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The purpose of this paper is to bring the discussion on the relationship between management and medicine a step forward by focussing on: first, how the notion of hybrid and hybridity has been used in the literature on healthcare management. Second, the authors have mapped the alternative ways that the concept have been used in order to conceptualize a more specific set of possible combinations of managerial and professional roles in healthcare management. Hybrid management is a topic that ought to be important for training, communication among researchers and for identifying areas of future research: in management, in healthcare reforms, in sociology of professions and in theory of organizations.

The authors provide a systematic literature review in order to map the various conceptualizations of hybrid management. The authors have searched for “hybrid leadership,” “hybrid management” combined with hospitals and health care in a whole range of journals, identified in Google scholar, Academic Search Premier, Academic Research Library and Sage Publication. The authors have also used already existing literature reviews. The search has resulted in more than 60 articles and book titles that have been classified according to whether they make a fit with three alternative ways of conceptualizing hybrid management. The authors are aware that they might have missed some relevant literature but the literature included is quite comprehensive.

In the literature the authors have found three conceptualizations of management. The clinical manager who combines professional self-governance with a general management logic. The commercialized manager who combines professional self-governance with an enterprise logic. The neo-bureaucratic manager who combines self-governance with a neo-bureaucratic logic.

In most analyses of hybridity in management and organization the notion of hybrid has been used in a rather superficial way. By mapping the various uses of hybrid in the literature and suggest how a professional logic may be combined with a set of alternative logics of management the authors provide a platform for developing the concept of hybrid management into a more useful tool for analyses of changes in healthcare management.

The article seeks to explain whether and how value-based healthcare principles lead to hybridization. The public management literature has been increasingly interested in hybrid forms of governance and hybrid performance management, but empirical studies are still rare. Further, the article studies the design of performance management and accounting systems as healthcare organizations reorganize their care processes applying value-based healthcare principles.

This article first connects the theoretical discussions on value-based healthcare and performance management for hybrids. The conceptual understanding of performance management in hybrid healthcare uses a case study of a Finnish healthcare organization with documentary data and transcribed interviews with healthcare professionals from both the strategic and operative levels of healthcare.

The article illustrates and analyses how new policy-level objectives and principles of value-based healthcare led to hybridity in healthcare, manifest in mixed ownership of a particular care path and new forms of social and financial control. Further, the article provides empirical evidence of how increased hybridity necessitated new organizational modes and roles, new managerial tools for performance management and created a need to develop the capability to account and measure entire integrated care processes. Important enabling factors for the integration of care and hybrid performance management were commitment created in dialogue, voluntary-based trust and technology to generate factual shared information.

The study is informative for stakeholders, funders and managers of healthcare organizations, namely new knowledge for the discussion of hybrid governance in healthcare, including a critical account of the applicability and impact of a hybrid service model in healthcare management. Moreover, the article illustrates what needs to be reconsidered in performance management and accounting practices when reorganizing care processes according to the principles of value-based healthcare.

The article extends the analysis of performance management in hybrids and sheds new light on hybridization in healthcare. It also provides much-needed empirical evidence on the processes and practices of accounting and performance management after implementing a value-based healthcare strategy.

Fragmentation can inhibit joint goals and performance measures. Therefore, the purpose of this study is to investigate the level of fragmentation between public, private and third sectors in a hybrid organization's performance management systems and the effects of this fragmentation to propose hypotheses and new research methods for future studies.

The inductive research design was based on a mixed method approach. As empirical data, a survey, interviews and documents were used in this case study examining a hybrid organization called Welfare Alliance.

The results showed low-level fragmentation in the performance management system of the hybrid. Although the level of fragmentation was low-level, it affected the hybrid's ability to implement joint performance goals and measures. Performance management practices suffered as a consequence.

As a theoretical contribution to research addressing performance management in hybrids, the study proposes new concepts and theoretical hypotheses concerning fragmented performance management systems in hybrids. These theoretical hypotheses propose how performance goals and measures can become fragmented because they isolate service production units and activities from each other. The proposed hypotheses for future studies also attempt to provide explanations for how fragmentation can spread from one management function to another (i.e. from goal setting to performance measurement).

This research aimed to explore whether different project management approaches (traditional, agile or hybrid) differentiate concerning their impact on project success, taking project success as multidimensional phenomena. In addition to this, the authors wanted to explore if specific project characteristics moderate these effects.

The authors empirically addressed these on a sample of 227 project professionals worldwide. The exploratory factor analysis (EFA) of project success dimensions was done to validate these factors' constitution concerning their manifest variables. The K-means cluster method was used to distinguish respondents' profiles among agile, hybrid and traditional project management approaches. To test the significance among research groups, the research hypotheses were tested with ANOVA tests.

The authors evidenced that the agile approach has a more significant positive impact concerning the two out of five dimensions of project success, under analysis in this research (impact on the team and preparing for the future), over the traditional approach.

The research is relevant for project management practitioners to tailor the success-oriented project management approach and for academics to develop project management contingency theory.

