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The purpose of this paper is to explore the role of carers as coordinators of care in their own right. It outlines how statutory and voluntary agencies can work together to support carers in this role, yet also help them work towards personal outcomes to sustain their own quality of life. It also proposes that approaches to working with carers can reveal lessons for integration.

The research analysed data from focus groups and document analysis to examine how carers and professionals experienced two different approaches to engaging with carers: the Midlothian carer ' s assessment and VOCAL ' s outcomes focused approach. From this, several themes emerged which are relevant to the current debate on integration.

Carers were found to be key co-ordinators of care who play a role in the integration of services. Approaches to working with carers can better enable personal outcomes, and integrate carers as equal partners. In addition, improved integration between services can also improve outcomes for carers.

Approaches to working with carers should be carer and outcome focused, and partnership working can mean that carers feel more empowered and included. This helps to achieve personal outcomes, as well as enhance integrated working between other services. However, differentiation between services might, in places, contribute to better outcomes for people.

This paper shifts the focus of integration to look the role of carers as equal partners, and also illustrates how statutory and voluntary services can work better together, while preserving their distinct identities.

The purpose of this paper is to explore the relationship between external integration and innovation outcomes in the Brazilian food companies.

Based on a survey questionnaire with 84 participants from large and non-large food companies of Brazil, the paper has used linear regression to examine the relationship between external integration and innovation outcomes. Next, the paper used the Wilcoxon-Mann-Whitney Test to compare the two sets of companies, i.e. large companies (annual sales >US$5 million), and non-large companies (annual sales US$1-5 million).

The paper found that external integration with suppliers and customers is positively related to innovation outcomes in food companies. Besides, radical innovation is directly related to large companies rather than non-large food companies. Furthermore, customer integration is perceived in large food companies rather than non-large. To the best of the knowledge, this is pioneering information in food companies.

This research has been tested based only on participants’ perceptions. Therefore, the findings should also be verified through of a longitudinal fashion or in deep study.

The main practical implication lies with the embedding of these concepts in a research from the perspective of a developing economy. Seen in this light it is noteworthy that such findings may contribute to the understanding of innovation outcomes in other developing countries.

There are few empirical studies that explore the relationship between external integration and innovation outcomes in food companies. Besides, there is little knowledge about differences between large and non-large food companies regarding to incremental and radical innovation. Our research is the first study analyzing these issues in large and non-large food companies in the Brazil.

The purpose of this paper is to set the context for this special issue and provide an introduction to the individual contributions.

This paper uses a literature survey and analysis.

Integration remains both a central goal and a field of limited but possibly developing achievement. Multiple meanings and usages are themselves sources of confusion and contestability that contribute to poor performance, as does an emphasis on process over outcome. This special issue provides an opportunity for the limitations and possibilities of integration to be explored from a wide range of disciplinary perspectives and international settings. Individual papers draw on a wide and innovatory range of theoretical approaches in addressing reasons for limited progress and opportunities for taking it further. Nonetheless, how far we have a good fit between this area of study and the tools we use for its evaluation remains an issue for concern and further exploration.

This editorial is not a systematic review, though it draws on findings from a number of such reviews.

The various contributions all have practical implications for the strategies to develop integration and its evaluation.

The special issue as a whole was designed to encourage fresh perspectives and approaches to be brought to bear on understanding, conducting and evaluating integration. This editorial introduces each of these themes.

Post-acquisition integration matters for overall M&A outcome. However within this phase researchers have struggled to identify clear links between integration activities and post-acquisition outcome. This may be due to using organisational levels of analysis, where sub-organisational issues serve to confound findings. In order to unpack the post-acquisition phase, and to delve more deeply into organisations, this paper adopts a more granular perspective on integration activities by focusing upon the building blocks of organisations. Specifically we investigate ordinary routine amalgamation and their impact upon meta-routine outcome during acquisition integration. Drawing upon two longitudinal integration cases and using ‘retroductive’ analysis, two types of amalgamation are identified, namely ‘combination’ and ‘superimposition’. We find that, while the basic nature of routines, such as multiplicity and nestedness, inhibit routine amalgamation, external interference in the form of context, structural change or introduction of additional routines is needed to stabilise amalgamated routines. From our findings we are able to suggest a number of testable propositions about the factors that influence the amalgamation of routines. This empirical study contributes to the M&A literature by opening up the ‘black box’ of post-acquisition integration by providing details at a granular level of what actually happens during integrations.

