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Independent travelers are those vacationers who have booked only a minimum of their transportation and accommodation arrangements prior to departure on the vacation. Independent travel is an important and growing sector of worldwide tourism. Choice of vacation itinerary for the independent vacation represents a complex series of decisions regarding purchase of multiple leisure and tourism services. This chapter builds and tests a model of independent traveler decision-making for choice of vacation itinerary. The research undertaken employs a two-phase, inductive–deductive case study design. In the deductive phase, the researcher interviewed 20 travel parties vacationing in New Zealand for the first time. The researcher interviewed respondents at both the beginning and the end of their New Zealand vacations. The study compares pre-vacation research and plans, and actual vacation behaviors, on a case-by-case basis. The study examines case study narratives and quantitative measures of crucial variables. The study tests two competing models of independent traveler decision-making, using a pattern-matching procedure. This embedded research design results in high multi-source, multi-method validity for the supported model. The model of the Independent Vacation as Evolving Itinerary suggests that much of the vacation itinerary experienced in independent travel is indeed unplanned, and that a desire to experience the unplanned is a key hedonic motive for independent travel. Rather than following a fixed itinerary, the itinerary of an independent vacation evolves as the vacation proceeds. The independent traveler takes advantage of serendipitous opportunities to experience a number of locations, attractions and activities that they had neither actively researched nor planned.

The Institute of Medicine (IOM) views Health Information Technology (HIT) as an essential organizational prerequisite for the delivery of safe, reliable, and cost-effective health services. However, HIT presents the proverbial double-edged sword in generating solutions to improve system performance while facilitating the genesis of novel iatrogenic problems. Incongruent organizational processes give rise to technological iatrogenesis or the unintended consequences to system integrity and the resulting organizational outcomes potentiated by incongruent organizational–technological interfaces. HIT is a disruptive innovation for health services organizations but remains an overlooked organizational development (OD) concern.

Recognizing the technology–organizational misalignments that result from HIT adoption is important for leaders seeking to eliminate sources of system instability. The Health Information Technology Iatrogenesis Model (HITIM) provides leaders with a conceptual framework from which to consider HIT as an instrument for organizational development. Complexity and Diffusion of Innovation theories support the framework that suggests each HIT adoption functions as a technological change agent. As such, leaders need to provide operational oversight to managers undertaking system change via HIT implementation. Traditional risk management tools, such as Failure Mode Effect Analysis and Root Cause Analysis, provide proactive pre- and post-implementation appraisals to verify system stability and to enhance system reliability. Reconsidering the use of these tools within the context of a new framework offers leaders guidance when adopting HIT to achieve performance improvement and better outcomes.

Purpose – To offer a theoretical explanation for observed physician resistance and rejection of high reliability patient safety initiatives.

Design/methodology/approach – A grounded theoretical qualitative approach, utilizing the organizational theory of sensemaking, provided the foundation for inductive and deductive reasoning employed to analyze medical staff rejection of two successfully performing high reliability programs at separate hospitals.

Findings – Physician behaviors resistant to patient-centric high reliability processes were traced to provider-centric physician sensemaking.

Research limitations/implications – Research, conducted with the advantage that prospective studies have over the limitations of this retrospective investigation, is needed to evaluate the potential for overcoming physician resistance to innovation implementation, employing strategies based upon these findings and sensemaking theory in general.

Practical implications – If hospitals are to emulate high reliability industries that do successfully manage environments of extreme hazard, physicians must be fully integrated into the complex teams required to accomplish this goal.

Social implications – Reforming health care, through high reliability organizing, with its attendant continuous focus on patient-centric processes, offers a distinct alternative to efforts directed primarily at reforming health care insurance. It is by changing how health care is provided that true cost efficiencies can be achieved. Technology and the insights of organizational science present the opportunity of replacing the current emphasis on privileged information with collective tools capable of providing quality and safety in health care.

Originality/value – The fictions that have sustained a provider-centric health care system have been challenged. The benefits of patient-centric care should be obtainable.

Given the definition for traffic safety culture (proposed in the first chapter) as the shared beliefs of a group which affect behaviors related to traffic safety, this chapter provides practical guidance on ways to measure traffic safety culture, analyze collected data, and use the analysis to inform interventions. The proposed definition of “shared beliefs” used a behavioral model to inform specifically what beliefs may influence intentional behaviors involved with either reducing or improving traffic safety. This behavioral model provides a framework to guide measurement. Analyses include examining the prevalence of beliefs and behaviors, the relationships between beliefs and behaviors, and identifying “gaps” in beliefs that may be important to address in interventions. Finally, an example of a traffic safety culture program which includes a collecting of strategies working across the social ecology to improve traffic safety is introduced (in this case, seat belt use).

This study reviews the academic literature on global reputations and its implications for meritocracy. Over the years, systems of measuring and visualizing reputation have proliferated globally with organizations competing for talented employees, clients, and resources in a situation of limited supply, resulting in the emergence of reputation systems as a device to position businesses in the international market and to contend cross-nationally for prestige. Yet, the tangible utilities of these systems for promoting a meritocratic culture remain contested. Notwithstanding their utility as cognitive heuristics, global reputation systems can distort information and become dysfunctional when consumers embedded in vastly different cultures and institutional environments navigate these systems. This chapter identifies gaps in extant knowledge and suggests number of ways of improving our theoretical and analytical frameworks on the association between reputation and meritocracy. Specifically, it advances the concept of “reputation work” to understand how reputations are built, evaluated, maintained, communicated, consumed, and deconstructed and calls for attention to each of these dimensions to forge a stronger coupling between reputations and meritocracy.

An important issue for medium-sized enterprises (MEs) in strategic management research is the ability to be resilient, recover and bounce back, after a disturbing and extenuating external event, such as the recent financial and economic crisis. Researchers have made efforts to understand the antecedents to resilience. Some studies propose capabilities and resources that strengthen experimentation while other researchers emphasize factors that support reliability. This study seeks to reconcile these views relying on upper echelons theory as the top management of MEs’ shape organizational attitudes and behaviors. The authors propose two antecedents in MEs related to management capabilities, ambidexterity and consistency, and the characteristics of family ownership that allow building of experimentation and reliability. We test our hypotheses on a dataset of 3,006 MEs and show how manager ambidexterity and family ownership play important roles in ME resilience.