The authors constructed a research framework to test the impact and effectiveness of different project management approaches (traditional, agile, hybrid) on the dimensions of project success in different contextual conditions (organization industry, project type, novelty, technology, complexity and pace). The paper's main contribution is to expand data on the impact of these approaches on project success and compare them with relevant results and findings of previous research.

Drawing on paradox theory, this study explores how ambidextrous sustainability relates to organisational performance in hybrid organisations represented by Swedish municipal housing corporations, and how this relationship is contingent on the organisational structure of these organisations.

The study relies on the data collected from Swedish municipal housing corporations. These data sources consist of a survey sent to the management team members in Swedish municipal housing corporations, financial and non-financial archival data on these corporations, interviews with the management team and board members, and observations of meetings involving the management team and board of directors at a Swedish municipal housing corporation. Quantitative data of the study were analysed using descriptive statistics, correlation analysis and linear multiple regression analysis. Qualitative data were analysed employing deductive thematic analysis and were used to illustrate and discuss the results of the quantitative analysis.

The quantitative findings show that ambidextrous sustainability, i.e. the alignment between an explorative orientation and an exploitative orientation towards sustainability, has a weakly positive relationship with financial performance and a positive relationship with social performance in hybrid organisations represented by Swedish municipal housing corporations. The study further shows that a high level of the structural element “connectedness” weakened the relationship between the ambidextrous sustainability and financial performance of the organisation in the study. In contrast, a lower level of connectedness reinforced and strengthened this relationship. Our qualitative material illustrates how the quantitative findings could be explained by the interaction between the board of directors and the management team of these hybrid organisations.

The study shows how ambidextrous sustainability, employed for conceptualisation of the sustainability strategy in hybrid organisations, represented by Swedish municipal housing corporations, can impact on facets of performance (i.e. financial, social and environmental) differently. The study further highlights the importance of organisational structures in these relationships in a hybrid context.

COVID-19 has forced Big 4 firms to challenge existing management control arrangements and adapt their ways of working. Yet, we know little about how management control might be enacted in the future of the sustainable workplace. The objective of the study is to examine the patterns of management control change in the Big 4 accounting firms during the COVID-19 pandemic.

Adopting an exploratory qualitative research design, the authors draw on 42 interviews with directors and associates in the Big 4 professional services firms.

The findings reveal two pathways of management control change including alignment and displacement. The authors found that relatively minor adaptions to action and result controls were relied upon to respond to substantial cultural and personnel control changes.

The contributions are threefold: the authors take a temporal perspective to (1) unpack the changes to management control arrangements; (2) theorise the findings by developing a three-dimensional taxonomy of change pathways encompassing pace, scope and longevity of management control change and (3) contextualise management control arrangements in a hybrid work setting.

1. COVID-19 has forced Big 4 firms to challenge existing management control arrangements.

2. Literature has focused on traditional, onsite work settings and largely ignored change pathways.

3. The authors take a temporal perspective to unpack changes to management control arrangements.

4. Big 4 firms adapted to hybrid work with substantial changes to personnel and cultural controls.

5. The authors theorise the findings by developing a three-dimensional taxonomy of change pathways.

COVID-19 has forced Big 4 firms to challenge existing management control arrangements.

Literature has focused on traditional, onsite work settings and largely ignored change pathways.

The authors take a temporal perspective to unpack changes to management control arrangements.

Big 4 firms adapted to hybrid work with substantial changes to personnel and cultural controls.

The authors theorise the findings by developing a three-dimensional taxonomy of change pathways.

This article is drawn from doctoral research exploring the identity struggles faced by professionals who take on management and leadership roles. The research focused on the experience of medical directors – the most senior doctor‐manager with board responsibility for medical affairs. Based on the fact that a medical director is a hybrid manager this research has implications for any professional who takes on a managerial or leadership role while continuing to practice their profession. Some challenges of working as a hybrid are associated with the difference in orientations between professionals and managers. While the notion of who and what a professional is has changed and new forms of accommodation have been forged the hybrid identity remains a site of potential conflict for the individual and those they work with. The purpose of this paper is to explore the experience of the hybrid identity.

The experience of the hybrid identity is explored through social identity theory (Tajfel and Turner).

The analysis reveals that the medical director role is ambiguous, that medical identity is robust and that medical management is difficult compared to clinical work. Managerial identity in general is constructed negatively and from the perspective of doctors. The importance of maintaining clinical credibility is both embraced as a resource which bolsters and maintains medical identity and so distinguishes medical directors from the taint associated with the pejorative managerial identity that doctors construct of managers.

The implications for the selection, training and development of doctors and medical directors are raised as are those for the relationship between doctors and patients, and doctors and the organisation. Some implications identified, specifically for leadership in practice are as follows: leadership/management is challenging and difficult compared to professional work; language use is significant for how leaders are perceived; language use has implications for leader effectiveness; early exposure to leadership for professionals is important; and leadership role definition is important for consistency and role credibility.

