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Collegiality is often discussed and analyzed as a challenged form of governance, a form of working that used to function well in universities prior to the emergence of contemporary and modern forms of governance. This seems to suggest that collegiality used to dominate, while other forms of governance are now taking over. The papers in volume 86 of this special issue support the notion of challenged collegiality, but also show that for the most part, nostalgic notions of “the good old days” are neither true nor helpful if we are to revitalize academic collegiality. After examining whether a golden age of collegiality ever existed, we discuss why collegiality matters. Exploring what are often described as limitations or “dark sides” of collegiality, we address four such “dark sides” related to slow decision-making, conflicts, parochialism, and diversity. This is followed by a discussion of how these limitations may be handled and what measures must be taken to maintain and develop collegiality. With a brief summary of the remaining papers under two headings, “Maintaining collegiality” and “Revitalizing collegiality,” we preview the rest of this volume.

Diffusion of innovations, defined as the adoption and implementation of new ideas, processes, products, or services in health care, is both particularly important and especially challenging. One known problem with adoption and implementation of new technologies is that, while organizations often make innovations immediately available, organizational actors are more wary about adopting new technologies because these may impact not only patients and practices but also reimbursement. As a result, innovations may remain underutilized, and organizations may miss opportunities to improve and advance. As innovation adoption is vital to achieving success and remaining competitive, it is important to measure and understand factors that impact innovation diffusion. Building on a survey of a national sample of 654 clinicians, our study measures the extent of diffusion of value-enhancing care delivery innovations (i.e., technologies that not only improve quality of care but has potential to reduce care cost by diminishing waste, Faems et al., 2010) for 13 clinical specialties and identifies healthcare-specific individual characteristics such as: professional purview, supervisory responsibility, financial incentive, and clinical tenure associated with innovation diffusion. We also examine the association of innovation diffusion with perceived value of one type of care delivery innovation – artificial intelligence (AI) – for assisting clinicians in their clinical work. Responses indicate that less than two-thirds of clinicians were knowledgeable about and aware of relevant value-enhancing care delivery innovations. Clinicians with broader professional purview, more supervisory responsibility, and stronger financial incentives had higher innovation diffusion scores, indicating greater knowledge and awareness of value-enhancing, care delivery innovations. Higher levels of knowledge of the innovations and awareness of their implementation were associated with higher perceptions of the value of AI-based technology. Our study contributes to our knowledge of diffusion of innovation in healthcare delivery and highlights potential mechanisms for speeding innovation diffusion.

In this chapter, we discuss the main themes of the book and give examples of how the rest of the chapters are related to these themes. We have identified two main aspects that are partly overlapping and are equally relevant for international firms’ work with ethical questions related to their business. One concerns how ethical behaviour related to sustainability can be applied as a main part of firms’ corporate strategy and how this may strengthen the international competitive position. This is particularly relevant when considering that it cannot be taken for granted that there is always a positive relationship and that actors may sometimes question an emphasis on ethical behaviour that goes beyond the accepted norms and regulations. The other main theme is related to international firms’ crucial role in supporting sustainability on an international level and contributing towards achieving sustainable development goals (SDGs). Solving many of the challenges related to climate change, migration, poverty and inequality is likely to require the involvement of international firms. The book identifies several routes forward to achieve this.