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Healthcare policy-makers are implementing practices based on the logic of cost-opportunity to rationalize investments and resource consumption. The successful implementation of these practices depends on policy-makers’ capacity to involve professionals dispersed in the ecosystem, and who are unaccustomed to cooperating. Our case study investigates the institutional work pursued by the Lombardy Region to stimulate a Health Technology Assessment (HTA) program.

This chapter is based on a longitudinal case study of institutional change linked with a HTA program in the Lombardy Region. The HTA program initiatives were implemented during the 2009–2012 period. The case study is based on triangulating data from archival data, contents of the assessment forms and interviews with regional staff and experts.

The Lombardy Region implemented two distinct strategies, with mixed results. A strategy that was based on the formalization of the HTA program in a legislative direct through educational efforts did not obtain the commitment of the key actors in the relevant ecosystem. Subsequently, the Region implemented an ‘institutional work’ design strategy that included a combination of political, cultural, technical and structural work. This strategy stimulated local HTA experiments that might be used in the future to legitimize the full diffusion of the new practice in the ecosystem.

This study highlights a viable strategy of change that policy-makers can use to manage processes of institutional change in a professional ecosystem. The ‘institutional work’ strategy can support the establishment of new practices that incorporate the logic of cost-opportunity, which might rationalize the use of resources and improve investment decisions.

This chapter provides a reflective synopsis of six cases focused on making healthcare sustainable. The nature and value of an ecosystem perspective is explored. The intent is to apply and generate organizational knowledge to understand and guide purposeful design and learning.

From five countries where healthcare is organized differently, these cases illuminate particular approaches to develop the capabilities for healthcare to deliver greater value to society. Each case is examined through the lens of an appropriate theoretical perspective. This chapter reports the themes that were common in the six case studies.

New approaches are changing the connections in the healthcare ecosystem, including the flows of: medical knowledge, clinical information, and resources. Common themes include: the importance of networks in the emerging healthcare ecosystem; the role of governance mechanisms and leadership to align the diverse ecosystem components; the engagement of dominant ecosystem actors; the need for adaptive change capabilities, and for multi-stakeholder research collaborations to generate actionable knowledge.

Taking an ecosystem perspective enables healthcare leaders to broaden their conceptualization of the changes that will be required to be sustainable in a changing society.

Almost every man, woman and child is affected by the healthcare system. Increasing the sustainability of healthcare is integral to increasing societal sustainability overall.

Viewing the ecosystem as the appropriate focus of purposeful change departs from a traditional approach that focuses on the effectiveness of each element.

Previous research argues that customer switching costs play an important role in the firm’s ability to retain customers and achieve competitive advantage. Research also indicates that in the increasingly networked environment, switching costs are changing in important ways. Despite switching costs’ recognized role in contributing to competitive advantage and its increasingly strategic characteristics in the expanding networked environment, we find a lack of coherence and completeness in the conceptual tools and models developed to understand its role and help effectively to manage the phenomenon. In this paper we attempt to address these needs by expanding and refining the conceptualization of customer switching costs and developing a more useful and comprehensive framework for managers.

The purpose of this paper is to address the effects of retail out-of-stocks from a service-dominant (S-D) logic view.

Conceptual, combining classic S-D logic research with recent research of S-D logic in supply chains, and applying this to out-of-stocks in a retail setting of fast-moving consumer goods.

The paper unveils out-of-stocks as emergent operant resources that alter and attenuate value creation across manufacturers, retailers, shoppers, users and their networks. The paper develops a model of value co-creation where manufacturer supply and shopper/user demand meet in the retailer ' s realm. Differentiating between shopper and user in a sequential model of value creation, it identifies the shopper as an active entity whose response to out-of-stocks redistributes value within the retail service ecosystem. An additional model is developed that illustrates the novel costs of an out-of-stock as uncovered by the S-D logic perspective, allowing retailers and manufacturers to align their interests in improving on-shelf availability.

