Search results

Value-based health care (VBHC) argues that health-care needs to re-focus to maximise value creation, defining value as the quota when dividing the outcomes important for the patient, by the cost for health care to deliver such outcomes. This study aims to explore the perception of value among different stakeholders involved in the process of implementing VBHC at a Swedish hospital to support leaders to be more efficient and effective when developing health care.

Participants comprised 19 clinicians and non-clinicians involved in the implementation of VBHC. Semi-structured interviews were conducted and content analysis was performed.

The clinicians described value as a dynamic concept, dependent on the patient and the clinical setting, stating that improving outcomes was more important than containing costs. The value for non-clinicians appeared more driven by the interplay between the outcome and the cost. Non-clinicians related VBHC to a strategic framework for governance or for monitoring different continuous improvement processes, while clinicians appreciated VBHC, as they perceived its introduction as an opportunity to focus more on outcomes for patients and less on cost containment.

There is variation in how clinicians and non-clinicians perceive the key concept of value when implementing VBHC. Clinicians focus on increasing treatment efficacy and improving medical outcomes but have a limited focus on cost and what patients consider most valuable. If the concept of value is defined primarily by clinicians’ own assumptions, there is a clear risk that the foundational premise of VBHC, to understand what outcomes patients value in their specific situation in relation to the cost to produce such outcome, will fail. Health-care leaders need to ensure that patients and the non-clinicians’ perception of value, is integrated with the clinical perception, if VBHC is to deliver on its promise.

This paper explores how conflicting institutional logics shape the behaviors of macro- and micro-level actors in their use of a calculative practice. Thereby, this paper explains how quantification can undermine the intended purpose of a governance system based on a single number.

The study draws upon the literature on calculative practices and institutional logics to present the case of how a single number—specifically the conversion factor for Atlantic Cod, established by macro-level actors for the purposes of governance within the Norwegian fishing industry—is interpreted and used by micro-level actors in the industry. The study is based on documents, field observations and interviews with fishers, landing facilities, and control authorities.

The use of the conversion factor, while intended to protect fish stock and govern industry actions, does not always align with the institutional logics of micro-level actors. Especially during the winter season, these actors may seek to serve their interests, leading to potential system gaming. The reliance on a single number that overlooks seasonal nuances can motivate unintended behaviors, undermining the governance system’s intentions.

Integrating the literature on calculative practices with an institutional logics perspective, this study offers novel insights into the challenges of using quantification for the governance of complex industries. In particular, the paper reveals that when the logics of macro- and micro-level actors conflict in a single-number governance system, unintended outcomes arise due to a domination of the macro-level logics.

President Trump's tenure was accompanied by a series of protectionist measures that intended to reinvigorate US-based production and make manufacturing supply chains more “local”. Amidst these increasing institutional pressures to localise, and the business uncertainty that ensued, this study investigates the extent to which manufacturers reconfigured their supply bases.

Bloomberg's Supply Chain Function (SPLC) is used to manually extract data about the direct suppliers of 30 of the largest American manufacturers in terms of market capitalisation. Overall, the raw data comprise 20,100 quantified buyer–supplier relationships that span seven years (2014–2020). The supply base dimensions of spatial complexity, spend concentration and buyer dependence are operationalised by applying appropriate aggregation functions on the raw data. The final dataset is a firm-year panel that is analysed using a random effect (RE) modelling approach and the conditional means of the three dimensions are plotted over time.

Over the studied timeframe, American manufacturers progressively reduced the spatial complexity of their supply bases and concentrated their purchase spend to fewer suppliers. Contrary to the aims of governmental policies, American manufacturers increased their dependence on foreign suppliers and reduced their dependence on local ones.

The research provides insights into the dynamics of manufacturing supply chains as they adapt to shifting institutional demands.

The purpose of this research is to explore how one unsanctioned community sport organization (CSO), AM Hockey, sought to acquire legitimacy in a highly institutionalized minor hockey marketplace at various points in its organizational life cycle.

This study was guided by instrumental case study methodology. Twenty (20) AM Hockey stakeholders from a variety of roles (e.g. executives, program directors and coaches) were interviewed. Document analysis was also utilized to supplement the interviewees. Internal and public documents reflective of the CSO's creation and growth were obtained.

Findings revealed that the CSO had to navigate distinct phases of evolution including the Building, Growth, Competition and Stabilization phases. Although the four life cycle phases identified in this study share similarities with the phases identified by Lester et al. (2003), findings indicated that institutional work mechanisms must be understood in their context as they can vary over the life cycle of an organization. Therefore, start-up sports organizations must approach the pursuit of legitimacy as a continual process rather than something acquired and defended through maintenance work.

Developing legitimacy remains a central challenge for CSOs that seek to deliver alternative sport programming, yet it continues to be understudied. Ultimately, the long-term viability of an unsanctioned CSO in a federated sports system relies, in part, on its ability to continually determine the actions needed to achieve legitimacy within its environment.

This study aims to investigate why and how shared service centres (SSCs) are implemented as well as how they affect audit firm practice and audit quality.

In this qualitative study guided by the theoretical framework of institutional theory, the authors conducted 25 semi-structured interviews in seven European countries, including 16 interviews with audit partners from Big 4 firms, 6 with audit team members, 2 with interviewees from second-tier audit firms and 1 with a member of an oversight body.

The authors show that the central rationale for audit firms to implement SSCs is economic rather than external legitimacy. The authors find that SSC implementation has substantial effects on audit practices, particularly those related to standardisation, coordination and monitoring activities. The authors also highlight the potential impacts on audit quality.

