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This study explores how a hospital works, which is important for further enhancing hospital performance. Following the introduction of a Hospital Planning Centre (HPC), changes are explored in a hospital in terms of integration (the coordination and alignment of tasks), differentiation (the extent to which tasks are segmented into subsystems), rules, coordination mechanisms and hospital performance.

A case study was conducted examining the hospital’s social network, rules, coordination mechanisms and performance both before and after the introduction of the HPC. All planning and execution tasks for surgery patients were studied using a naturalistic inquiry and mixed-method approach.

After the introduction of the HPC, the overall network structure and coordination mechanisms and coordination mechanisms remained largely the same. Integration and certain rules changed for specific planning tasks. Differentiation based on medical discipline remained. The number of local rules decreased and hospital-wide rules increased, and these remained largely in people’s minds. Coordination mechanisms remained largely unchanged, primarily involving mutual adjustment and standardization of work both before and after the introduction of the HPC. Overall, the hospital’s performance did not change substantially. The findings suggest that integration seems to “emerge” instead of being designed. Hospitals could benefit, we argue, from a more conscious system-wide approach that includes collective learning and information sharing.

This exploratory study provides in-depth insight into how a hospital works, yielding important knowledge for further research and the enhancement of hospital performance.

Integration, that is, the coordination and alignment of tasks, is widely promoted as a means to improve hospital performance. A previous study examined integration and differentiation, that is, the extent to which tasks are segmented into subsystems, in a hospital's social network. The current study carries this research further, aiming to explain integration and differentiation by studying the rules and coordination mechanisms that agents in a hospital network use.

The current case study deepens the analysis of the social network in a hospital. All planning tasks and tasks for surgery performance were studied, using a naturalistic inquiry approach and a mixed method.

Of the 314 rules found, 85% predominantly exist in people's minds, 31% are in documents and 7% are in the information system. In the early planning stages for a surgery procedure, mutual adjustment based on hospital-wide rules is dominant. Closer to the day of surgery, local rules are used and open loops are closed through mutual adjustment, thus achieving integration. On the day of surgery, there is mainly standardization of work and output, based on hospital-wide rules. The authors propose topics for future research, focusing on increasing the hospital's robustness and stability.

This exploratory case study provides an overview of the rules and coordination mechanisms that are used for organizing hospital-wide logistics for surgery patients. The findings are important for future research on how integration and differentiation are effectively achieved in hospitals.

To further extend the understanding of multidimensional engagement of stakeholders embedded in service systems, the purpose of this paper is to explore the antecedents that constitute stakeholder engagement in inter-organizational service ecosystems where stakeholders co-create innovations over time.

An explorative, longitudinal case study design is employed to analyze stakeholders’ engagement in co-innovation in an inter-organizational service system in an engineering context.

The study identifies eight antecedents for stakeholder engagement in innovation in the context of a B2B environment. Building on related engagement research, the empirical data show how stakeholder engagement is influenced at both individual and organizational levels by the antecedents friendship, common experiences, self-representation, trust, a common goal, resource dependency, level in the hierarchy, institutional arrangements, and local proximity.

The paper extends current understanding of engagement and illuminates stakeholder engagement on a micro level, addressing four key issues for stakeholder engagement in a service ecosystem. How can stakeholder engagement be maintained over time? Does stakeholder engagement at specific hierarchical levels enhance or hinder inter-organizational co-innovation? Is strong engagement necessary for innovation activities? Are the different engagement antecedents linked?

In many security domains, the ‘human in the system’ is often a critical line of defence in identifying, preventing and responding to any threats (Saikayasit, Stedmon, & Lawson, 2015). Traditionally, such security domains are often focussed on mainstream public safety within crowded spaces and border controls, through to identifying suspicious behaviours, hostile reconnaissance and implementing counter-terrorism initiatives. More recently, with growing insecurity around the world, organisations have looked to improve their security risk management frameworks, developing concepts which originated in the health and safety field to deal with more pressing risks such as terrorist acts, abduction and piracy (Paul, 2018). In these instances, security is usually the specific responsibility of frontline personnel with defined roles and responsibilities operating in accordance with organisational protocols (Saikayasit, Stedmon, Lawson, & Fussey, 2012; Stedmon, Saikayasit, Lawson, & Fussey, 2013). However, understanding the knowledge that frontline security workers might possess and use requires sensitive investigation in equally sensitive security domains.

This chapter considers how to investigate knowledge elicitation in these sensitive security domains and underlying ethics in research design that supports and protects the nature of investigation and end-users alike. This chapter also discusses the criteria used for ensuring trustworthiness as well as assessing the relative merits of the range of methods adopted.

Many healthcare organizations are looking for methods, such as Lean, to reduce their costs and increase the productivity of their professionals. The Lean method looks at every step in every process to assess if this step adds value for the customer or not. The aim of this study was to explore the value adding and non-value adding process steps in stroke patient admission in an integrated care stroke service in the Netherlands.

This study focused on discharge of stroke patients from hospital acute treatment, and they were admitted for rehabilitation. According to the Grounded Theory, value stream mapping, organized interviews and expert meetings and coded was used. A configuration analysis was used to distinguish aggregates and configurations.

The most reported issues concerned in the paper are as follows: (1) insufficient internal logistics in the hospital, (2) miscommunication about medical readiness for discharge of the patient, (3) missing or delayed medical patient information, (4) overlapping discharge interviews, (5) unsafe transfer of sensitive information and (6) waiting lists and queuing up in rehabilitation facility.

At least six main areas of waste were identified in this stroke service, and they form the target for waste reducing activities. The results give insight in possible wastes in healthcare organizations and are therefore beneficial for other healthcare organizations which are planning to reduce wastes.

This paper illustrates how Guba and Lincoln's parallel criteria for establishing trustworthiness, can be adapted and applied to qualitative research on indigenous social protection systems. It provides insights for social protection researchers, exploring plausible qualitative research rigor evaluation criteria, on plausible alternatives.

The paper draws on qualitative evidence from a larger ethnographic study on the dynamics of indigenous social protection systems in Nigeria. It illustrates the systematic application of Guba and Lincoln's parallel criteria.

Available evidence from the study shows that Guba and Lincoln's parallel criteria is viable for establishing trustworthiness of qualitative research on indigenous social protection systems. The criteria can facilitate credible and reliable research outcomes in research on improving social protection policy and practice.

Qualitative inquiries that draw on Guba and Lincoln's parallel criteria as evaluation criteria for trustworthiness can complement quantitative research on social protection. This makes it imperative to incorporate both, in social protection research for a holistic system. How this can be done is beyond the scope of this paper but needs to be explored by future research.

Contrary to the use of Guba and Lincoln's parallel criteria in qualitative research in other contexts, the use of the criteria has not been carefully examined in qualitative research on indigenous social protection systems. This paper is an attempt to fill this gap.