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The purpose of this paper is to investigate if a rational perspective can be used to interpret cooperation problems in a health care organisation. This perspective is proposed as a complementary perspective to the cultural perspective that dominates as an explanation of cooperation problems. The focus of the research is multiprofessional teamwork in contemporary Swedish health care.

Four cases studies, in which the cooperation in daily work is described, are used to test the two perspectives. The cases concern the cooperative methods health care professionals use when work conditions depend upon an internal norm of mutual cooperation. Although the research is not designed to evaluate the two perspectives, it permits the rational explanations of cooperation problems to be compared with possibly cultural explanations.

The investigation concludes that health care cooperation problems may be primarily explained by the rational perspective, and only secondarily by the cultural perspective. The actors can be seen as underinstitutionalised in the sense they have not yet developed the intra‐organisational norms of cooperation needed for the provision of customised health care.

The paper provides a complementary explanatory framework of cooperation problems based on actors' perceptions of their self‐interests as producers. The examples of uncooperative behaviour reflect two forms of the free rider problem that Ostrom describes as a Common Pool Resource Problem. Management has to prove that cooperation is beneficial to the team members and has to promote a cooperative team spirit by instilling a common understanding of the concept of cooperation.

Inclusive education is about creating beneficial environments for all students (Booth & Ainscow, 2011). Within Germany, the role of special education within inclusive schools has been widely discussed (Powell et al., 2016). Educators worldwide consider collaborative teaching between special educators and general educators to be a fundamental precondition for inclusive education (Hoppey & McLeskey, 2014).

The history of the German school system, however, is characterized by a rigorous division of special and regular schools that is reflective of broad divisions in teacher education. Since the ratification of the Convention on the Rights of Persons with Disabilities (CRPD) in Germany in 2009, more students with special educational needs, as well as special educators, have begun to attend and work in inclusive schools. While cooperation between general and special educators is a key to the development of inclusive schools, many teachers report that responsibilities are divided between special and general teachers, while various challenges exist regarding cooperation (Urban & Lütje-Klose, 2014). Nevertheless, dysfunctional cooperation can foster mechanisms of separation and exclusion even in “inclusive” settings (Idel et al., 2019).

The present chapter offers a reflection on the different roles of special educators and the current state of research on interdisciplinary and multiprofessional cooperation in inclusive schools in Germany. It also provides a discussion of relevant implications for the development of inclusive schools and teacher training.

The goal of integrated, multidisciplinary and person-centered care is on the welfare policy agenda in many countries, but how about integrated service delivery in action? This paper describes a three-year service journey of an elderly person from home to a nursing home through home care, specialized hospital and inpatient care. The aim of this viewpoint paper is to consider how customer orientation and integration are realized when an older lady living an active life becomes seriously ill and loses the ability to conduct daily functions.

The service path will be described from the perspective of a relative.

The paper raises questions related to governance as well as multidisciplinary and customer orientation in integrated care.

The paper discusses a real-life experience of an elderly care journey from active senior life to a nursing home in Finland. When making visible an elderly care journey, this gives real-life information about the challenges and the needs for development. Better practical understanding helps to remove inter-organizational barriers toward more integrated and patient safe care.

The discussion about public sector performance is still present today, despite the profound research that has already tried to address this subject. Furthermore, theory links negative effects on organizational performance with increased levels of organizational complexity. However, literature thus far did not succeed to put forward a successful theory that explains why and how public organizations became increasingly complex. To answer this question, we argue that increased organizational complexity can be explained by viewing public organizations as the hybrid result of different institutional logics, which are shaped by various management views. However, former research mainly concentrated on the separate study of management views such as traditional public management (TPM), NPM, and post-NPM. Although appealing, research that approaches hybridity from this perspective is fairly limited.

We conducted a literature review in which we studied 80 articles about traditional public management, NPM, and post-NPM.

We found that these management views essentially differ on the base of three fault lines, depending on the level of the organizational culture. These fault lines, according to the management view, together result in nine dimensions. By combing dimensions of the different management views, we argue that a public organization becomes hybrid. Furthermore, in line with findings of contingency theory, we explain the level of hybridity might depend on the level of tight coupling for a given organization. Finally, we developed propositions that explain hybridity as the result of isomorphic forces, organizational change, and organizational resistance to change and that link hybridization with processes of selective coupling.

The value of this chapter lies in its real-life applicability.

