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This study focuses on a particular type of public organization characterized by weak boundaries and strong informal relationships, elements that have assisted in driving the reform of an entire national public management system. The case is the Public Healthcare System of the Southern Italy in the period beginning in the early 1990s through the beginning of the new millennium, with particular emphasis on the Sicilian region, selected since it represents an extreme case of informal networks that affect organizational boundaries and governance functions.

At the beginning of the 21st century, multiple and diverse social entities, including the public (consumers), private and nonprofit healthcare institutions, government (public health) and other industry sectors, began to recognize the limitations of the current fragmented healthcare system paradigm. Primary stakeholders, including employers, insurance companies, and healthcare professional organizations, also voiced dissatisfaction with unacceptable health outcomes and rising costs. Grand challenges and wicked problems threatened the viability of the health sector. American health systems responded with innovations and advances in healthcare delivery frameworks that encouraged shifts from intra- and inter-sector arrangements to multi-sector, lasting relationships that emphasized patient centrality along with long-term commitments to sustainability and accountability. This pathway, leading to a population health approach, also generated the need for transformative business models. The coproduction of health framework, with its emphasis on cross-sector alignments, nontraditional partner relationships, sustainable missions, and accountability capable of yielding return on investments, has emerged as a unique strategy for facing disruptive threats and challenges from nonhealth sector corporations. This chapter presents a coproduction of health framework, goals and criteria, examples of boundary spanning network alliance models, and operational (integrator, convener, aggregator) strategies. A comparison of important organizational science theories, including institutional theory, network/network analysis theory, and resource dependency theory, provides suggestions for future research directions necessary to validate the utility of the coproduction of health framework as a precursor for paradigm change.

This paper aims to set out a framework that can be used for locating strategies for incorporating patient and public involvement (PPI) in the wider process of translative healthcare research.

This paper is analytical and synthesizes knowledge from several disciplines in order to provide a coherent framework for understanding the scope and purpose of PPI. The framework sets out four idealised strategies for PPI based on mode and purpose of involvement. The paper concludes by summarising a range of implications for organisations involved in the governance of translative healthcare research.

The framework defines four idealised strategies for PPI in translative healthcare research. The strategies range in purpose from collecting patient data, through to improving public involvement and knowledge with respect to healthcare research.

The framework presented has direct relevance for agencies concerned with the management and governance of translative healthcare research. The framework is relevant when either designing or auditing research pathways in terms of PPI activities. The framework is also important in highlighting to healthcare leaders, researchers, patients and the wider public, the potential role of participation in healthcare research.

This paper's value is that it combines perspectives from the wider literature on innovation, user‐led design and participation, to the problem of translative healthcare research.

The purpose of this paper is to examine the enactment of collaborative governance as a policy strategy in healthcare – in particular its effects in coordinating multiple collaborative initiatives dedicated to improve the performance of health organizations. It studies overarching governance mechanisms that serve as platforms at a meta-level between policy and frontline practice.

Four collaborative governance arrangements dedicated to improve health outcomes in the Netherlands are analyzed in a comparative case-study design, based on extensive document analysis (n=121) and interviews (n=56) with key stakeholders in the field, including the Dutch Ministry of Health, health organizations and other actors.

The studied policy-based governance mechanisms for the coordination of multiple micro-level collaborative initiatives function partly as platforms in bringing actors and resources together successfully. They do so, by fostering evolvability (the capacity to generate diversity in emergent ways) in relation to goal-setting and intermediation between actors. Yet, they marginalize open access to participants through high selectivity and deliberate exclusion strategies for certain actors, contrary to a platform logic of action.

While the collaborative governance literature focuses on these dimensions as independent elements, findings reveal both trade-offs and interdependencies between studied dimensions of coordination associated with platforms, that need to be negotiated and managed.

Selectivity and exclusion in collaborative arrangements may negatively affect relational bonds and ties between actors, which challenges the application of collaborative governance as a policy strategy in pursuit of health objectives.

Responding to recent calls in the literature, this study applies ideas from public administration to the field of health organization and management to avert failures in the translation of policy ambitions into health practice.

Policy makers are applying market-inspired competition and financial incentives to drive efficiency in healthcare. However, a lack of knowledge exists about the process whereby incentives are filtered through organizations to influence staff motivation, and the key role of managers is often overlooked. The purpose of this paper is to explore the strategies managers use as intermediaries between financial incentives and the individual motivation of staff. The authors use empirical data from a local case in Swedish specialized care.

