian change, development studies and rural livelihoods can help to increase theoretical depth of inquiries to accommodate the increasingly global dimensions of food. As a result, we map out a future research agenda to unpack the dynamic food system interactions and to unveil the social, economic and environmental impacts of these rapid transformations. We identify policy and managerial implications coupled with sustainable pathways for change.