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This paper describes managed care, competition and high health care costs and reductions in funding as the major market forces that affect US academic health centers. As academic health centers continue to preserve their missions of providing patient care, educating and training health professionals and conducting research, they are negatively impacted by these market changes, thus, resulting in increased expenses and lowered revenue. A key component to surviving in difficult times is market‐focused management. This paper develops a model to show the path of senior level management teams in their decision making. Through the performance of essential managerial roles, senior level managers are responsible for strategies that result in the long‐term viability and growth of academic health centers.

In response to increasing competition for consumer attention, sport governing bodies have innovated short-format, action-oriented versions of traditional sports to attract new fans. This article explores how sport governing bodies (SGBs) manage the need for innovations to both conform to existing stakeholder expectations whilst offering novel benefits in comparison to competition (i.e. legitimate distinctiveness).

Created by the English Cricket Board (ECB), The Hundred competition was used as a case study to explore the conformity-differentiation tension through a legitimacy lens using document and media analysis.

Seven themes were created to explain how the ECB managed legitimacy tensions: rule modification, team creation, scheduling, game-day experience, broadcasting, gender equity and sponsorship. In each theme, differentiation and conformity were traded-off by the ECB to prioritise pragmatic legitimacy with broadcasters and sponsors.

For sport management professionals, the Hundred demonstrates the commercial value of differentiating new sporting events from competitors via hybrid broadcasting partnerships, embedded gender equity and designing game-day experiences that attract hard-to-reach consumer demographics.

SGBs must trade-off legitimacy between sources when innovating to survive, and when faced with conflicting expectations, commercial imperatives determined whether to conform or differentiate.

Discusses challenges facing the US health‐care system now that prepaid or capitated health plans are gaining market share. Investigates how this affects providers, payers and policy makers and the concerns for the maintenance of a quality system. Concludes that the current changes in the US health‐care system are driven by the changing role of the consumer, concerns for quality and efforts to contain costs. Maintains that further research is needed to provide better guidelines to help these challenges to be met.

Discussion of health care costs has expanded beyond the technical domains of accountancy and entered the realms of public discourse. Analyses this discourse through an examination of all the stories published in The New York Times between 1 April 1992 and 1 May 1993 which contained the phrase “health care costs”. Describes the current discourse and examines how antagonostic social interests strive to inscribe the concept of health care cost with conflicting meanings and ideological accents.

It is clear that dramatic changes are taking place in the way health care organizations are being managed. Health care executives are having to make the transition from managing with a “pass the cost along to the consumer” perspective to one of extreme competitive pressure to reduce costs while maintaining appropriate levels of quality. Reports the results of a survey of 135 American hospitals′ executives. Uses factor analysis to uncover four distinct strategies being operationalized. Classifies hospitals′ strategies as: strategic analysers, externally focused and offensively proactive; quality providers, internally‐focused and defensive reactors; price negotiators, externally‐focused and offensively reactive; or cost efficiency providers, internally focused and defensively proactive.

Argues that US health care is in a state of crisis. Escalating costs account for 13 per cent of GNP, making health care the third largest industry in the USA, and spending is expected to increase. Claims health‐care providers need to control rising costs, improve productivity and flexibility, adopt appropriate technologies, and maintain competitive levels of quality and value. States that TQM may provide an environment that will focus on quality of patient care and continuous quality improvement at all levels of the organization including the governing body, the administrative, managerial, and clinical areas. Any new national or state health‐care plan will force providers to be more efficient while maintaining quality standards. Concludes that it will be strategically imperative that health‐care providers ranging from family physicians to major medical centres and suppliers ranging from laboratories to pharmaceutical firms establish methods for making rapid continuous improvement and total quality management the cornerstone of the strategic planning process.

Describes the current scenario for maternity services. Delineates an integrative approach dealing with the information cycle and applies it to the market for obstetrical services. Discusses directions for future research and provides strategic recommendations.

Narrative is believed to be a crucial component of sense-making in organizations, and previous research in the field suggests that multiple levels and forms of narrative are inherent to the definition of professional identities (Clarke et al., 2009; Ybema et al., 2009; Brown and Lewis, 2011). For example, narrative can be found in the stories told by organizational actors as they informally interact in the workplace, in the formalized basic assumptions that support organizational strategy-making, in the accounts people give of their work, and in the artifacts they produced and experienced while engaged in accomplishing tasks. The purpose of this paper is to consider narrative as a way of giving sense to organizational membership, of constituting an overall and possibly shared sense of direction, of focussing one’s professional identity, and of enabling and/or constraining the ongoing activities of actors. The context of the research was given by a group of sport federations enrolled within the Italian National Olympic Committee (CONI), which is the national most authoritative network of professional local sport organizations.

Participants involved in the study were 42 professional referees belonging to this network and active in different sport disciplines and 12 people from the CONI management. In-depth narrative interviews were collected in the aim to investigate the narrative cues revealing the organizational sense-making processes that animate the representation of this professional identity both at a subjective and at an organizational level. Data have been explored adopting the semiotic square and diatextual analysis as to highlight the strict relationship between text, context and interlocutors.

Data have been explored adopting the semiotic square and diatextual analysis as to highlight the strict relationship between text, context and interlocutors. Results showed that there was an evident gap between what the management formally defined as strategic vision, mission and cultural guidelines that actually shape the organizational identity of the CONI and what was concretely experienced by its actors, in this case the referees.

Most of the studies conducted in sport organizations focussed either on an intra-organizational level investigating the specific features of given professional categories such as athletes and/or coaches, or at an inter-organizational level, paying attention mostly to the marketing and networking strategies oriented toward stakeholders. On the other hand, most studies conducted on referees have devoted attention strictly to performance assessment, that, in line with a positivist approach, considered the latter as an output of situational and psychological variables (e.g. Marie, 1999; MacMahon et al., 2007). Conversely, the findings coming from the present study contributed to support the promotion of an alternative organizational approach, more specifically based on the strategic relevance of horizontal (within the federations) and vertical (between the federations and the center of the network) communication as to enhance the identification process which give sense to the organizational basic assumptions.

Circular supply chain management (CSCM) is considered a promising solution to attain sustainability in the current industrial system. Despite the exigency of this approach, its application in the food industry is a challenge because of the nature of the industry and CSCM being a novel approach. The purpose of this study is to develop an industry-based systematic analysis of CSCM by examining the challenges for its application, exploring the effects of recognised challenges on various food supply chain (FSC) stages and investigating the business processes as drivers.

Stakeholder theory guided the need to consider stakeholders’ views in this research and key stakeholders directly from the food circular supply chain were identified and interviewed (n = 36) following qualitative methods.

Overall, the study reveals that knowledge, perception towards environmental initiatives and economic viability are the major barriers to circular supply chain transition in the UK FSC.

This research provides a holistic perspective analysing the loopholes in different stages of the supply chain and investigating the way a particular circular supply chain stage is affected by recognised challenges through stakeholder theory, which will be a contribution to designing management-level strategies. Reconceptualising this practice would be beneficial in bringing three-tier (economic, environmental and social) benefits and will be supportive to engage stakeholders in the sustainability agenda.