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This chapter presents a framework for an action research based intervention to develop and transform sustainable healthcare in a regional context. The framework is illustrated by the case of the Regional Cancer Centre (RCC) West in western Sweden.

The framework draws upon and develops Pettigrew’s context–content–process model of strategic change and applies it to the unfolding narrative of the change effort. The empirical focus is the activities of a learning platform consisting of the RCC leadership, senior cancer physicians designated as process owners and an action research team. Data were collected from documents, observations of the learning platform, notes from meetings and interviews. Outcome data were obtained via the self-reporting of the physicians.

The learning platform established the capability for wide ranging development and quality improvement on the 23 cancer pathways as well as some support activities around principles of patient-centred care. A clear result is greater inter-organisational collaboration between care professionals as well as the introduction of new medicines, clinical methods, joint learning activities and new forms of measurement and monitoring of care practices. All of the improved measures are sustained.

Whilst there is no shortage of rhetoric on patient-centred care, the reality is that in complex healthcare systems solutions such as process-oriented approaches often fail. This case presents a model and an approach that eschews clear visions for change and instead places an emphasis on dialogue, participation, professional autonomy and collaborative communities as means for achieving the patient-centred ideal. The case also shows the value of seeing sustainable health systems as being grounded on practitioner–scholar collaboration that combines practical knowing with scientific knowledge.

Introducing the concepts of equality, diversity, and inclusion (EDI), the chapter provides an overview of frameworks and approaches used to manage workforce diversity. First, the authors introduce the notion of the old deal based on the uneven relationship between human diversity, nature, and technological innovation. The chapter then explores the new deal between humans, nature, and technology. The authors are providing cases from the EU, Ecuador, Bolivia, and Iceland to show the emergence of the new deal in managing diversity.

In this chapter, the authors theorize organizational integration by extending, elaborating, and combining various theoretical perspectives, such as structural contingency theory, organization economics, and organizational culture. The aim of this study is to provide the foundation for a holistic theory of integration that examines the different relevant facets of integration and a comprehensive set of tools – integrative devices – by which integration can be sought by those who design the organization. To this end, the authors examine the integration challenge that arises from various types of subunit interdependence – pooled, sequential, and reciprocal – and theorize which configurations of integrative devices are more likely to be effective in a given task environment. The authors close by discussing directions for future research on organizational integration.

Business process reengineering, although initially developed for and within the private sector, is an approach that can form a valuable part of information age reform if it can transform the work processes of public sector organisations. Information technology (IT) has played a central role in reengineering. This chapter therefore describes many ways in which IT can be used to support public sector reengineering, including applications identified from analysis of the ‘political value chain’. Nevertheless, IT-supported reengineering originated from technical/rational organisational models that do not necessarily reflect the realities of the public sector. The chapter therefore proposes the concept of public sector process rebuilding (PUPREB): an approach to reengineering that includes a special awareness of the public sector context.

Modernization attempts have been undertaken in Uruguay during the last 20 years, inspired by both neo-managerial and neo-Weberian approaches. However, except for a few cases, most reforms have failed to achieve substantial gains in administrative capacity, effectiveness, or efficiency. We argue that some virtuous qualities of Uruguayan democracy can also show a dark side as they frequently turn into obstacles for State sector reform, no matter its orientation. Firstly, the electoral and party system obliges the Executive to build wide interparty consensus through intensive negotiations in order to advance significant transformations. Secondly, there are multiple nonpartisan actors which are powerful enough to block reform attempts. Moreover, the current pact between politicians and bureaucrats carries several negative consequences: high politicization of management decisions, serious management deficit, as well as low responsiveness of middle and lower staff levels. For all these reasons, the road to modernization of public management in Uruguay is sinuous and plagued with obstacles.

Volgograd, Russia, my home for most of my life, was entirely rebuilt after World War II. Under its prior name, Stalingrad, the city was the epicenter for what many believe was the most crucial battle in the entire war. That battle came at the cost of many millions dead and wounded and the destruction of all but one shell of a building. From this oblivion, a new city arose under the direct order of Stalin, who mobilized captured German engineers for the task. Following his concept of planning, the city would be long and narrow, hugging the banks of the mighty Volga River for some 80km. The width would involve only two main thoroughfares with side streets. The narrow profile would allow for farms and dachas to be close by on one side and the river on the other, providing bounteous and accessible food. Residences were organized in neighborhoods formed around key enterprises lining the river to meet their needs for water. The neighborhood designs allowed workers to easily walk to work. It was a truly utopian scheme.

The German institutional setting of skill formation is supposed to enable young people smooth and structured transitions into the labor market. For decades, the large majority of graduates of the “dual system” of vocational education experienced good chances to immediately access appropriate job positions. However, labor market entry has become less stable in the last two decades. In this paper, we examine the changing transition from vocational training to the first job in Germany. We analyze the consequences of inter-firm mobility and unemployment after finishing vocational education for the transition to the first job. Our results show that leaving the training firm, and especially unemployment, strongly enhance occupational shifts at labor market entry. In addition, not keeping one’s trained occupation negatively affects the chances to enter skilled job positions.