As hybrid organizations become increasingly common, the authors observe that some hybrid forms are becoming institutionalized and legitimated. The authors explore the implications of the institutionalization of hybridity, addressing both the internal tensions that plague many hybrids and the external tensions stemming from evaluator assessments and stakeholder uncertainty. The authors propose that institutionalization can dampen internal tensions associated with hybridity and also facilitate legitimation and acceptance by external audiences. The authors present identity as a useful theoretical lens through which to examine these questions, as identities are born from, but also have the potential to modify, existing institutional arrangements. The authors present directions for future research at the juncture of identity, hybridity, and institutionalization, suggesting potential avenues of inquiry in this productive stream of research.

The purpose of this paper is to explore if the application of a framework building on organisational learning focusing on organisational processes can increase our understanding of how hybrid organisation develops over time and why they fail to live up to external expectations.

The aim of this study is descriptive and explorative. It is accordingly designed as a qualitatively oriented case study. To capture the process of forming and developing hybrid organisations, the study takes a longitudinal approach. The case chosen for the study is a municipally owned company in Sweden providing waste management services. The study revolves around empirical data gathered in official documents and in face-to-face interviews. All the data concern the time span between 2004 and 2016.

The analysis of the case studied provides us with insights into how hybridity manifests itself in mind-set and processes. There is a need for individuals within and around the organisation to be aware of and accept new goals and strategies to change their behaviour accordingly. The result of this study thus shows that contrary to findings in previous research on hybrid organisations, merely changing the structure of the organisation is not sufficient. Instead, learning is key to the development of hybridity and to overcome goal incongruence and conflicts of interest in hybrid organisations. However, this takes time and is likely to be dependent on individuals’ willingness to accept and adapt these new strategies and goals.

The result of this study is based on one single case study in one specific hybrid context. No empirical generalisation is aspired to. Instead, the aim has been to – through an explorative approach – make an analytical contribution to the knowledge about hybrid organisations. Further studies are thus necessary to deepen the understanding of the hybrid context and the situations under which hybrid organisations operate and develop.

Based on the result from this study, it seems that an organisation needs to learn how to be a hybrid organisation. There are no isolated structural solutions that can create a hybrid organisation other than in a formal sense. New ways to exploit organisational resources and the hybrid context are necessary to find new and innovative ways of how to use the hybrid context in a way that improves service sector delivery.

Predominately, research on hybrid organisations has until recently been working with the premise that hybrids are not a breed of its own but a mix of two or several ideal types. Consequently, the result from this type of research has often landed in a conclusion regarding the complexity of combining what often is considered contradictory and conflicting goals. In this paper, a different and novel approach is taken. The paper illustrates how hybrid organisations develop over time, and it suggests that hybridity manifests itself in mindset and processes. The main contribution is an exploration and illustration of how organisational learning may be considered as the missing link between the structural orientation of previous explanations of hybrid organisations and the organisational property of hybridity. Hybridity is the result of exposure to, acceptance of and adaptation to new goals and strategies and expresses itself in “hybrid behaviour”.

The purpose of this paper is to analyse role transition for professionals moving towards hybrid managerial roles. Specifically, the authors examine reforms to the national tax agency in the UK, focusing on attempts to shift hybrid managers away from a focus on tax compliance, to a greater customer focus. This extends understanding of the relationship between New Public Management (NPM) and the public professions, by offering greater insight into the dynamic between regulators and regulatees, as professionals are co-opted into management roles that encompass greater customer orientation.

The authors draw on documentary data relating to reform from 2003 to 2012 and 43 semi-structured interviews with senior tax inspectors co-opted into hybrid manager roles.

The findings support established accounts of the effect of NPM reform to public professions, as these professionals are co-opted into hybrid management roles. Some hybrid managers resist, others embrace the demands of the new role. Linked to a hitherto neglected aspect of analysis (the extent to which hybrid managers embrace a greater customer orientation) the findings also show a more novel third response: some hybrid managers leave the national tax agency for opportunities in the private sector. These public-to-private professionals the authors call “canny customers”. Canny customers are ideally placed to exploit aspects of NPM reform, and thereby accelerate changes in the governance of public agencies, but in a way that might undermine the function of the tax agency and tax professions.

In regulatory settings, policy reform to co-opt professionals into hybrid managerial roles may have mixed effects. In settings where a focal dynamic is the regulator-regulatee relationship, effective governance will require understanding of the labour market to temper excess influence by those hybrid managers who become canny customers, otherwise, in settings where it is easy for individuals to move from regulator to regulatee, the pace and consequences of reform will be harder to govern. This runs the danger of eroding professional values. The specific case of tax professionals reflects themes in the literature examining hybridisation for accountants, and provides novel insight into the dynamics of professionalism that extend to the case of accountants.

The contribution is to extend the literature on role transition of professionals. The authors focus on hybrid managers in the context of a regulatory agency: the UK national tax agency. Policy reforms associated with hybridisation emphasised customer orientation. The authors highlight labour market characteristics impacting the regulator-regulatee dynamic, and an as yet unexplored, unintended consequence of reform. The public professional who leaves for the private sector becomes a “canny customer” who can exploit and accelerate reform.