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Information systems (IS) research in general and health IS studies, in particular, are prone to a positivity bias – largely focusing on upside gains rather than the potential misuse practices. This paper aims to explore failures in health IS use and shortcomings in data privacy and cybersecurity and to provide an explanatory model for health record misuse.

This research is based on four data sets that we collected through a longitudinal project studying digital health (implementation, use and evaluation), interviews with experts (cybersecurity and digital health) and healthcare stakeholders (health professionals and managers). We applied qualitative analysis to explain health records misuse from a sociotechnical perspective.

We propose a contextualized model of “health records misuse” with two overarching dimensions: data misfit and improper data processing. We explain sub-categories of data misfit: availability misfit, meaning misfit and place misfit, as well as sub-categories of improper data processing: improper interaction and improper use-related actions. Our findings demonstrate how health records misuse can emerge in sociotechnical health systems and impact health service delivery and patient safety.

Through contextualizing system misuse in healthcare, this research advances the understanding of ineffective use and failures in health data protection practices. Our proposed theoretical model provides explanations for unique patterns of IS misuse in healthcare, where data protection failures are consequential for healthcare organizations and patient safety.

Increasingly, healthcare providers are implementing lean practices to achieve quality results. Implementing lean healthcare practices is unique compared to manufacturing and other service industries. The purpose of this paper is to present a model that identifies and defines the lean implementation key success factors in healthcare organisations.

The model is based on an extant literature review and a case illustration that explores actual lean implementation in a major USA hospital located in a Midwestern city (approximately 300,000 people). An exploratory/descriptive study using observation and follow-up interviews was conducted to identify lean practices in the hospital.

Lean practice key drivers include growing elderly populations, rising medical expenses, decreasing insurance coverage and decreasing management support. Effectively implementing lean practices to increase bottom-line results and improve organisational integrity requires sharing goals and processes among healthcare managers and professionals.

An illustration explains the model and the study provides a sound foundation for empirical work. Practical implications are included. Lean practices minimise waste and unnecessary hospital stays while simultaneously enhancing customer values and deploying resources in supply systems. Leadership requires clear project targets based on sound front-end planning because initial implementation steps involve uncertainty and ambiguity (i.e. fuzzy front-end planning). Since top management support is crucial for implementing lean practices successfully, a heavyweight manager, who communicates well both with top managers and project team members, is an important success factor when implementing lean practices.

Increasingly, green orientation and sustainability initiatives are phrases that replaced lean practices. Effective results; e.g. waste reduction, employee satisfaction and customer values are applicable to bigger competitive challenges arising both in specific organisations and inter-organisational networks.

Healthcare managers are adopting business practices that improve efficiency and productivity while ensuring their healthcare mission and guaranteeing that customer values are achieved. Shared understanding about complex goals (e.g. reducing waste and enhancing customer value) at the front-end is crucial for implementing successful lean practices. In particular, this study shows that nursing practices, which are both labour intensive and technology enabled, are good candidates for lean practice.

The purpose of this paper is to explore the formation and composition of “regions” as places of care, both empirically and conceptually.

This paper draws on action-oriented research involving experiments aimed at designing, implementing and evaluating promising solutions to the entwined problems of a burgeoning elderly population and an increasing shortage of medical staff. It draws on ethnographic research conducted in 14 administrative areas in the Netherlands, a total of 273 in-depth interviews and over 1,000 h of observations.

This research challenges the understanding of a healthcare region as a clearly bounded topological area. It shows that organizations and professionals collaborate in a variety of different networks, some conterminous with the administrative region established by policymakers and others not. These networks are by nature unstable and dynamic. Attempts to form new regional collaborations with neighbouring organizations are complicated by existing healthcare governance and accountability structures that position organizations as competitors.

Policymakers should take the pre-established partnerships of healthcare organizations into account before delineating the area in which regionalization is meant to take place. A better alignment of governance and accountability structures is also needed for regionalization to occur in healthcare.

This paper combines insights from valuation studies with sociogeographical literature and provides a framework for understanding the assembling and disassembling of “regions”.

This paper aims to describe relationships among healthcare professionals in a French public hospital using social network analysis (SNA) and to improve health service quality by strengthening health service management and leadership.

This study was based on a questionnaire sent to randomly selected French public hospital professionals and administrators. Network composition measures were obtained using a name generator. Analysis focused on three main indicators: “centrality”, “prestige”, and “clique participants”. The SNA was carried out using UCINET^® and statistical analyses were performed with SPSS version 15.0.

A total of 104 questionnaires were returned and analysed. Centrality, prestige and clique indicators were highly correlated (all p‐value were less than 0.01). Physicians had the highest scores for the three indicators. Older age (≥45 years) was associated with higher centrality and clique numbers scores. Transversal activity was associated with higher scores than other specific activities (hospitalisation, ambulatory care), except for emergency care.

The paper shows how networks and SNA techniques provide novel and useful means to understand communication and collaboration between hospital professionals.

Drawing on the experiences of healthcare professionals in one paediatric hospital, this paper explores the influence of context and organisational behaviour on the implementation of a person-centred transition programme for adolescents and young adults (AYA) with long-term conditions.

A single embedded qualitative case study design informed by a realist evaluation framework, was used. Participants who had experience of implementing the transition programme were recruited from across seven individual services within the healthcare organisation. The data were gathered through semi-structured interviews (n = 20) and analysed using thematic analysis.

Implementation of the transition programme was influenced by the complex interaction of macro, meso and micro processes and contexts. Features of organisational behaviour including routines and habits, culture, organisational readiness for change and professional relationships shaped professional decision-making around programme implementation.