This research seeks to identify the motivations, means and outcomes of supply chain integration (SCI) among firms in the middle market (i.e. those with annual revenues between US$10m and US$1bn). These firms often interface with larger, more powerful firms in the supply chain – both suppliers and customers. Understanding how these firms are challenged and benefit from integrative mechanisms in supply chain relations can lead to better outcomes more often.

The research utilizes an online focus group methodology featuring 39 participants. The participants were able to interact in written form with a professional moderator, as well as each other, over the course of three days.

The research presents evidence that firms in the middle market adopt SCI as a response to pressure from customers and suppliers. These firms also view technology as a primary means of achieving integration. Despite their disadvantageous size position relative to larger customers and suppliers, firms in the middle market achieved positive outcomes from integration.

Because of the specific context of middle-market firms, this research may lack generalizability. However, providing contextualization regarding firm size contributes specificity to the large number of studies detailing the challenges and benefits of SCI.

Managers of firms in the middle market should find value in this study as it explicates the possible benefits their firms may realize through integration with customers and suppliers. Moreover, this research outlines several of the possible means through which integration can be achieved. Further, managers in smaller and larger firms can better understand the motives and needs of middle-market companies with which they interact.

Despite voluminous literature on SCI, this paper provides context-specific findings by isolating the implications of SCI to firms in the middle market.

To examine the evolution of health care integration strategies and associated conceptualization and practice through a review and synthesis of over 25 years of international academic research and literature.

A search of the health sciences literature was conducted using PubMed and EMBASE. A total of 114 articles were identified for inclusion and thematically analyzed using a strategy content model for systems-level integration.

Six major, inter-related shifts in integration strategies were identified: (1) from a focus on horizontal integration to an emphasis on vertical integration; (2) from acute care and institution-centered models of integration to a broader focus on community-based health and social services; (3) from economic arguments for integration to an emphasis on improving quality of care and creating value; (4) from evaluations of integration using an organizational perspective to an emerging interest in patient-centered measures; (5) from a focus on modifying organizational and environmental structures to an emphasis on changing ways of working and influencing underlying cultural attitudes and norms; and (6) from integration for all patients within defined regions to a strategic focus on integrating care for specific populations. We propose that underlying many of these shifts is a growing recognition of the value of understanding health care delivery and integration as processes situated in Complex-Adaptive Systems (CAS).

This review builds a descriptive framework against which to assess, compare, and track integration strategies over time.

Integration is policy, practice as well as object of systematic investigation. What we do not know is whether or not integration can be understood as a science. In his book The Structure of Scientific Revolutions, Thomas Kuhn formulated a notion of (natural) sciences based on the emergence of commitments amongst a community of scientists to a set of logics, model and exemplars. He called this a paradigm. The purpose of this paper is to assess the scientific nature of integration by perceiving it as a paradigm in Kuhn’s sense.

The paper proceeds by conceptual reflection through matching existing components, theories and exemplifications of integration to Kuhn’s model of a scientific paradigm. Integration is understood broadly, either vertical or horizontal, and located within the practical domains of policy formulation, policy implementation and evaluation research. The nature, scope and depth of group commitments amongst students and practitioners of integration receive particular attention in line with Kuhn’s social interactionist approach.

Employing Kuhn’s notion of paradigm in the context of integration highlights the fundamental tension between integration efforts and integration outcomes. Whilst integration defines itself in contradistinction to professional boundaries and fragmentation, the paper argues that it fails to develop a strong theoretical and empirical foundation for a robust and stable group commitment. The reason is that the key motivational force that may create a stable group commitment amongst those engaged in integration, the patient perspective, remains outside the integration paradigm. This leaves integration as a practice and policy model underdeveloped, mainly paradigmatically illustrated by singular exemplars and rooted in aspirational policy vocabulary, while clustered around a near dogmatic belief that working together between services must lead to improved quality of care. To become a scientific paradigm the group commitment in integration would have to coalesce around a clear ontology (symbolic generalisations), epistemology (models of knowledge) and manifestations in practice (exemplars).

