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The authors explored clinical staff perceptions of their interactions with middle management and their experiences of the uncongeniality of their working environment.

Semi-structured interviews of clinical staff from an Australian public health service's Emergency, Surgery and Psychiatry departments. Volunteer interview transcripts were inductively coded using a reflexive thematic content analysis.

Of 73 interviews, 66 participants discussed their interactions with management. Most clinicians considered their interactions with middle management to be negative based on a violation of their expectations of support in the workplace. Collectively, these interactions formed the basis of clinical staff perceptions of management's lack of capacity and fit for the needs of staff to perform their roles.

Strategies to improve management's fit with clinicians' needs may be beneficial for reducing uncongenial workplaces for healthcare staff and enhanced patient care.

This article is among the few papers that discuss interactions with management from the perspective of clinical staff in healthcare. How these perspectives inform the perception of workplace uncongeniality for clinicians contributes greater understanding of the factors contributing to adversarial relationships between clinicians and managers.

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 paper is to explore how leadership is practiced across four different hospital units.

The study is a comparative case study of four hospital units, based on detailed observations of the everyday work practices, interactions and interviews with ten interdisciplinary clinical managers.

Comparing leadership as configurations of practices across four different clinical settings, the author shows how flexible and often shared leadership practices were embedded in and central to the core clinical work in all units studied here, especially in more unpredictable work settings. Practices of symbolic work and emotional support to staff were particularly important when patients were severely ill.

Based on a study conducted with qualitative methods, these results cannot be expected to apply in all clinical settings. Future research is invited to extend the findings presented here by exploring leadership practices from a micro-level perspective in additional health care contexts: particularly the embedded and emergent nature of such practices.

This paper shows leadership practices to be primarily embedded in the clinical work and often shared across organizational or professional boundaries.

This paper demonstrated how leadership practices are embedded in the everyday work in hospital units. Moreover, the analysis shows how configurations of leadership practices varied in four different clinical settings, thus contributing with contextual accounts of leadership as practice, and suggested “configurations of practice” as a way to carve out similarities and differences in leadership practices across settings.

The term ‘digital assistive technology' refers to the use of ICTs for the support of older people's everyday tasks. These tasks could range from online shopping to information seeking and searching the web in a variety of ways eg. by the use of desktop or ubiquitous computing. Currently, research under the New Dynamics of Ageing Programme, funded by the ESRC, EPSRC, BBSRC, MRC and AHRC, and research funded by other bodies, including SPARC, tries to improve older people's quality of life through the exploitation and exploration of new developments in computing and information technology. However, the acceptance rate of digital assistive technology by older people is still low, while the abandonment of already existing technologies increases. The purpose of this paper is to propose a framework for process requirements to inform the decision‐making of designers and implementers of digital assistive technologies. These process requirements should facilitate the development of more adaptable user‐centred systems that can dynamically accommodate the changing needs of older people and decrease the rate of abandonment of digital assistive technologies.

Communities of Practice (CoPs) are increasingly being created to facilitate knowledge mobilization in organizations. This paper aims to elucidate an underexplored aspect of participation in mandated CoPs – identity reconciliation. Specifically, the authors explore how actors reconcile their existing identities with becoming members of new knowledge mobilization CoPs.

The authors conducted a longitudinal qualitative case study over a 12-month period to explore identity reconciliation practices during the formation of the “ED CoP” – mandated by policymakers to mobilize knowledge between process improvement advisors and clinicians from various hospitals. Observation and interviews allowed us to uncover “front stage” and “backstage” practices of identity reconciliation.

The findings reveal two key unexpected modes of identity reconciliation – “distancing” and “peripheral lurking”. These modes resulted in different trajectories of participation of two of the key participant groups – “veteran” improvement advisors and “veteran” clinicians.

Different modes of identity reconciliation of different participants impact the formation of CoPs and how knowledge mobilization occurs within them. This paper offers a sensitizing lens for practitioners creating CoPs which enhances awareness of hidden identity practices, and recommendations to enable practitioners to effectively facilitate CoP formation.

This study suggests that identity reconciliation is an integral aspect of CoP formation, and essential for knowledge mobilization within CoPs. Whereas studies on CoPs in the knowledge management literature have mostly assumed that collaboration produces beneficial knowledge mobilization outcomes, the findings build a more nuanced picture of the processes involved in producing these outcomes.

