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The purpose of the article is to analyze how physicians and nurses, as the two major health care professions, experience psychological empowerment for managerial work.

The study was designed as a qualitative interview study at four primary care centers (PCCs) in Sweden. In total, 47 interviews were conducted, mainly with physicians and nurses. The first inductive analysis led us to the concept of psychological empowerment, which was used in the next deductive step of the analysis.

The study showed that both professions experienced self-determination for managerial work, but that nurses were more dependent on structural empowerment. Nurses experienced that they had competence for managerial work, whereas physicians were more ignorant of such competence. Nurses used managerial work to create impact on the conditions for their clinical work, whereas physicians experienced impact independently. Both nurses and physicians experienced managerial work as meaningful, but less meaningful than nurses and physicians' clinical work.

For an effective health care system, structural changes in terms of positions, roles, and responsibilities can be an important route for especially nurses' psychological empowerment.

The qualitative method provided a complementary understanding of psychological empowerment on how psychological empowerment interacted with other factors. One such aspect was nurses' higher dependence on structural empowerment, but the most important aspect was that both physicians and nurses experienced that managerial work was less meaningful than clinical work. This implies that psychological empowerment for managerial work may only make a difference if psychological empowerment does not compete with physicians' and nurses' clinical work.

The paper aims to identify and address matching problems in leader development and to propose how these problems can be dealt with.

Based on previous research, traditional leadership development (LD) is criticized and alternative approaches are suggested.

This research identifies two major matching problems in traditional LD – between participant and development effort and between development effort and realities of managerial work. A context-sensitive and emergent view of LD is suggested to address these matching problems.

The paper illustrates the need of leader development that is addressing the complex nature of managerial work in a more holistic way and to help participants to understand how such complexities can be dealt with.

An alternative view of leader development is identified. It matches managers’ diversities and the realities of managerial work better than traditional leader development does.

This article aims to increase the understanding of the role of individual actors and arenas in dealing with multiple institutional logics in family firms.

This study follows a case-study approach of two family-owned newspaper companies. Based on interviews and secondary sources, the empirical material was analysed focussing on three institutional logics, that is, family logic, management logic and journalistic logic.

First, the authors show how and in which arenas competing logics are balanced in family-owned newspaper companies. Second, the authors highlight that family owners are central actors in the process of balancing different institutional logics. Further, they analyse how family members can become hybrid owner-managers, meaning that they have access to all institutional logics and become central actors in the balancing process.

The authors reveal how multiple institutional logics are balanced in family firms by including formal actors and arenas as additional lenses. Therefore, owning family members, especially hybrid owner-managers, are the best-suited individual actors to balance competing logics. Hybrid owner-managers are members of the owner families who are also skilled in one or several professions.

Healthcare organisations are often described as less innovative than other organisations, since organisational culture works against innovations. In this paper, the authors ask whether it has to be that way or whether is possible to nurture an innovative culture in a healthcare organisation. The aim of this paper is to describe and analyse nurturing an innovative culture within a healthcare organisation and how culture can support innovations in such a healthcare organisation.

Based on a qualitative case study of a healthcare unit that changed, within a few years, from having no innovations to repeatedly generating innovations, the authors describe important aspects of how innovative culture can be nurtured in healthcare. Data were analysed using inductive and deductive analysis steps.

The study shows that it is possible to nurture an innovative culture in a healthcare organisation. Relationships and competences beyond healthcare, empowering structures and signalling the importance of innovation work with resources all proved to be important. All are aspects that a manager can influence. In this case, the manager's role in nurturing innovative culture was very important.

This study highlights that an innovative culture can be nurtured in healthcare organisations and that managers can play a key role in such a process.

The paper describes and analyses an innovative culture in a healthcare unit and identifies important conditions and strategies for nurturing innovative culture in healthcare organisations.

The purpose of this paper is to empirically explore and demonstrate the ability of healthcare professionals to attain professional fulfilment when providing healthcare inspired by “value shops”.

A qualitative case study incorporating interviews and observations was conducted.

The empirical data suggest that the professional fulfilment of both physicians and nurses is facilitated when care is organized through “value shops”. Both groups of professionals state that they are able to return to their “professional core”.

The beneficial outcomes of organizing healthcare inspired by the “value shop” have previously been explored in terms of efficiency and quality. However, the professional fulfilment of healthcare professionals when providing such care has not been explicitly addressed. Professional fulfilment is vital in order to safeguard high-quality care, as well as healthcare professionals' involvement and engagement in implementing quality improvements. This paper highlights the fact that care provision inspired by the “value shop” may facilitate professional fulfilment, which further strengthens the potential positive outcomes of the “value shop” when utilized in a healthcare setting.

The purpose of this paper is to describe and analyze conditions that influence how employees engage in healthcare quality improvement (QI) work.

Qualitative case study based on interviews (n=27) and observations (n=10).

The main conditions that influence how employees engage in healthcare QI work are professions, work structures and working relationships. These conditions can both prevent and facilitate healthcare QI. Professions and work structures may cement existing institutional logics and thus prevent employees from engaging in healthcare QI work. However, attempts to align QI with professional logics, together with work structures that empower employees, can make these conditions increase employee engagement, which can be accomplished through positive working relationships that foster institutional work, which bridge different competing institutional logics, making it possible to overcome barriers that professions and work structures may constitute.