At present both the ontology and epistemological foundations of integration practice and research are insufficiently clear. This hampers the development of integration practice as well as a better understanding of how to evaluate integration outcomes. Future studies should focus on the depth, nature and subject of group commitments to assess whether integration is a viable candidate for scientific paradigm or an assorted construct of policy aspirations.

The paper questions the rigour and trajectory of integration practice, policy and research. It identifies a tension at the centre of the field between group commitments to scientific exemplars (case studies) and symbolic generalisations, encapsulated in the desire to improve patient care. The notion of a scientific paradigm thus helps to re-frame the discussion about research and practice in integration.

Digital transformation is a foundational change in how firms operate and deliver value to customers by using digital technologies to create new business opportunities. The purpose of this study is to offer a conceptual framework by reorganizing the elements of digital transformation, including resources, technology, capabilities and performance, into a workable process and investigating how firms integrate these resources, build new capabilities and transform them into enhanced performance.

This framework builds three blocks: resource integration, organizational capabilities and outcomes, exploring the impact of resource integration on outcomes through organizational capabilities. For resource integration, this study adopts a resource-based view (RBV) and service-dominant logic (SDL) to integrate organizational resources, including information technology (IT)-based resources, which play a role in moderating the effect of resource integration. Moreover, the author argues that firms’ capabilities have two levels: higher-order capabilities and lower-order capabilities, which will convert these resources through the capabilities into organizational performance.

This framework is built to understand the process of digital transformation and its antecedents for firms’ performance in business environments. Drawing on RBV, it provides a more holistic perspective that has been linked to resource integration, organizational capabilities and outcomes at the firm level. In this way, the theoretical basis for diminishing implicitness associated with the current perspective of digital transformation can be strengthened.

This paper offers a coherent discussion of digital transformation and explains the process of digital transformation, thus advancing prior work. The major contribution is connecting the process of digital transformation through which firms integrate resources, i.e. digital technologies and valuable, rare, inimitable and nonsubstitutable (VRIN) and nonVRIN resources as well, to build organizational dynamic capabilities based on RBV and SDL.

Health care integration is crucial in improving service equality and patient outcomes. However, measuring integration between the health and social care sectors remains challenging. This article aims to review existing systematic models to identify alternative health and social care integration measurement tools. The review focuses on models that involve systematic planning and long-term cooperation across different organizational sectors.

The study examines various dimensions and elements of integration, including process, outcome and structural measures. It compares different tools used to measure social and health care integration, such as the Rainbow model, Balanced Scorecard (BSC) Scorecard, PRISMA, SCIROCCO, integRATE, health-data simulation (HSIM) and the model developed by Åhgren and Axelsson. The analysis includes both empirical studies and theoretical frameworks.

The findings highlight the importance of standardized measurement methods to assess the impact of integration initiatives on patient outcomes, healthcare costs and the quality of care.

The review contributes to the ongoing discourse on social and health care integration, particularly in the Nordic context. The results can inform social and healthcare providers, policymakers and researchers in evaluating and improving integration initiatives.

This paper is an empirical study of the organisational approaches used for integration of management systems (MSs) and the comparative effectiveness of such approaches.

Research employed four case studies. Results are derived from the analysis of triangulated evidence obtained from in‐depth interviews, observations, internal documents analysis, archives, and short questionnaires.

Results identified two archetypes of integration strategies termed “systems approach” and “techno‐centric approach”. Maximum benefits are achieved by using a systems approach to integration of MSs, while using the techno‐centric approach leads to benefits mainly at the operational level.

This research is qualitative and, as such, does not investigate the integration of MSs across a large number of organisations. The research does not investigate the causality between strategies employed for integration and their outcomes.

There is little empirical research to date on the strategies employed for integration of MSs and their effectiveness. This research contributes to both literature and practice by demonstrating that a systems approach gives rise to greater integration throughout various organisational levels and greater benefits as compared to other approaches.