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The purpose of this paper is to report on an action research project carried out in an Italian university hospital that was facing a strategic challenge. The role of intellectual capital (IC) for university hospital strategic management is discussed after developing and applying an IC framework to enhance the visualisation of strategic IC elements.

An action research process has been applied in the studied setting based on Susman and Evered’s (1978) definition of the engaged research cycle.

The action research process allowed a gap between theory and practice to be bridged; the strategic control process resulted supported by new measures; a different approach to strategy management was launched, and other organisations perceived the relevance of the IC representation and wished to import it.

Research limitations are related to those recognised for the interventionist research approach.

The paper contributes to the improvement of managerial and accounting technologies for practitioners managing university hospitals and discusses a university hospital’s strategic goals.

The paper represents a methodological contribution related to the interventionist research stream of literature, and enriches the limited studies focused on IC in health care organisations. Furthermore, the paper enables appreciation of the role of academics in the convergence of theory and practice.

The purpose of this paper is to examine the experiences of gender bias among women hospital CEOs and explore to what these female leaders attribute their success within a male-dominated hospital executive leadership milieu.

This qualitative study involved 12 women hospital CEOs from across Ontario, Canada. Purposeful sampling techniques and in-depth qualitative interview methods were used to facilitate discussion around experiences of gender and leadership.

Responses fell into two groups: the first group represented the statement “Gender inequality is alive and well”. The second group reflected the statement “Gender inequity is not significant, did not happen to me, and things are better now”. This group contained a sub-group with no consciousness of systemic discrimination and that claimed having no gendered experiences in their leadership journey. The first group described gender issues in various contexts, from the individual to the systemic. The second group was ambivalent about gender as a factor impacting leadership trajectories.

Representations of women’s leadership have become detached from feminism, with major consequences for women. This study reveals how difficult it is for some women CEOs to identify gender bias. The subtle everyday norms and practices within the workplace make it difficult to name and explain gender bias explicitly and may explain the challenges in understanding how it might affect a woman’s career path.

To understand the partnership between clinicians and academics who come together to provide high-quality care alongside research and innovation, identifying challenges and productive conditions for innovation and collaboration across multi-disciplinary teams.

An explorative action research methodology was adopted. Semi-structured interviews were conducted with 15 clinical, academic and executive leads at a large metropolitan tertiary care hospital with an academic health services portfolio in the UK.

Clinical leaders recognise the division of limited resource, restrictive employment contracts and the divergent priorities of each organisation as challenges hindering the collaborative process and derailing innovation. Developing a culture of respect, valuing and investing in individuals and allowing time and space for interaction help facilitate successful innovation and collaboration. Successfully leading collaborative innovation requires a combination of kindness, conviction and empowerment, alongside the articulation of a vision and accountability.

Action research continues at this site, and further enquiry into the experiences, challenges and solutions of non-leaders when collaborating and innovating will be captured to present views across the organisation.

Clinical and academic collaboration and innovation are essential to the continued success of healthcare. To ensure hospitals can continue to facilitate this in increasingly challenging circumstances, they must ensure longevity and stability of teams, devote time and resource to research and innovation, nurture interpersonal skills and develop kind and empowering leaders.

This work uniquely focuses on a real-time collaborative and innovative development. By employing action research while this development was happening, we were able to access the real time views of those at the centre of that collaboration. We offer insight into the challenges and effective solutions that consultant-level clinical leaders encounter when attempting to innovate and collaborate in practice.

Hospital mergers are common in the United Kingdom and internationally. However, mergers rarely achieve their intended benefits and are often damaging. This study builds on existing literature by presenting a case study evaluating a merger of two hospitals in Oxford, United Kingdom with three distinct characteristics: merger between two university hospitals, merger between a generalist and specialist hospital and merger between two hospitals of differing size. In doing so, the study draws practical lessons for other healthcare organisations.

