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Open Access
Article
Publication date: 15 September 2021

Thérèse Eriksson, Lars-Åke Levin and Ann-Charlotte Nedlund

Using financial incentives has been criticised for putting too much focus on things that can be measured. Value-based reimbursement may better align professional values with…

Abstract

Purpose

Using financial incentives has been criticised for putting too much focus on things that can be measured. Value-based reimbursement may better align professional values with financial incentives. However, professional values may differ between actor groups. In this article, the authors identify institutional logics within healthcare-providing organisations. Further, the authors analyse how the centrality and compatibility of the identified logics affect the institutionalisation of external demands.

Design/methodology/approach

41 semi-structured interviews were conducted with representatives from healthcare providers within spine surgery in Sweden, where a value-based reimbursement programme was introduced. Data were analysed using thematic content analysis with an abductive approach, and a conceptual framework based on neo-institutional theory.

Findings

After the introduction of the value-based reimbursement programme, the centrality and compatibility of the institutional logics within healthcare-providing organisations changed. The logic of spine surgeons was dominating whereas physiotherapists struggled to motivate a higher cost for high quality physiotherapy. The institutional logic of nurses was aligned with spine surgeons, however as a peripheral logic facilitating spine surgery. To attain holistic and interdisciplinary healthcare, dominating institutional logics within healthcare-providing organisations need to allow peripheral institutional logics to attain a higher centrality for higher compatibility. Thus, allowing other occupations to take responsibility for quality and attain the feeling of professional pride.

Originality/value

Interviewing spine surgeons, physiotherapists, nurses, managers and administrators allows us to deepen the understanding of micro-level behaviour as a reaction (or lack thereof) to macro-level decisions.

Details

Journal of Health Organization and Management, vol. 35 no. 9
Type: Research Article
ISSN: 1477-7266

Keywords

Open Access
Article
Publication date: 1 June 2020

Martin Lackéus

Three different pedagogical approaches grounded in three different definitional foundations of entrepreneurship have been compared in relation to their effects on students. They…

8547

Abstract

Purpose

Three different pedagogical approaches grounded in three different definitional foundations of entrepreneurship have been compared in relation to their effects on students. They are: (1) “Idea and Artefact-Creation Pedagogy” (IACP), grounded in opportunity identification and creation, (2) “Value-Creation Pedagogy” (VaCP), grounded in value creation and (3) “Venture-Creation Pedagogy” (VeCP), grounded in organisation creation.

Design/methodology/approach

Data were collected at 35 different sites where education was deemed to be entrepreneurial and experiential. A quantitative, smartphone app-based data collection method was used alongside a qualitative interview approach. 10,953 short-survey responses were received from 1,048 participants. Responses were used to inform respondent selection and discussion topics, in 291 student and teacher interviews. Comparative analysis was then conducted.

Findings

The three approaches resulted in very different outcomes, both in magnitude and in kind. VaCP had strong effects on entrepreneurial competencies, on student motivation and on knowledge and skills acquisition. VeCP had weaker effects on knowledge and skills acquisition. IACP had weak effects on all outcomes probed for. Differences were attributed to variation in prevalence of certain emotional learning events and to variation in purpose as perceived by students.

Research limitations/implications

VaCP could serve as an escape from the potential dilemma faced by many teachers in entrepreneurial education, of being caught between two limiting courses of action; a marginal VeCP approach and a fuzzy IACP one. This could prompt policymakers to reconsider established policies. However, further research in other contexts is needed, to corroborate the extent of differences between these three approaches.

Originality/value

Most impact studies in experiential entrepreneurial education focus only on organisation-creation-based education. This study contributes by investigating entrepreneurial education that is also grounded in two other definitional foundations. Allowance has been made for novel comparative conclusions.

Details

International Journal of Entrepreneurial Behavior & Research, vol. 26 no. 5
Type: Research Article
ISSN: 1355-2554

Keywords

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