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Despite the undeniable need for innovation in hospital building design, the literature highlights the disconnect between research and practice as the primary knowledge gap hindering such innovation. This study shows this focus to be an oversimplification, for the complex processes that trigger design innovations and impact their ecosystems need to be examined from a systemic perspective. This paper aims to conceptualise the evolution of hospital building design and identify and explain the main factors triggering design and construction innovations over the past 100 years.

A novel hybrid research design to mixed grounded theory (MGT) methodology, with Charmaz constructivist paradigm, is developed as a new systematic way of constructing and interpreting the concepts and interconnections among them that triggered design innovation.

This study represents a taxonomy of concepts and an explanatory innovation framework, containing 617 interconnections between 146 factors classified across 14 categories. The complex innovation ecosystem comprises multi-faceted processes between heterogenous factors with both individual and collective impacts on design innovations.

This research highlights the main components of the innovation ecosystem and its overall behaviour in this field, and the most influential and interrelated contextual factors, as well as representing and mapping generative interactions that support innovation processes. This knowledge can help hospital researchers, designers, policymakers and stakeholders adopt a multidimensional outlook to analyse the strength of all influential factors, introduce potential novel ways of collaborating, conceptualise an organisational approach, re-formulate research questions through transdisciplinary methods and introduce interdisciplinary courses and programs in architecture schools, thereby contributing to timely design innovation.

Asserts that innovation, which plays a key role in product and process improvement in many companies, is the very lifeblood of high technology firms. Considers that because technological change is a function of the economic growth model then technological substitution must be a sub‐function of this model. The ability to forecast technological substitution in the long‐term macro view enables strategic planners to develop trends for their specific technological application. Begins with a brief statement of the problem, followed by a discussion of the theoretical framework, review of related literature, methodology, findings, discussion of findings and their implications and, finally, recommendations to practitioners.

The purpose of this paper is to increase the understanding of organizational challenges when decision-makers try to comply with technological developments and increasing demands for a more rational distribution of health care services. This paper explores two decision-making processes from 2007–2019 in the area of vascular surgery at a regional and a local level in Norway.

The study draws upon extensive document analyses, semi-structured interviews and field conversations. The empirical material was analyzed in several steps through an inductive approach and described and explained through a theoretical framework based on rational choice (i.e. bounded rationality), political behavior and institutionalism. These perspectives were used in a complementary way.

Both decision-making processes were resource-intensive, long-lasting and produced few organizational changes for the provision of vascular services. Stakeholders at both levels outmaneuvered the health care planners, though by different means. Regionally, the decision-making ended up in a political process, while locally the decision-making proceeded as a strategic game between different departments and professional fields.

Decision-makers need to prepare thoroughly for convincing others of the benefits of new ways of organizing clinical care. By providing meaningful opportunities for public involvement, by identifying and anticipating political agendas and by building alliances between stakeholders with divergent values and aims decision-makers may extend the realm of feasible solutions.

This paper contributes to the understanding of why decision-making processes can be particularly challenging in a field characterized by rapid technological development, new treatment options and increasing demands for more rational distribution of services.

Purpose – The aim of this paper is to examine the diffusion of a new surgical procedure with lower per-case cost and how its diffusion path is affected by the simultaneous introduction of a new drug class that may be an effective treatment to prevent surgery. In particular, we examine whether a process of technology substitution exists that influences the diffusion process of the surgical technology. Given their different cost implications, the interaction of these two different technologies, surgery and drug intervention, is relevant from the perspective of health expenditure. This is of particular interest in health care as technology adoption and diffusion has been cited as a major driver of expenditure growth. Such expenditure growth has been increasingly targeted through the use of market-orientated policy tools aimed at increasing efficiency. Our research is thus addressing the question of how economic incentives influence the diffusion process and we discuss the impact of a set of incentives on hospital behavior.

Design/methodology – Hospital admission data for the financial years 1998/1999 to 2007/2008 in England are used to empirically test the contribution of prescription uptake and market-oriented reforms. Dynamic panel data models are used to capture any changes in technology preference during the period of study.

Findings – Our results suggest that the hospital sector exhibits a strong new technology preference, tempered by the interaction of competition for patients and the ability of the primary care sector to substitute treatments.

