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The purpose of this paper is to investigate inter-organizational designs for care–cure conditions in which low-risk patients are cared for in specialized care organizations and high-risk patients are cared for in specialized cure organizations. Performance impacts of increasing levels of integration between these organizations are analyzed.

Mixed methods were used in Dutch perinatal care: analysis of archival data, clinical research and system dynamics simulation modeling.

Inter-organizational design has an effect on inter-organizational dynamics such as collaboration and trust, and also on the operational aspects such as patient flows through the system. Solutions are found in integrating care and cure organizations. However, not all levels of integrated designs perform better than a design based on organizational separation of care and cure.

A clear split between midwifery practices (care) and obstetric departments (cure) will not work since all pregnant women need both care and cure. Having midwifery practices only works well when there are high levels of collaboration and trust with obstetric departments in hospitals. Integrated care designs are likely to exhibit superior performance. However, these designs will have an adverse effect on organizations that are not part of this integration, since integrating only a subset of organizations will feed distrust, low collaboration and hence low performance.

The originality of this research is derived from its multi-method approach. Archival data and clinical research revealed the dynamic relations between organizations. The caveat of some integrated care models was found through simulation.

Purpose – Aims to describe a project carried out within Hampshire Social Services investigating potential care pathways for older people after discharge from hospital and to show the potential of the simulation methodology in such situations. Design/methodology/approach – A discrete‐event simulation was used to determine the system capacities and to estimate the likely associated reimbursement costs. Findings – A prototype simulation model was developed showing the potential value of this approach. Research limitations/implications – Restrictions in data access shifted the focus from quantitative service mapping to a more descriptive approach. Practical implications – Currently, many older patients experience delayed discharge from acute beds because of capacity limitations in Social Services’ traditional post‐acute care services. At the same time, new regulations require Local Authorities to reimburse NHS Acute Trusts if hospital discharge is delayed solely due to inadequate provision of social care assessments and services. In order to overcome the so‐called “bed‐blocking” problem, a new range of services termed “Intermediate Care” has been introduced to offer alternative options for older patients. These services are examined in terms of capacity and appropriateness. Originality/value – This paper fulfils an identified need to record and evaluate the new post‐acute packages introduced by the Social Services and NHS and proposes simulation as one of the most suitable methodologies for such objectives.

Football, or soccer as it is known in the United States, is one area in which managerial positions are hugely volatile with what is often called a ‘merry-go-round’ of managers sacked for poor performance at their club and reemployed by another club. Not only does this practice often not increase performance but it is also very costly. Considering the nature of football, that is, the relatively high impact of chance on the rare events that goals are, and the high correlation between success and the wage bill, the influence of managers on performance is often over-estimated. However, potentially better preparation of future managers might help to increase competitive advantages. In this chapter, we are looking in depth at leadership in the context of football and the lessons we can draw for other contexts.

The purpose of this paper is to determine the reason for faculty and staff (N=657; 35 percent males; M _age=45.20) at a large Southern university, for either using or not using the free fitness facilities on campus.

Participants identified themselves as either current (n=306), former (n=213), or never-users (n=138) of the facilities, and completed an on-line self-report qualitative questionnaire asking them to describe their reasons for using or not using the campus fitness facilities.

Thematic coding revealed that motives fell into three broad categories for all user types: personal (i.e. cost, location, social support), facility-specific (i.e. quality and amount of equipment, class variety, hours of operation), and motivational climate (i.e. feeling valued, welcomed, best effort was emphasized). Current users highlighted positive aspects of each category whereas former and never users described each category as a barrier to their exercise routines.

The identified themes offer campus administration specific suggestions to entice more non-users and former-users to exercise in the fitness facilities available on campus.

While researchers have considered barriers to exercise in past studies, the barriers identified were not specific to fitness facilities. The current work not only examines individuals’ reasons for choosing or not choosing a campus fitness facility for their exercise, but also compares the perspectives of former- and never-users to current-users.