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Change in ownership among U.S. community hospitals has been frequent and, not surprisingly, remains an important issue for both researchers and public policy makers. In the past, investor-owned hospitals were long suspected of pursuing financial over other goals, culminating in several reviews that found few differences between for-profit and nonprofit forms (Gray, 1986; Sloan, 2000; Sloan, Picone, Taylor, & Chou, 2001). Nevertheless, continuing to the present day, several states prohibit investor-ownership of community hospitals. Conversions to investor-ownership are only one of six types of ownership change, however, with relatively less attention paid to the other types (e.g., for-profit to nonprofit, public to nonprofit). This study has two parts. We first review the literature on the various types of ownership conversion among community hospitals. This review includes the rate at which conversions occur over time, the relative frequency in conversions between specific ownership categories and the observed effects of conversion on hospital operations (e.g., strategic direction and decision-making processes) and performance (e.g., access, quality, and cost). Overall, we find that the impact of ownership conversion on the different measures is mixed, with slightly greater evidence for positive effects on hospital efficiency. As one explanation for these findings, we suggest that the impact of ownership conversion on hospital performance may be mediated by changes in the hospital's strategic content and process. Such a hypothesis has not been proposed or examined in the literature. To address this gap, we next study the role of strategic reorientation following hospital conversion in a field study. We conceptualize ownership conversion within a strategic adaptation framework, and then analyze the changes in strategy content and process across sixteen hospitals that have undergone ownership conversions from nonprofit to for-profit, public to for-profit, public to nonprofit, and for-profit to nonprofit. The field study findings delineate the strategic paths and processes implemented by new owners post-conversion. We find remarkable similarity in the content of strategies undertaken but differences in the process of strategic decision making associated with different types of ownership changes. We also find three main performance effects: hospitals change ownership for financial reasons, experience increases in revenues and capital investment post-conversion, and pursue labor force reductions post-conversion. Membership in a multi-hospital system, however, may be a major determinant of both strategy content and decision-making process that is confounded with ownership change. That is, ownership conversion may mask the impact of system membership on a hospital's strategic actions. These findings may explain the pattern of performance effects observed in the literature on ownership conversions.

Two factors explain why the Serbian privatization experience deserves close attention from outside world. First, Serbia's starting conditions for privatization, with a historical tradition of workers’ management, strong trade unions, and an ambivalent initial attitude toward privatization, have as much in common with circumstances surrounding privatization in the developing countries as with those in the so-called economies in transition. Second, Serbia embarked on a resolute privatization path only in 2001, following more than 10 years of diverse privatization efforts in other post-socialist economies of the region. This makes Serbia a perfect case study of how a country can learn from the experience (both positive and negative) of other reformers.

The purpose of this paper is to delve into three themes about democratic enterprises.

(1) The first theme is the question of capital structure where labor-managed firms (LMFs) are often pictured as having “horizon problem.” Yet this is only a minor technical problem which is solved by the system of internal capital accounts as in the Mondragon cooperatives.

(2) The second theme concerns the attempt to implement participative management and the related ideas of active learning in educational theory in the workplace. The point is that the democratic firm is the natural setting to implement these ideas, not the conventional firm where the staff have the legal role of “employees” rented by the company.

(3) The third theme is the old canard the cooperatives are incompatible with entrepreneurship. My rethinking of the issue was inspired by the analysis of the late Jane Jacobs who emphasized that the primary means of growing economic “biomass” is through economic offspring (e.g., spin-offs) – in analogy with the biological principle of plentitude. Yet the conventional form of ownership operates as a fetter on this process since the ownership and management wants to expand its empire and maintain “ownership” of any potential offspring. But that constraint against spin-offs is absent in democratic firms, and the Mondragon complex has indeed illustrated how to catalyze this process of growth through offspring.

A public policy to encourage all companies to grow by affiliated and perhaps democratic spin-offs would create more jobs (through filling extra niches) and more stability (through the agility of separate companies).

This chapter illustrates the concept of organisational innovation leadership (OIL) through a case study of the organisational transformation of Eddyfi Technologies to achieve superior innovative capacity through synergetic centralisation. The case study focusses on the real challenges faced when effecting organisational transformation, and how innovation leadership practices provided constructive resolutions that culminated in a successful reorganisation. We find that effective innovation leadership is conveyed primarily through establishing close relationships, open communication, and setting the example in a consistent and strict manner.

This chapter provides some concluding reflections on the different experiences of structural change encountered by the TARGET partners. The various TARGET partners had different roles in the structural change processes: seven organisations designed, implemented and monitored gender equality plans (GEPs) for the first time, two organisations provided tailored support to implementing institutions and one organisation evaluated GEP implementation. This edited volume provides an account of these diverse experiences of engaging with and catalysing structural change in very different research organisations operating in extremely different contexts both within the EU and beyond. The volume thus contributes to the growing body of literature generated from structural change projects by offering a specific focus on the TARGET approach. The TARGET process of structural change – undertaken through the development and implementation of tailored, evidence-based GEPs – was found to be strengthened through formal top management commitment and by taking a reflexive approach that was powered by communities of practice and supported by financial resources, gender expertise as well as gender and organisational change competences. Engaged institutions thus managed to overcome unfavourable conditions and implement tailor-made, context-specific interventions, some of them in areas at the cutting edge of topics and issues linked to gender equality in research and innovation such as tackling sexual harassment, sustainability and integrating the gender dimension into research content and curricula.

Timor-Leste is a small, island country situated between South East Asia, Australia, and the Pacific, where it shares a unique mix of climates from all three neighboring regions (Kirono, 2010). The country achieved independence in 2002 having suffered over 400 years of colonialism and foreign occupation, first by the Portuguese and then by the Indonesians (Sandlund et al., 2001). The post-referendum troubles in 1999 left Timor-Leste with seriously damaged infrastructure and relatively little economic activity (Hill, 2001). However, since 1999, the country has made significant steps forward and despite some upheaval in 2006 has significantly developed in terms of infrastructure and economic activity. Nonetheless, Timor-Leste, as a Small Island Developing State (SIDS) also has a number of other vulnerabilities and challenges to contend with including its mountainous region, relative isolation, dependence upon agriculture, and high levels of unemployment. Timor-Leste has a land mass of 14,874km² with a population of approximately 1 million, which is rapidly increasing (Government of Timor-Leste, 2010). The country is dominated by the central Mountain range of Ramelau with as much as 44% of Timor-Leste's land having a slope of more than 40% and over 70% of the country's population dependent upon agriculture for their livelihood (Sandlund et al., 2001).

This study empirically examines the relationship between institutional ownership and innovation activity in the unique setting of the clinical trials for US biopharmaceutical companies. We used multiple statistical techniques in the period from 1990 through 2006 for firms in the biopharmaceutical industry to examine this relationship. Contrary to the widely believed relationship discussed in the literature, our findings suggest that institutional investors vary in their reactions to innovative progress. Specifically, we find that institutional investors with a long-term investment horizon (i.e., dedicated owners) increase their holdings of a firm’s equity as the number of the firm’s products increases in phases I and II of FDA clinical trials. These findings are robust for heteroskedasticity and autocorrelation as well as for different operationalizations of the change of institutional ownership.