There exists a significant body of research relating to the role of context and its influence on the successful implementation of complex healthcare interventions. However, within the area of healthcare transition there is little published evidence on the role that organisational behaviour and contextual factors play in influencing transition programme implementation. This paper provides an in-depth understanding of how organisational behaviour and contextual factors affect transition programme implementation.

Lean concept is implemented in healthcare organizations, as it deals with improvement processes so that best services may be provided to the patients and competitive advantage may be achieved. The purpose of this paper is to evaluate the important factors which influence implementation of lean principles in the healthcare industry.

The factors influencing lean implementation in the healthcare industry have been determined through literature review and results of a survey where questionnaires were distributed among 325 healthcare professionals. Fuzzy Interpretive Structural Modeling (FISM) approach has been used to analyze the interrelationships among these factors. A FISM model has been developed to extract the key factors influencing lean implementation.

Results of the survey and model show that lean leadership, professional organizational culture and teamwork and interdepartmental cooperation are the top level factors. Clarity of organizational vision, communication of goals and results, follow up and evaluations are the factors with strong driving as well as strong dependence power. Even a slight action taken on these factors will have a significant impact on other factors.

The healthcare professionals and managers can acquire information from the drive power dependence matrix so that they can thoroughly understand the relative importance, interdependencies and relationships among these factors. The model will help in determining the hierarchy of various actions and activities which may be taken by the management for managing the factors that remarkably affect the lean management in hospitals.

In this paper, only 15 variables appropriate for the Indian healthcare industry have been identified. The model developed in the present research has not been validated statistically which can be done by structural equation modeling (SEM).

Though there are various studies which depict that lean principles have been implemented successfully in various industries, there are few studies specifying the application of lean principles in healthcare sector in India. This paper is an attempt to identify various factors which are important for application of Lean concept in the healthcare sector.

The purpose of this paper is to examine how rhetoric of cooperation is expressed and constructed during rituals of consultation and how this rhetoric is integrated into the consultant’s dramaturgical awareness that incorporates both impression management and the expression of self.

This paper uses a discursive approach and semi-structured interviews with directors and consultants working in the healthcare sector, a sector that routinely employs consultants to accompany directors in organizational change management. Rhetoric is constructed around four narrative lines that also constitute the four ritualized phases of the consulting process.

The mantra of “respect rituals of passage and avoid breaking frames” is an integral part of the consultant’s dramaturgical awareness throughout the process, so as not to infringe upon the order of the interaction established with the directors. Moreover, the development of cooperative relations with other members of the organization is based largely on a rather vast repertoire of action resources that the consultant will have to deploy to face four areas of uncertainty in the rites of interaction; namely, anticipation, interpretation, delegation and adherence. Furthermore, this cooperation is far from definitively acquired and must be reflected upon along the way to maintain control over the definition of the situation. This study expands upon the interrelations between the strategic actor and the reflective practitioner in a consultant’s dramaturgical awareness.

Practical implications are highlighted using the notion of reflective contract (Schön, 1983) for managers as clients, the transcendental precepts of authenticity put forward by Coghland (2008) for consultants as practitioners, and progressive forms of critical theory performativity as suggested by Spicer et al. (2009) and Wickert and Schaefer (2015) for researchers.

The concept underlying this study is dramaturgical awareness. It is a concept but sparingly explored in the literature, yet nonetheless present among advocates who promote organizational dramaturgy based on the work of Goffman. This concept is linked to Crozier and Friedberg’s theory of the strategic actor and Schön’s theory of the reflective practitioner.

This ethnographic revisit of a general hospital aims to critically explore and describe the mechanisms of corporate culture change and how institutional excellence is facilitated and constrained by everyday management practices between 1996/1997 and 2014/2015.

A five-month field study of day-to-day life in the hospital's nursing division was conducted by means of an ethnographic revisit, using participant-observation, semi-structured interviews, free conversations and documentary material.

Using labour process analysis with ethnographic data from a general hospital, the corporate culture is represented as faceted, complex and sophisticated, lending little support to the managerial claims that if corporate objectives are realised, they are achieved through some combination of shared values, beliefs and managerial practices. The findings tend to support the critical view in labour process writing that modern managerial initiatives lead to tightened corporate control, advanced employee subjection and extensive effort intensification. The findings demonstrate the way in which the nursing employees enthusiastically embrace many aspects of the managerial message and yet, at the same time, still remain suspicious and distance themselves from it through misbehaviour and adaptation, and, in some cases, use the rhetoric against management for their own ends.

What are the implications for clinical and managerial practitioners? The recommendations are to (1) develop managerial practitioners who are capable of managing change combined with the professional autonomy of clinical practitioners, (2) take care to practise what you preach in clinical and managerial reality, as commitment, consent, compliance and difference of opinion are signs of a healthy corporate culture and (3) consider the implications between social structures and human actions with different work behaviours on different levels involved.

This ethnographic revisit considers data from a labour process analysis of corporate culture change in a general hospital and revisits the ways in which contradictory expectations and pressures are experienced by nursing employees and management practitioners spread 17 years apart.

This paper aims to propose that healthcare is dominated by a managerialist ideology, powerfully shaped by business schools and embodied in the Masters in Business Administration. It suggests that there may be unconscious collusion between universities, healthcare employers and student leaders and managers.

Based on a review of relevant literature, the paper examines critiques of managerialism generally and explores the assumptions behind leadership development. It draws upon work which suggests that leading in healthcare organisations is fundamentally different and proposes that leadership development should be more practice-based.

The way forward for higher education institutions is to include work- or practice-based approaches alongside academic approaches.

The paper suggests that there is a challenge for higher education institutions to adopt and integrate practice-based development methods into their programme designs.

The paper provides a challenge to the future role of higher education institutions in developing leadership in healthcare.