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Organizational change is a key mechanism to ensure the sustainability of healthcare systems. However, healthcare organizations are persistently difficult to change, and literature is riddled with examples of failed change endeavors. In this chapter, we attempt to unravel the underlying causes for failed organizational change. We distinguish three types of change with different levels of depth that require different change approaches. Transformations are the deepest forms of change where beliefs and principles need to be modified to successfully influence routines. Renewals are deep forms of change where principles need to be modified to successfully influence routines. Improvements are shallow forms of change where only modifications at the level of routines are needed. Using deoxyribonucleic acid (DNA) as our metaphor, we propose a theory of “organizational DNA” to understand organizations and these three types of organizational changes. We posit that organizations are made up of a double helix consisting of a so-called “social string,” which contains the “soft” interaction or communication among the organization's members, and a so-called “technical string,” which contains “hard” organizational aspects such as structure and technology. Ladders of organizational nucleotides (i.e., Routines, Principles, and Beliefs) connect this double helix in various combinations. Together, the double helix and accompanying nucleotides make up the DNA of an organization. Without knowledge of the architecture of organizational DNA and whether a change addresses beliefs, principles, and/or routines, we believe that organizational change is constrained and based on luck rather than change management expertise. Following this metaphor, we show that organizational change fails when it attempts to change one part of the DNA (e.g., routines) in a way that renders it incompatible with the connecting components (e.g., principles and beliefs). We discuss how the theory can be applied in practice using an exemplar case.

It has long been recognized that overwhelmed employees of bureaucratic organizations use a variety of strategies to cope with demand for their services, often at the expense of their clients. One such strategy involves discouraging clients from taking action by making references to complex bureaucratic procedures and routines. While the public management literature has a well-developed research program focusing on the mobilization of such administrative burdens, organization theory seems to be lagging behind in the analysis of that type of misconduct. In this chapter, we explain how references to the representational dimension of routines can be used to discourage clients from taking action, what are the boundary conditions of such a strategy, and its possible consequences for clients.

This chapter discusses the design of the LHS and the steps taken to ensure data privacy and security. Usage of the application programming interface (API) is discussed, paying attention to how an Electronic Health Record (EHR) provider would use the API. Finally, the clinician’s interaction with the system is discussed.

All of us are born critical thinkers; some perfect this talent; others ignore it as useful in daily life. This chapter follows those who perfected this talent in order to learn from them the art and models of critical thinking in terms of its optimal inputs, processes, and outputs. According to great critical thinkers in business management, critical thinking questions – or should question – the obsessive generalizations, constraints, and “best” practices of the prevailing system of management, and try to replace them with more valid assumptions and more meaningful generalizations that uphold the dignity, uniqueness, and inalienable rights of the individual person and the community. After setting out some cases illustrating the lack of critical thinking, in Part I of this chapter, we introduce some representative management thinkers on critical thinking, and in Part II, we introduce eight models or practical approaches for critical thinking.

Many autistic students have been struggling with the COVID-19 pandemic situation for years. Special and inclusive education experts collaborated with multi-disciplinary experts to address and solve the problems that have arisen. This chapter presents some examples of using serious games and applications to help autistic students to study and improve their quality of life in a VUCA world. Mobile device platforms are practical for online learning and provide many interactions to support inclusive design. Three serious games showed how to bring interactive content to special education, and two mobile applications demonstrated inclusive designs to solve autism problems.

The purpose of this theoretical chapter is to rework a promising but limited theory of the foundations of reciprocity. Reciprocity is often attributed to an “internalized norm of reciprocity” – a deeply felt moral obligation to help those who have helped us in the past. Leifer's theory of local action develops a radically different and compelling foundation for reciprocity – one in which the impetus for reciprocity is a thinly veiled battle for status. We rework the theory to offer a new one that addresses its limitations. The key idea is that the impetus for reciprocity is the desire to signal that one intends to create joint value rather than to capture it from the counterparty.

Our analytical approach rests on close examination of a puzzling and underrecognized feature of social exchange: people who initiate social exchange routinely deny giving anything of value (“it was nothing”) while the receiver inflates their indebtedness to the giver (“this is too much!”). We refer to this negotiation strategy as reverse bargaining and use it as a window into the logic of social exchange.

We develop a more general theory of how people manage the threat of opportunism in social exchange that subsumes local action theory. The key insight is that people who initiate social exchange and seek reciprocity must balance two competing objectives: to ensure that the person receiving a benefit recognizes a debt she must repay; and to mitigate the receiver's suspicion that the giver's ulterior motive is to capture value from the receiver.