Public sector reforms of recent decades in Europe have promoted managerialism and aimed at introducing private sector thinking and practices. However, with regard to public sector executives’ self-understanding, managerial role identities have not replaced bureaucratic ones; rather, components from both paradigms were combined. In this chapter, we introduce a bi-dimensional identity approach (attitudes and practices) that allows for different combinations and forms of hybridity. Empirically, we explore the role identities of public sector executives across Europe, building on survey data from over 7,000 top public officials in 19 countries (COCOPS survey). We identify country-level profiles, as well as patterns across countries, and find that administrative traditions can account for these profiles and patterns only to a limited extent. Rather, they have to be complemented by factors such as stability of the institutional environment (indicating lower shares of hybrid combinations) or extent of reform pressures (indicating higher shares of hybrid combinations).

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.

This paper examines the influence of facilitators and barriers on employees’ preference to work in a hybrid model. The study uses the theoretical lens of stimulus-organism-response (SOR) and dual factor theory (DFT). It examines the influence of health consciousness (stimulus), facilitators (e.g. work flexibility, work–life balance and team building) (organism) and barriers (e.g. pandemic and travel stressor and role overload [organism] on employees’ preference to work in a hybrid model) (response). Further, it tests the moderating influence of organizational culture.

A questionnaire survey was conducted among employees in India, Sri Lanka and Germany, obtaining 281 usable questionnaires. Structural equation modeling (SEM) using Warp PLS 7.0 was used as the analytical technique to examine the model fit and test hypotheses.

The findings reveal that health consciousness is essential in enhancing facilitators and motivating employees to prefer a hybrid working model. The study’s findings also prove the positive influence of work flexibility, work–life balance and team building as facilitators. The results suggest that pandemic and travel stressors inhibit employees’ preference for working in a hybrid model.

The study is based on a cross-sectional research design to generalise the findings. Future researchers can utilize longitudinal design to decipher the variation in response over time. The study has developed a model combining SOR with DFT; the authors suggest that future researchers use other theories in combination with SOR, like self-determination theory (SDT), to decipher the influence of intrinsic and extrinsic motivation of employees in the context of the hybrid working model.

This study identifies the need for open communication with the employees to overcome their concerns regarding the hybrid working model. The study also suggests that human resource (HR) managers need to prioritize the task that needs to be accomplished from the office versus working from home. The authors recommend various measures, like water cooler breaks and a buddy system, to motivate employees to work in a hybrid model.

This study is among the first studies focused on the hybrid working model. The current study adds to the limited literature on the facilitators and barriers of working in a hybrid work model.

This chapter takes a new approach to emotions through the lens of a relational identity among hybrid professionals, using those in healthcare as particularly relevant examples. Sharpening the focus on underpinning emotional dynamics may further explain how professional managers can be effective in hybrid roles. The chapter seeks to build on the internal emotional states of these professional managers by understanding how outward emotional displays might influence their subordinates. The understanding of how emotional states/displays in manager–employee relationships influence target behaviors may help multiprofessional organizations generate better-informed leadership practice in relation to desired organizational outcomes, e.g. more efficient and effective health services.

This article focusses on the hybrid strategy, a simultaneous combination of cost leadership and differentiation strategy. The study aims to examine the impact of hybrid strategy on firm performance through its anticipated positive effects on process and product innovation. In addition, we study the moderating role of adaptive capacity in the direct relationships of hybrid strategy with process and product innovation.

Structural equation modelling was used to analyse 1,842 Spanish firms with fewer than 250 employees. We randomly selected small and medium-sized enterprises (SMEs) operating in Spain from the Spanish Central Business Directory (2021) database. The overall sample design was based on stratified sampling.

We found that hybrid strategy is positively related to firm performance and to process and product innovation. Additionally, in firms implementing hybrid strategies, process innovation fostered firm performance. Finally, adaptive capacity strengthened the relationships of hybrid strategy with process and product innovation. This sheds light on how and when hybrid strategy is most effective in fostering SME performance.

We highlight that SMEs need to establish strategies that use diverse resources and capabilities and not just generate competitive advantage using one strategy (cost leadership or differentiation strategy). This requires an agile and flexible systems and structures.

Our research provides novel results by proposing the adoption of hybrid strategies instead of pure strategies (cost leadership and differentiation strategy) as a way for SMEs to survive during crises. Unlike “stuck in the middle” strategies, our study demonstrates the importance of hybrid strategies in a comprehensive model that links them to innovation and firm performance, with adaptive capacity being a determining factor.