Mixed-methods single-case evaluation. Qualitative data from 19 individual interviews and three focus groups were analysed thematically, using constant comparison to synthesise and interpret findings. Qualitative data were triangulated with quantitative clinical and financial data. To maximise research value, the study was co-created with practitioners.

The merger was a relative success with mixed improvement in clinical performance and strong improvement in financial and organisational performance. The merged organisation received an improved inspection rating, became debt-free and achieved Foundation Trust status. The study draws six lessons relating to the contingencies that can make mergers a success: (1) Develop a strong clinical rationale, (2) Communicate the change strategy widely and early, (3) Increase engagement and collaboration at all levels, (4) Be transparent and realistic about the costs and benefits, (5) Be sensitive to the feelings of the other organisation and (6) Integrate different organizational cultures effectively.

This case study provides empirical evidence on the outcome of merger in a university hospital setting. Despite the relatively positive outcome, there is no strong evidence that the benefits could not have been achieved without merger. Given that mergers remain prevalent worldwide, the practical lessons might be useful for other healthcare organisations considering merger.

Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) is being widely promoted in healthcare settings to train staff in evidence-based approaches that promote patient safety. It involves a comprehensive curriculum that spells out key principles and actionable tools for a culture change toward patient-safety-focussed teamwork. Activities begin with selected personnel attending TeamSTEPPS Master Trainer Training (MTT) and then organizing and providing TeamSTEPPS training for staff in their organization. The authors conducted interviews with respondents at community hospitals conducting TeamSTEPPS staff training. To structure the interviews, the authors used 11 key questions identified by Weaver et al. in their in-depth team training literature review. The purpose of this paper is to examine approaches taken by community hospital personnel and compare those to the best practices recommended by Weaver et al.

The authors interviewed 57 staff and administrators at 22 community hospitals sending teams to TeamSTEPPS MTT.

The authors find that training implementation in community hospitals differs significantly from the established, research-based principles for effective team training described in the research literature, which is largely based in academic medical centers.

The current findings suggest that several TeamSTEPPS training features could be enhanced in community hospitals including: choosing staff who have the skills to be effective trainers in this train-the-trainer model; emphasizing active learning; and sustaining lessons through on-the-job application, practice and feedback. These principles apply to many training approaches employed in small healthcare organizations.

The purpose of this paper is to investigate how a combination of diverse sources of knowledge is important for generation of new ideas and address how institutional infrastructures and practices support integration of knowledge across organizations in medicine and life sciences.

The paper investigates new product ideas that emerge from hospital and university employees, and looks at the extent of interaction between clinical and scientific environments in the idea generation process. The paper utilizes data about all new product ideas within life science that were reported in South-Eastern Norway in 2009-2011, as well as information about the individuals and teams that had been involved in disclosing these ideas. Interviews with inventors have also been carried out.

Interaction and integration across scientific and clinical domains are common and important for generating new product ideas. More than half of the disclosed life science ideas in the database come from groups representing multiple institutions with both scientific and clinical units or from individuals with multiple institutional affiliations. The interviews indicate that the infrastructure for cross-domain interaction is well-developed, particularly for research activities, which has a positive effect on invention.

The paper uses an original data set of invention disclosures and investigates the hospital-science interface, which is a novel setting for studies of inventive activities.

The use of hospitalists in the care of in‐patients is a relatively new phenomenon in the USA – hospitalists are delivering medical care to patients in private practice, public hospitals, and academic medical centers. Several obstacles hinder understanding of the characteristics of academic medical center‐based hospitalists. These include differences in definitions and nomenclature, differences in job descriptions, roles and administration across hospitalist programs, and in qualifications and credentialing of hospitalists versus other physicians. These differences derive from the heterogeneity of AMCs by bed size, level of local and regional competition, and cultural, utilization and referral patterns. The field needs an agreed definition of the term “hospitalist”. Assuming a good definition, one could take advantage of already good descriptive data on AMCs to quantify hospitalists within AMCs and to study how hospitalist programs vary by AMC characteristics.