Moving distribution thought and management towards a goal of service provision, this article suggests three logistics research possibilities: retailer-manufacturer misalignment, spatio-temporal supply-demand mismatch, and shopper-user interaction.

This article shows how the S-D perspective can bring previously misaligned incentives of supply chain actors into alignment. Previous goods-dominant research showed little common ground for manufacturers and retailers to jointly improve on-shelf availability. The S-D logic view demonstrates compelling rationale for both parties ' involvement.

The paper extends S-D logic literature by considering value attenuation through failures in physical distribution and logistics management, adding that non-availability causes operand resources to become operant and attenuate/redistribute value. The paper extends the out-of-stock literature by providing a theoretical foundation, and by showing the ecosystem effects of out-of-stocks.

This paper analyses public sector accounting and organisation reforms, focusing on the departments in charge of defence, military procurement and war between 1850 and 2000 in Britain. Over this period, three parliamentary acts, resulting from a power struggle between the Treasury and Parliament, produced the shift between two institutional logics: probity (spending properly) and performance (spending well). The purpose of this paper is to describe how the acts produced a shift between two institutional logics.

The authors adopt Quattrone’s (2015) procedural notion of institutional logics and the consequent concept of “unfolding rationality”. Using documents from the National Archives, the authors analyse three reforms: The Exchequer and Audit Departments Act 1866 (towards probity), The Exchequer and Audit Departments Act 1921 (towards performance) and the National Audit Office Act of 1983 (towards performance and probity).

For a long time, the actors narrated in this story argued and acted as if probity and performance were incompatible. The two are now treated as compatible and equally important. Before that, the “incompatibility” was a rhetorical, or “procedural”, device. The authors argue that a procedural rather than substantive notion of institutional logics is more suitable to explain the trajectory that was the result of constant negotiation among actors.

The study might contribute to the understanding of the increase in national defence-spending at continental level and the call for a common European Union (EU) military procurement strategy that followed the invasion of Ukraine. The war could produce changes in what is a traditional tension between two logics: sovereignty or efficiency.

The originality of this paper stands in highlighting the link between the institutional logic of public-administration accounting and military history. This link emerges also thanks to a very long time-horizon. Additionally, from a theoretical viewpoint, the authors have put Quattrone’s approach to the test in a context very different from the original one (the Jesuit order).

Drawing on the upper echelons theory, this study focuses on how top management team (TMT) heterogeneity affects breakthrough innovations and examines how strategic decision-making logic (including causation and effectuation) moderates the relationship between TMT heterogeneity and breakthrough innovation.

By conducting an empirical test of 227 sample firms in China, the authors applied linear hierarchical regression analysis to test the hypotheses on the TMT heterogeneityinnovation relationship and the moderating roles of causation and effectuation.

The empirical tests show that TMT heterogeneity positively affects breakthrough innovation, and both causation and effectuation positively moderate the positive relationship between TMT heterogeneity and breakthrough innovation. In addition, effectuation has a stronger moderating effect on the positive correlation between TMT heterogeneity and breakthrough innovation than causation.

This study extends the upper echelons theory to explain how the characteristics of TMTs affect firm innovation. Specifically, the authors explore the TMT heterogeneity–breakthrough innovation relationship from the perspectives of information processing and core competence and reveal the boundary condition of strategic decision-making logic in the correlation between TMT heterogeneity and breakthrough innovation. In this vein, the authors contribute to the literature by untangling the internal mechanisms between TMT heterogeneity and breakthrough innovation and extending the discussion on effectuation theory from the entrepreneurship domain to the innovation field. Furthermore, the research findings can provide helpful implications for TMTs to manage breakthrough innovation effectively.

Basing one's business decision on an approach that relies on experience may work sometimes. Experience is a useful part of the process, but it may also lock the decision maker into a method that cannot lead to an innovative solution. An alternative to this experience‐based (linear) way of problem solving is a certain skillful way of thinking known as lateral thinking. This paper aims to present a simple alternative approach to managerial decision making.