By exploring the motivation for and effects of SSC implementation amongst audit firms, the authors offer insights into the best practices related to subsequent change processes and audit quality.

The worldwide imposition of lockdown measures to control the 2020 coronavirus disease 2019 (COVID-19) outbreak has shifted most executive communications with external stakeholders online, resulting in quick responses from stakeholders. This study aims to understand how presentational styles exhibited in online communication induce immediate audience responses and empirically test the effectiveness of reactive impression management tactics.

The authors analyze presentational styles using MP3 files containing executive utterances during earnings call conferences held by S&P 100-listed firms after June 2020, the quarter after the World Health Organization declared the COVID-19 outbreak a pandemic on March 11, 2020. Using timestamps, the authors link each utterance to a 1-minute interval change in the ask/bid prices of the stocks that occurs a minute after the corresponding utterance begins.

Exhibiting an informational presentation style in earnings calls leads to positive and immediate audience responses. Managers tend to increase their reliance on promotional presentation styles rather than on informational ones when quarterly earnings exceed market forecasts.

Drawing on organizational genre theory, this research identifies the discrepancy between the presentation styles that audiences positively respond to and those that managers tend to exhibit in earnings calls and provides a reactive impression management typology for immediate responses from online audiences.

The purpose of this study is to describe latent classes explaining the innovation logic in the Finnish construction companies. Innovativeness is a driver of competitive performance and vital to the long-term success of any organisation and company.

Using finite mixture structural equation modelling (FMSEM), the authors have classified innovation logic into latent classes. The method analyses and recognises classes for companies that have similar logic in innovation activities based on the collected data.

Through FMSEM analysis, the authors have identified three latent classes that explain the innovation logic in the Finnish construction companies – LC1: the internal innovators; LC2: the non-innovation-oriented introverts; and LC3: the innovation-oriented extroverts. These three latent classes clearly capture the perceptions within the industry as well as the different characteristics and variables.

The presented latent classes explain innovation logic but is limited to analysing Finnish companies. Also, the research is quantitative by nature and does not increase the understanding in the same manner as qualitative research might capture on more specific aspects.

This paper presents starting points for construction industry companies to intensify innovation activities. It may also indicate more fundamental changes for the structure of construction industry organisations, especially by enabling innovation friendly culture.

This study describes innovation logic in Finnish construction companies through three models (LC1–LC3) by using quantitative data analysed with the FMSEM method. The fundamental innovation challenges in the Finnish construction companies are clarified via the identified latent classes.

During the 1990s, Italian healthcare organisations (HOs) underwent a process of corporatisation, and the most innovative HOs introduced the balanced scorecard (BSC) to address the need for broader accountability. Currently, there is a limited understanding of the dynamics and outcomes of such a process. Therefore, this study aims to explore whether the BSC is still considered an effective performance management tool and analyse the factors driving and hindering its evolution and endurance in public and non-profit HOs.

We conducted a retrospective longitudinal analysis of two pioneering cases in the adoption of the BSC: one in a public hospital and the other in a non-profit hospital. Data collection relied on accessing institutional documents and reports from the early 2000s to the present, as well as conducting semi-structured interviews with the internal sponsors of the BSC.

We found evidence of three main categories of factors that trigger or hinder the adoption and development of the BSC: (1) the role of the internal sponsor and professionals’ commitment; (2) information technology and the controller’s technological skills; and (3) the relationship between the management and professionalism logics during the implementation process. At the same time, there is no evidence to suggest that specific technical features of the BSC influence its endurance.

The paper contributes to the debate on the key factors for implementing and sustaining multidimensional control systems in professional organisations. It emphasises the importance of knowledge-based assets and distinctive internal capabilities for the success of the business. The implications of the BSC legacy are discussed, along with future developments of multidimensional control tools aimed at supporting strategy execution.

The purpose of this study is to explore the relationship between Lean manufacturing and Industry 4.0 for small and medium size of enterprise in Japan and Brazil.

The authors conducted a quantitative survey (20 companies in Japan and 30 companies in Brazil) combined with a qualitative interview (2 companies in Japan and 15 companies in Brazil).

According to the quantitative study, 90% of them practice Lean manufacturing and 40% of them practice Industry 4.0. In the qualitative study in Brazil, four managers responded that the Lean manufacturing is a prerequisite for Industry 4.0 since any production process with waste cannot be productive, even with sophisticated digitalization technology.

The authors explored further the relationship between “defensive Digital Transformation (DX),” which is based mainly on Lean manufacturing, and “offensive DX,” which relates to customer value creation through Industry 4.0. This study clarifies the relationship and plays as a roadmap to develop better the manufacturing from current status to the vision of Industry 4.0.

The evolution and trends of special education and educational leadership are evident, especially in recent years. The former has strived to provide equitable educational opportunities to students with disabilities. The latter has dealt with how people in positions of authority in K-12 schools create policy, use resources, and influence other people to achieve educational goals. Together, these notions constitute an idea that school leaders and administrators can provide insight, oversight, assistance, and guidance toward creating educational environments for students with and without disabilities. This chapter examines the current state of special education and educational leadership by exploring the evolution of special education, relevant legal cases, and the enactment of inclusive education. Furthermore, this chapter addresses contemporary issues for leaders, such as the influence of the COVID-19 pandemic, while dealing with special education and the increasing pressure from families for equity for students with disabilities.