Guided by the growing importance of social-mediated organisational communication, this study examines how communication professionals within healthcare organisations perceive and respond to the reputation impacts of social media on the organisation’s reputation. Although the healthcare sector finds itself in the midst of a (continually) transforming landscape characterised by large amounts of digital health (mis)information and an empowered “patient-as-consumer”, little is known about how professionals in this sector understand the changes and respond to them. Moreover, much extant scholarship on the topic is published in specialised health or medical journals and does not explicitly address the communication implications for healthcare organisations.

In-depth semi-structured interviews were conducted with communication professionals responsible for social media across eight hospitals in the Netherlands. The sample included two participants working as communication consultants/social media advisors for healthcare organisations. In all, 15 interviews were conducted.

Building on interviewee perspectives, the authors advance the CARE (Control, Access(ability), Responsive(ness) and Engagement) model of social-mediated communication, highlighting the dualistic characteristics of each dimension. This model is built upon a careful analysis of healthcare professional responses. In an always-on environment, understanding and managing the tensions within the authors’ model may be decisive to the reputation implications of social media use.

Understanding the tensions within each dimension lends a more nuanced perspective on the potential impact(s) of social media as experienced by professionals in the field. In shifting away from a binary, either/or approach, the paper contributes to explicating the complexities of a pervasive phenomenon (i.e. social-mediated communication) and its multifaceted impacts on the healthcare sector.

Today, quality management systems (QMS) are a promising candidate for the improvement of healthcare services. The purpose of this paper is to investigate the opinions/attitudes of gynecology healthcare professionals toward quality and quality management in healthcare facilities (HFs) in Greece.

An anonymous self-administered questionnaire was distributed to healthcare professionals, asking for opinions on quality objectives associated with the everyday workflow in HFs (e.g. management of patients, resources, etc.) and on QMS. The study was conducted in Hippokration Hospital of Thessaloniki, including 187 participants. Statistical assessment and analysis of the questionnaires were carried out.

Although 87.5 percent recognized the importance of potential QMS implementation and accreditation, over 50 percent believed that it would lead rather to increased workload and bureaucracy than to any considerable quality improvement. More than 60 percent were completely unaware of the implementation of quality objectives such as quality handbook, quality policy, audit meetings and accreditation status in their HFs. This unawareness was also reported in terms of patient, data, human and general resources management. Finally, awareness over medical malpractice and positive attitude toward official reporting were detected.

Most respondents acknowledged the significance of quality, QMS implementation and accreditation in Greek hospitals. However, there was a critical gap in knowledge about quality management objectives/processes that could be possibly resolved by expert teams and well-organized educational programs aiming to educate personnel regarding the various quality objectives in Greek HFs.

The purpose of this study was to explore the cultural and structural conditions that influence male and female physicians’ career choices and career expectations. Although women constitute 59 percent of the physicians and 55 percent of the specialists in Finland in 2014, the rate of women in oto-rhino-laryngology (38 percent) was one of the lowest among the specialties. The data consist of semi-structured interviews with young physicians (N = 19), who have entered a career in oto-rhino-laryngology (ORL) in Finland.

The results point to three features which characterize the career pattern in the specialty. First, the specialty is not one that draws students to medicine per se but rather one that is chosen during medical training. The decision to specialize in ORL was by many respondents framed as a “coincidence,” while others were attracted by the diverse character of the specialty. Second, the skills needed for being a “good” practitioner were defined as handiness, courage, and social skills, but these were not defined in a gendered way. Third, the career prospects for women within the specialty were defined by a neutralizing or a gendering framework. The neutralizing framework was represented by the pipeline argument which suggests that there is a temporary time lag in women’s representation in higher positions and that women are advancing steadily in the academic and administrative pipeline. The gendering framework pointed to the male ethos of the surgical tasks in the specialty as a barrier for women’s advancement in those areas. This chapter concludes that the pipeline view belittles existing gender inequalities in men’s and women’s medical careers and views gender differences as temporary maladjustments rather than inherent features of gendered organizations.