Nurse leaders are challenged by ethical issues in today’s complex health-care settings. The purpose of this study was to describe and analyze key elements of moral distress identified by nurse leaders from health-care systems in the USA, Germany, Austria and Switzerland. The aim was to develop an understanding of distressing ethical issues nurse leaders face in the USA and three German-speaking European countries.

This descriptive cross-sectional study surveyed a convenience sample of nurse leaders in the USA, Germany, Austria and Switzerland. The voluntary, anonymous survey also included qualitative questions and was distributed using the Qualtrics® platform. A thematic analysis of the qualitative data in each country was carried out and a comparative analysis identified similarities and differences between the groups of nurse leaders comparing the US data to that from three German-speaking European countries.

The survey was completed by 316 nurse leaders: Germany, Austria, and Switzerland (n = 225) and the USA (n = 91). Similar themes identified as causing all nurse leaders moral distress included a lack of individual and organizational integrity, hierarchical and interprofessional issues, lack of nursing professionalism, patient care/patient safety concerns, finances negatively impacting care and issues around social justice. Within these six themes, there were also differences between the USA and the three German-speaking European countries.

Understanding the experiences associated with distressing ethical situations can allow nurse leaders and organizations to focus on solutions and develop resilience to reduce moral distress in the USA and three German-speaking European countries.

The purpose of this study is to describe the perceptions of registered nurses (RNs), enrolled nurses (ENs), and leaders (i.e. the first‐line nurse manager, F‐LNM and the substitute F‐LNM) as to what characterises an excellent work environment in a palliative care unit and the involvement of leadership in that environment.

Data were collected using two separate instruments: a questionnaire, group interviews with nurses and leaders, and documents at a palliative care unit. Qualitative content analysis was used to analyse the material.

According to the participants, the most important component at the palliative care unit was to accomplish the vision of good palliative care. Congruence in leadership, mature group functioning, adequate organisational structures and resources, and comprehensive and shared meaningfulness were all identified as essential components for fulfilling the vision.

This study indicates that fulfilling the vision of good palliative care may function as a buffer against stress in such a workplace

This article conceptualizes and constructs a comprehensive framework that can better help to answer that question – Who is accountable for social and public problems? – theoretically and practically.

Tracing the drivers behind two phenomena “accountability hole” and “accountability black hole”, stemming from “pushing power game” and “pulling power game”, respectively, this study considers (1) the three actors of society: citizens (civil society), corporations (market) and civil servants (government), and (2) the principal-agent relationship between the three actors in the face of social and public problems. As a result, the 4CAs framework that contains the three actors’ collaborative accountabilities to one another is presented.

The 4CAs model emphasizes (1) all three actors function as agents that are accountable to one another, (2) collaborative accountability beyond collaborative governance and (3) repowering citizens and corporations beyond just empowering them, i.e. returning their inherent rights and obligations to serve one another.

The 4CAs model may function as a descriptive and prescriptive lens through which the trilemma between market failure, government failure and citizen failure can be re-assessed and balanced. The model can also be used as a set of indicators for assessing and helping a society to better resolve the social and public problems collectively.

The purpose of this paper is to investigate opportunities and challenges for multi-professional paramedic-firefighter units in small municipalities in Finland.

The data were collected by means of four focus group interviews conducted with managers (N =12) and a questionnaire comprising open-ended questions for the personnel working in the units (n =73). Data from both sources were analyzed using inductive content analysis.

The empirical results suggest that the use of multi-professional units (MPUs) may be one means of providing a better standard of service in rural areas. However, the working practices and different professional backgrounds in MPUs are considered challenging by the personnel. Managers had a broader perspective; during the interviews they raised matters such as citizen characteristics, legal issues like varying working hours, and economic aspects. Both the personnel and the managers agreed on the strengths and weaknesses of the MPU model in principle.

The results of this study may clarify the opportunities and challenges posed by MPUs in rural areas from the perspectives of personnel and managers.

The study provides novel information on MPUs comprising paramedics and firefighters, who function at the interface of emergency medical services and rescue services and who have new tasks in rural areas, including home healthcare support and accident prevention.

The aim of this chapter is to describe a five-year long cooperation between seven Higher Education Institutions (Universities of Applied Sciences and Universities) in Europe. The focus of the text is to describe the structure of the Intensive Program (IP) and the pedagogical approach behind it. The aim is to introduce the results of this course. Our question in this chapter is “How can the Intensive Program support students and teachers to develop their mindset of European professional (in their own field) and what kind of pedagogical approaches and teaching methods/pedagogical solutions are needed for it?”