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The chapter redefines the focus of the changes required to create sustainable healthcare away from fixing healthcare organizations and toward reconfiguring the constituent elements of the healthcare ecosystem and redefining how they interrelate to yield value more sustainably.

Based on a review of recent literature on healthcare reform, we argue that unlike other sectors, healthcare organizations cannot change themselves without changing their connections to the rest of the healthcare ecosystem, including other healthcare organizations, patients, governments, research institutions, vendors, and the citizenry at large. This is because these are not only stakeholders but also integral parts of healthcare processes.

Interventions intended to create more sustainable healthcare must bring together knowledge and perspectives from across the ecosystem, and must converge different sources of information and analysis to generate novel ways of connecting across the ecosystem. Change within a healthcare system cannot achieve the magnitude of transformation needed to become sustainable.

If the healthcare ecosystem evolves in the manner described in this chapter, the healthcare ecosystem will no longer center around particular institutions and doctors’ offices but rather be defined by flexible and variable interactions between co-acting elements of the ecosystem.

The chapter treats the context as the focus of change in order to change the healthcare system. It proposes three kinds of flows: knowledge, clinical, and resource that are already beginning to change and that will eventually result in fundamentally different approaches to healthcare.

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.

The rapid adoption of the ecosystem concept in innovation contexts has led to a proliferation of differing uses. Scholars need to be crystal clear which concept of the ecosystem they are using to facilitate communication between scholars and allow for cumulativeness and creativity. This paper aims to introduce some clarity into the conceptual mist that surrounds the notion of “ecosystems” in innovation contexts.

A review of the extant literature on ecosystems in innovation contexts to derive an integrated approach to understanding the variety of constructs in use.

This paper introduces clarity into the conceptual mist that surrounds the term “innovation ecosystem”, showing there are three basic types of ecosystems, all of which have a common focus on the collective production of a coherent system-level output.

Contributes through a comprehensive overview of the differing ecosystem types in innovation contexts and with a heuristic to disambiguate types of innovation ecosystems.

The COVID pandemic has prompted B2B and industrial marketing scholars to understand more about how external disruptions impact parties involved in B2B transactions. This paper aims to adopt an ecosystem perspective to conceptually classify the interactions between actors involved in B2B ecosystems.

This conceptual paper presents a framework across multiple levels of ecosystem interactions (at micro, meso and macrolevels) to illustrate how value cocreation and knowledge flows (as mechanisms underlying B2B relationships) are related to firm performance.

Based on this framework, this paper offers propositions and several research questions about the effects of disruptions and how they propagate among these essential business ecosystem elements.

This conceptual framework underscores the vital role of relationships and interactions in shaping B2B ecosystems, especially during disruptive periods. With a greater understanding of how these interactions operate across levels (micro, meso and macro), scholars and practitioners may be better able to navigate disruptive periods.

This paper concerns the pivotal role that entrepreneurial universities can play in developing knowledge transfer and translation processes tailored to the cultural ecosystem.

The paper examines IncubiAmo Cultura, an innovative project that aims to mentor potential entrepreneurs and offer incubation and acceleration for cultural start-ups. The research methodology is based on action research and theory building from cases. An interventionist approach has been adopted, as one of the authors is also the founder of the ongoing project.

The in-depth collection of first-hand information on this pilot project has allowed the authors to formulate an analytical reflection and generate the design of a knowledge translation model driven by an entrepreneurial university that manifests itself through the creation of cultural and creative start-ups.

This article offers an original contribution to scholarship by offering a conceptual model for knowledge translation in cultural ecosystems. Common values (i.e. social, cultural, ethical and aesthetic ones) emerge as the basis on which to build open innovation and knowledge circulation.

For local policymakers, this study provides a clue to understand the need for both an integrated vision of knowledge translation and policies that aim to make an impact at the cultural ecosystem level. For entrepreneurial university governance, our investigation offers suggestions on the design and implementation of knowledge translation processes that fit with the specificity of the cultural ecosystem. For practitioners in the cultural field, a change of mindset is required to combine resources, energies and knowledge.

This work fills several gaps in the literature, as research generally concerns knowledge transfer from entrepreneurial universities to the market with regard to high-tech sectors. In contrast, the cultural sector is often neglected, despite its importance in the renewal and development of a territory.

Proposes two concepts for the empirical analysis of society‐nature interrelations: first, socio‐economic metabolism – the material and energy flows between societies and their natural environment and second, the colonization of nature – the sum of deliberate interventions into natural systems aimed at their “improvement” with respect to socio‐economic goals. Discusses empirical examples for sustainability indicators, focusing on landscape processes, and relates land use to the analysis of material and energy flows.

The purpose of this paper is to introduce ecotones to the service literature as a conceptual extension of the service ecosystem (SE) framework.

To synthesise the contribution, an illustrative empirical case study with research of nine organisations and their service systems is developed.

Boundaries connect systems with their environment. Ecotone, a concept from natural ecosystems, provides a useful concept representing the boundary zones between adjacent systems, supporting emergent phenomena. The authors find that a service ecotone emerges through the interactions occurring at the intersections of relational, technological and institutional boundaries of two unique SEs. The case demonstrates ecotone edge effects – the unique landscape and diversity of actors and their roles – which play a role in the co-evolution of the separate SEs.

The ecotone concept provides an understanding of SE boundaries, helping practitioners understand the complex environments they operate. Developing strategy in complex ecosystems requires a clear understanding of where the boundaries of dependence and interdependence lie. The ecotone concept helps practitioners to develop responsiveness and resilience to their environment and take advantage of resources that may be currently unrecognised.

The authors introduce the ecotone concept and integrate it with service theory. This paper develops service ecotones for understanding the relationship between different systems that influence their functioning and development. Thus, ecotones suggest new avenues for understanding the diversity and roles of actors, and how new structural properties, resources and practices come to be through the tensions and interactions created in these complex boundaries of SEs.

The purpose of this paper is to present a case study of how ecological considerations can be integrated into campus strategic and statutory spatial planning. A process of developing ecological objectives and guidelines for inclusion in campus strategic and statutory spatial plans is presented.

This case study introduces a three-phase ecological assessment process developed and applied to the Technion – IIT campus. Ecological considerations are reviewed in multiple campus strategic and spatial plans (primarily in North America and Europe) and in institutional sustainability guidelines; biodiversity and ecosystem service surveys of the campus are conducted and considered with regard to planning; university administrative structures that enable the implementation of ecological planning guidelines are also assessed.

Ecological considerations (biodiversity conservation, habitat preservation and ecosystem integrity) play a relatively minor role in sustainability planning on university campuses. The concepts of connectivity and compactness are applied broadly, but generally refer to social and educational considerations. Physical planning provides an opportunity for integrating ecological priorities into the university’s mission.

Some of the insights may not be generalizable, so it is crucial to continue accumulating similar studies. It is crucial, too, to conduct follow-up research, reporting on the ecological outcomes of plan implementation.

Ecological stewardship is commensurate with the sustainability commitments of universities. Considering their spatial extent and diverse locations, universities can assume an important role in ecological conservation.

Relatively little attention has been given to ecological considerations (biodiversity, ecological integrity and ecosystem services) in campus plans and sustainability documents. This paper suggests how universities can move towards fulfilling a role as ecological stewards through strategic and spatial planning.