Here lateral thinking is defined as methods of thinking concerned with changing concepts and perception. Various tests are suggested that show how it might be measured. These tests were originally developed to identify creative thinking ability. One of these tests is used in an illustrative decision aid to reduce a common decision‐making “bias” labeled “hindsight bias”.

The simple decision aid reduced the hindsight effect for those decision makers who were deemed to be limited in their lateral thinking ability. Those who could already think laterally were not affected by the decision aid. The decision aid was decision‐making neutral for them.

Often, when attempting to improve decision making, the focus is on providing better information or models. Rarely is the cognitive ability of the manager specifically considered. Here, a simple decision aid has been suggested that appears to help managers adopt a different perception of the decision situation. For managers and organizations this is a low cost opportunity to achieve better results.

The purpose of this paper is to relate additive manufacturing (AM) and machining (CNC) synergistically in a modular approach in the design and manufacturing domains, to generate value for end‐users and manufacturers (a teleological system).

The research methodology decomposes a part into modules, by employing a teleological systems theory approach paired with principles of modular design. Modules are manufactured with either additive manufacturing (fused deposition modeling, FDM) or machining (CNC). Process selection is determined by a decision‐making framework that quantifies strength and weakness comparisons of FDM and CNC machining processes, accomplished using the analytic hierarchy process (AHP).

The developed methodology and decision‐making framework is successfully applied to the design and manufacturing of a large, complex V6 engine section sand casting pattern. This case study highlights the merits of the research.

The research assumes that the processes being considered are capable of meeting the product functional requirements. The proposed methodology can be extended to evaluate additional processes.

Value is assessed in this research relative to: time and cost opportunities, managing knowledge limitations of a process by leveraging hybrid options, and aligning design and manufacturing to create a product that accomplishes the goals of the end‐user (teleological effectiveness).

Utilizing the AHP process and a teleological perspective are new, and proven effective, approaches in relating additive and subtractive processes in a hybrid approach with end‐user perspectives. The research demonstrates a systematic methodology to quantify additive and subtractive process selection.

Today, social procurement and requirements to create employment for disadvantaged groups in particular, are increasingly used in the construction sector. The purpose of this paper is to explore the use of employment requirements and its organizational implications in Sweden, and to suggest a possible theoretical approach for studying this phenomenon in the future.

The paper is based on written sources describing influential Swedish cases where employment requirements have been used, as well as on interviews with central actors in industry and society.

Due to the increased use of employment requirements, the construction industry may currently be experiencing the initial stages of a process of institutional change. This implies that a traditional logic, where value is perceived as a function of the cost and quality of the physical product, is increasingly co-existing and competing with a logic where social value plays an important role.

An institutional perspective could enable a rich explication of processes, practices and roles, which might help individual practitioners and organizations to more purposefully work towards a more informed and effective use of employment requirements.

This study takes a first step towards increased theorization of the emergent practice of including employment requirements in construction procurement and its organizational implications. Thereby, research on this phenomenon may be more closely related to and informed by relevant developments in the wider academic community.

As useful as police data have been in furthering our knowledge of gangs and gang violence networks, not everything about gang networks can be learned from examining police data alone. There are numerous alternative sources of data that already exist on gang networks and some that can be developed further. This study aims to introduce existing research on social networks and gangs with a specific focus on prisons and schools.

This study reviews the existing empirical literature on gang networks in schools and prison settings and use the broader literature on social networks and crime to propose directions for future research, including specific suggestions on data collection opportunities that are considered to be low-cost; that is, strategies that simply make use of existing administrative records in both settings, instead of developing original data collection procedures.

The author found the existing literature on each of these settings to be quite limited, especially when the spotlight is put specifically on gang networks. These shortcomings can be addressed via low-cost opportunities for data collection in each of these settings, opportunities that simply require the network coding of existing administrative records as a foundation for gang network studies.

Investing in these low-cost network data collection activities have the potential for theoretical and empirical contributions on our understanding of gang networks, and may also bring value to practitioners working in school and prison settings as a guide for network-based planning or interventions.