The authors conducted an exploratory qualitative case study of a patient-choice reform, including financial incentives, in specialized orthopedics in Sweden. In total, 17 interviews were conducted with professionals in managerial positions, representing six healthcare providers. A hypo-deductive, thematic approach was used to analyze the data.

The results show that managers applied alignment strategies to make the incentive model motivating for staff. The managers’ strategies are characterized by attempts to align external rewards with professional values based on their contextual and practical knowledge. Managers occasionally overruled the financial logic of the model to safeguard patient needs and expressed an interest in having a closer dialogue with policy makers about improvements.

Externally imposed incentives do not automatically motivate healthcare staff. Managers in healthcare play key roles as intermediaries by aligning external rewards with professional values. Managers’ multiple perspectives on healthcare practices and professional culture can also be utilized to improve policy and as a source of knowledge in partnership with policy makers.

This paper explores the potential application of public value management theory to the practice of UK healthcare procurement. By conducting a literature review, key elements of public value theory and practice that can be applied to healthcare procurement are identified together with mechanisms that can be used in procurement to protect public values and enhance the creation of public value. These are formed into a Public Value Healthcare Procurement Framework which represents a fresh normative approach to healthcare procurement by focussing on a broader, societal view of value; by providing a blue print for procurement leaders centred around Moore's vision of “exploring” and “moral” public managers; and by promoting a public service ethos amongst all providers including the private sector.

The aim of the chapter is to compare Public–Private Partnership (PPP) healthcare investments in developed countries with those in emerging economies, analysing the sustainability issues of health-led growth. Healthcare PPP best practices in developed nations represent a template that catching-up economies may follow with local adaptations. A comparison starts from the UK case and then examines the Turkish experience as an ideal bridge between advanced and developing countries. Healthcare investments are a primary social infrastructure, with a deep impact on poverty alleviation. Demand for the infrastructure necessary to provide healthcare services has increased substantially in developing and emerging economies due to rapid economic growth, industrialization and urbanization, while public supply is limited by budget constraints. PPP best practices provide a global benchmark (World bank, 2015b). Integrated supply and value chains and management of viability milestone improve healthcare PPP sustainability and bankability. Different legal frameworks and funding issues are not thoroughly investigated. Careful customization and local fine-tuning of best practices require further scrutiny. Homogenization of best practices improves comparison of different projects, fostering competition and easing cross-border investments, accompanied by knowledge transfer, sharing and consequent value co-creation. Best practices improve value for money, bankability and resilience of PPP investments, with potential benefits for healthcare services and quality of life. This chapter makes an innovative and comprehensive comparison of healthcare PPP projects worldwide, looking for a common denominator of value-enhancing rules and resilient pro-growth strategies.

The purpose of this paper is to explore how strategies are put in place to formulate policies regarding the introduction and implementation of relationship marketing (RM) in the health sector, and how RM strategies are designed as part of the curricula for the training of prospective health professionals in Ghana.

Data were gathered using interviews and documentary review. A purposive sampling technique was used to recruit policy makers and health educationists in Accra for in-depth interviews. Qualitative interviews were analysed using framework analysis.

The findings revealed that, currently, there is no policy framework on RM in the health sector nor included in the curricula of health training institutions in the country.

Due to limited time and funding constraints, the study could not include many policy makers, educationists, health providers, facilities and regions outside the Greater Accra region of Ghana. This means that the authors missed out on useful insights from other relevant policy makers/educationists who would have added to the knowledge that this study contributes. There were still some areas that this study could not cover, including the lack of an exploration of the perceptions of health providers and patients.

Evidence from the current research provides the basis for scaling up of a similar study to the whole country to address the perennial RM or quality of care/patient satisfaction issues persisting in health facilities in the country. The outcome of this large-scale study would help to confirm the findings of the current study on the adoption and incorporation of RM into both policy framework and curricula of health training institutions in Ghana. The findings would culminate in the preparation and utilisation of guidelines on RM for client-centred service delivery in the health sector of the country.

This paper argues that RM orientation could enable health professionals to improve upon their healthcare service performance and quality of care so as to enhance patient satisfaction.

The study recommends that RM should be adopted by health policy makers and designers of curricula for health training institutions.