Value/originality – Given the current fast technological change, we examine the technological race occurring in the health care sector. We account simultaneously for the diffusion of different technologies not only within the same typology but also with technologies of a different class.

This study aims to explore whether globalization and technology are harmful to health using a global panel data set of 52 countries over the period 1990–2019.

The study focused on four continents: Africa, the Americas, Asia/Oceania and Europe. The authors used four advanced econometric methodologies, which include the standard panel fixed effect (FE), Arellano–Bover/Blundell–Bond dynamic panel, Hausman–Taylor specification and two-stage least squares (FE-2SLS)/Lewbel-2SLS approaches.

The empirical evidence highlights the significance of globalization and technology in promoting global health. The findings suggest that globalization has various impacts on global health indicators and that technology is useful in tracking, monitoring and promoting global health. In addition, the empirical evidence indicates that a truly health-centred process of globalization and technological innovation can only be realized by ensuring that the interests of countries and vulnerable populations to health risks are adequately considered in international decision-making regarding global economic integration.

The authors suggest that achieving the aspiration of global health will entail the use of globalization and information technology to extend human activities and provide equal access to global health.

The purpose of this paper is to assess the future direction of sustainable development in the healthcare industry. This study aims to reveal general similarities and specific differences between private hospitals and enabler or hinders of sustainable development.

Based on an inductive approach, judgmental sampling was applied to select relevant healthcare organizations. Informants were identified according to their knowledge of their organizations’ sustainability initiatives.

In the context the homogeneity that could be expected, the studied hospitals range from having a very strong organizational conviction as to the future direction of sustainable development to a very weak one. There are some general similarities and specific differences between them reported.

There is no common formula applicable across private hospitals to determine the future direction of their sustainable development. Although hospitals benchmark best practices, others use them only as a general frame of reference. This scenario offers opportunities for further research.

The economic, social and environmental sustainable development across private hospitals may evolve from general principles or guidelines, but the specific sustainable development at each hospital may well evolve along tailored economic, social and environmental actions.

Developing a framework considering similarities and differences between the sustainability actions of each hospital in the healthcare industry is important for understanding future directions. This study provides insights into factors that could enable success or constitute hinders of sustainable development. They can also guide the industry toward a common objective which improves the hospitals sustainability actions in the future, also minimizing the effort required.

General medical practitioners (GPs) in the UK are working from increasingly sophisticated premises. UK Government consultations have highlighted that inadequate premises are currently a barrier to improvements in primary health care. Therefore the National Health Service (Primary Care) Act 1997 permits pilot schemes for primary health care which may encompass property improvements. Provision of quality buildings has implications for the willingness of patients to consult GPs, the range of services offered by family doctors and the cost‐effectiveness of primary health care delivery. The decentralized nature of primary health care raises issues about the evolution of building design knowledge to cater for technical and organizational innovations in health care. As primary health care facilities become more sophisticated, advances in construction management techniques need to be applied so that they are procured efficiently. Current real estate arrangements for the provision of primary health care facilities are causing concern. The capital investment involved is increasingly burdensome for GPs. Lack of Government finance is leading to pressures for the employment of private capital, with accompanying new opportunities for property managers.

The term “social economics” has been in currency ever since J.S. Mill coined the phrase to cover the inductive study of the groups and social unions that man forms, guided by the principle of social altruism, to conduct his economic relationships. Although Mill rejected this approach in favour of deductive, self‐interested political economy, others, notably Wieser, J.M. Clark and Weber, have all tried to enact their versions of social economics in the centre stage. Even though Weber's theories became prominent in sociology, and both Clark and Wieser have their disciples, the study and theoretical development of social economics has remained at the periphery, making little impact upon the unswaying hold of the neo‐classical microeconomic orthodoxy.

The impact of the NHS reforms, and the resulting purchaser‐provider split, has refocused attention on the relationship between management and medicine in acute hospitals. It is timely to assess the explanatory power of various theoretical models regarding the management‐medicine interface. Argues that this interface is currently rather fluid and that a dynamic and adaptive model is best suited to understanding the way in which doctors and managers develop their relationship within the changing policy context. Two examples illustrate these shifting boundaries.