Understanding the conditions that influence how employees engage in healthcare QI work will make initiatives more likely to succeed.

Healthcare QI has mainly been studied from an implementer perspective, and employees have either been neglected or seen as passive resisters. Weak employee perspectives make healthcare QI research incomplete. In our research, healthcare QI work is studied closely at the actor level to understand healthcare QI from an employee perspective.

This paper applies systems thinking modelling to enhance the dynamic understanding of how to nurture an innovative culture in healthcare organisations to develop the innovation system in practice and speed up the innovative work. The model aims to provide a holistic view of a studied healthcare organisation's innovation processes, ranging from managerial values to its manifestation in improved results.

The study is based on empirical material from a healthcare unit that, within a few years, changed from having no innovations to repeatedly generating innovations. The study uses the modelling language of causal loop diagrams (CLDs) in the system dynamics methodology to identify the key important aspects found in the empirical material.

The proposed model, based on the stories of the interviewees, explores the dynamics of inertia when nurturing an innovative culture, identifying delays attributed to the internal change processes and system relationships. These findings underscored the need for perseverance when developing an innovative culture in the entrepreneurial phases.

The approach of using systems thinking to make empirical healthcare research results more tangible through the visual notations of CLDs and mental simulations is believed to support exploring complex phenomena to induce and nurture both individual and organisational learning.

The results from this approach provide deepened analysis and provoke the systems view to explain how the nurturing of the culture can accelerate the innovation processes, which helps practitioners and researchers to further expand their understanding of their healthcare contexts.

Procurement is increasingly used as a strategic tool to mitigate societal issues such as social exclusion and unemployment of marginalized groups. By conducting social procurement and imposing so-called employment requirements, organizations can create job opportunities for marginalized people. Such practices are becoming increasingly popular in the construction sector, but remain scattered, which hinders the effective creation, use and dissemination of cohesive and commonly shared social procurement practices. Accordingly, this paper analyzes the creation, use and dissemination of social procurement practices in the Swedish construction sector.

The theory of proto-institutions, which refers to institutions under development, is applied to analyze 46 interviews with construction practitioners.

There is currently little convergence of social procurement practices, due to practices not being fully internalized across organizations and projects; interns hired through employment requirements not having strong enough incentives to engage with their internships; actors working strategically and operatively having different possibilities to create social procurement practices; and the development of maintenance mechanisms for the formalization of sustainable practices being weak.

This paper contextualizes efforts to increase equality, diversity and inclusion of marginalized groups in the construction sector. The adoption of an institutional perspective of practice development elucidates the institutional constellation of existing institutional logics that impact on this practice development. This paper also indicates how the work with social procurement can become more effective and efficient and maximize the social value output for marginalized people living in social exclusion. For institutional theory, it illustrates how proto-institutions can be driven by both top-down and bottom-up perspectives.

The purpose of the paper is to describe and analyze differences in patients' quality perceptions of private and public primary care centers in Sweden.

The article explores the differences in quality perceptions between patients of public and private primary care centers based on data from a large patient survey in Sweden. The survey covers seven dimensions, and in this paper the measure Overall impression was used for the comparison. With more than 80,000 valid responses, the survey covers all primary care centers in Sweden which allowed for a detailed analysis of differences in quality perceptions among patients from the different categories of owners.

The article contributes with a detailed description of different types of private owners: not-for-profit and for profit, as well as corporate groups and independent care centers. The results show a higher quality perception for independent centers compared to both public and corporate groups.

The small number of not-for-profit centers (21 out of 1,117 centers) does not allow for clear conclusions for this group. The results, however, indicate an even higher patient quality perception for not-for-profit centers. The study focus on describing differences in quality perceptions between the owner categories. Future research can contribute with explanations to why independent care centers receive higher patient satisfaction.

The results from the study have policy implications both in a Swedish as well as international perspective. The differentiation between different types of private owners made in this paper opens up for interesting discussions on privatization of healthcare and how it affects patient satisfaction.

The main contribution of the paper is the detailed comparison of different categories of private owners and the public owners.

The purpose of this paper is to investigate the struggles of managerial identity in relation to the process of becoming/being a manager, and the personal conflicts involved within this process.

In a qualitative, longitudinal project, five managers were studied for two years using interviews and observations. This was undertaken before, during, and after their participation in personal development training. In total, 62 interviews and eight half‐day observations were conducted.

The study puts emphasis on the role of management training in providing templates for “how to be a manager”, but it also illustrates the double‐edged and complex role played by context in managerial being and becoming. On the one hand context shapes managerial identity; on the other hand, context might operate to dilute the identity an individual manager wishes to assume.

The study focuses on only five managers in two organizations. This small sample limits the generalisabilty of the research.

Management training tends to be based on the idea that management concerns the acquisition of competencies, techniques and personal awareness, while managerial practice is more fluid and contextually based. There is a challenge for organizers of all types of management training to bridge the gap between a fixed idea of what it is to be a manager and how management is actually practised.

The longitudinal and in‐depth qualitative approach facilitates an important contribution to understanding issues in developing a managerial identity.