The emergence and organizational choices of patient advocacy associations: Evidence from the Italian context

BACKGROUND

Within many advanced healthcare systems, patient advocacy associations are gaining a more relevant role in healthcare policy decisions. These associations provide help, representation, and voice to patients and citizens. However, although their role is important, a paucity of research exists analyzing their foundation dynamics, including their organizational decision, from a managerial perspective. To fill this knowledge gap, we formulated two research questions to investigate the motivations underlying the foundation of patient advocacy associations and the institutional pressures influencing the changes that have occurred in these associations throughout their evolution.

METHODS

Using a semi-structured questionnaire developed as part of a larger research project, we collected data about 31 patient advocacy associations operating within the Italian National Health Service. We employed qualitative analysis to examine the associations' birth and evolution as well as the motivations and influences driving change within the sampled organizations.

RESULTS

Questionnaire responses provided information about the patient advocacy associations' histories and highlighted their close links with the Italian National Health Service. Our results indicated the motivations for the associations' establishment could be grouped into five categories: support at the system level, patient protection and support, actions to increase awareness, actions for improving patients' health and quality of life, and dissemination of knowledge. We also identified the frequency and nature of the changes within the associations and explored the institutional pressures that influenced these organizational changes.

CONCLUSIONS

The results can be interpreted considering the organizational theories that focus on organizations' establishment decisions and how external pressures impact organizations' dynamics and evolution.

How Professional and Market Logics and the Conflict between Institutional Demands Affect Hospital Accreditation Compliance: A Multiple-Case Study in Brazil

Hospital accreditation has become ubiquitous in developing countries. While research acknowledges that accreditation can enhance healthcare quality, efficiency, and safety, concerns persist regarding hospitals' management of conflicts stemming from the diverse institutional logic inherent in this process. Therefore, this study aimed to investigate how professional and market logic, alongside conflicts arising from institutional demands, affect compliance with hospital accreditation. To this end, we conducted a multiple-case study in four Brazilian hospitals employing in-depth interviews and on-site observations. The triangulation of narrative analysis and the outcomes of multiple correspondence analysis revealed that when professional logic predominates, there is a greater propensity to tailor accredited activities by segmenting the tasks between physicians and nurses with the intention of mitigating existing conflicts. Conversely, when conflicts occur over established goals between professionals and orientated marked logic executives, the accreditation process is impeded, resulting in non-compliance. Ultimately, the findings underscore the alignment between the pursuit of legitimacy and efficiency within the accreditation process. We conclude by delineating the theoretical and practical implications of scrutinizing the internal dynamics of institutional logic.

Corporate Responses to Intimate Partner Violence

Intimate partner violence (IPV) is among society's most pernicious and impactful social issues, causing substantial harm to health and wellbeing, and impacting women's employability, work performance, and career opportunity. Organizations play a vital role in addressing IPV, yet, in contrast to other employee- and gender-related social issues, very little is known regarding corporate responses to IPV. IPV responsiveness is a specific demonstration of corporate social responsibility and is central to advancing gender equity in organizations. In this paper, we draw upon unique data on the IPV policies and practices of 191 Australian listed corporations between 2016 and 2019, that collectively employ around 1.5 M employees. Providing the first large-scale empirical analysis of corporate IPV policies and practices, we theorise that listed corporations' IPV responsiveness reflects institutional and stakeholder pressures which are multifaceted and central to corporate social responsibility. Our findings identify greater IPV responsiveness among larger corporations, as well as those corporations with higher proportions of women middle managers, greater financial resources, and more advanced employee consultation on gender issues. This paper concludes that there is a need for further research on corporate IPV responsiveness, to further illuminate corporate motivations, organizational support processes, and employee experiences.

Different while being similar: The dual institutional process and differential organizational status

Connecting the neoinstitutional theory with Bourdieu's field theory, we develop a framework on the dual institutional process of integration and differentiation in a field. While the neoinstitutional theory has focused on similar organizational structures, we shift the research focus to offer an institutional explanation of differential organizational status. Drawing insights from Bourdieu's theory and key concepts, we highlight that the very institutional mechanisms causing isomorphism-regulative forces, normative pressures, and cognitive processes-also generate systematic status differentiation among organizations via their different levels of capital, homologous structures, and various habitus in a field. Our extended framework has theoretical significance in advancing the neoinstitutional theory, the research of status in organizational and economic sociology, and the Bourdieusian perspective. By theorizing status differentiation among organizations, it also adds an important dimension to enrich our understanding of multilevel status and social hierarchies.

The role of organizational language in gaining legitimacy from the perspective of new institutional theory

This research addresses the role of organizational language in the establishment of legitimacy from the perspective of New Institutional Theory. Several conceptual and methodical contributions have been made. First, by pairing cultural-cognitive legitimacy with phenomenological institutionalism and socio-political legitimacy with social organizational institutionalism, we have proposed a new way of classifying legitimacy. Second, we made connections between language strategies of organizations and cultural-cognitive and socio-political legitimacy. Finally, by re-categorizing language strategies aimed at legitimacy, we have provided a framework that is applicable in studying the relationship between different language strategies and legitimacy. Using this framework, we conducted an empirical study in which we analyzed the press releases of five major Turkish business groups. It was found that their language strategies were generally similar and mostly aimed at socio-political legitimacy.

Maritime container terminal infrastructure, network corporatization, and global terminal operators: Implications for international business policy

Maritime shipping lines and global terminal operators have benefited from economies of scale to expand geographically and functionally their infrastructure, leading to a corporatized network. Terminal operators are key asset managers seeking value creation by expanding the global maritime container terminal infrastructure network. While corporatization has systematically ensured that terminal capacity was created to accommodate the rise in global trade volumes, the network hit its boundaries when confronted with COVID-19 induced global supply chain disruptions. This paper provides a better understanding of the importance of infrastructure and observed corporatization as a framework for explaining economic processes, notably when transport infrastructures are extensive and capital-intensive. The structure of the global container shipping network is analyzed to unveil the realities of liner service networks operated by shipping lines, and the market structure and consolidation in container shipping and terminal operations. The discussion on the corporatization of the global maritime infrastructure network for container handling is embedded in international business literature. This study also extracts the main implications of the current structure and governance of the global maritime infrastructure network for international business policy, with a particular focus on the current market structure and network resilience.

The Effect of Participative Leadership Style on Employees’ Performance: The Contingent Role of Institutional Theory

This study aimed to examine the moderating role of institutional theory in the association between participative leadership style and various outcomes, such as employee loyalty and job performance in organizations. A cross-sectional research design was employed, where data were gathered from 347 participants from all managerial levels in the United Arab Emirates (UAE). The findings demonstrated how the level of complexity of the institutional theory reduces the positive relationship between participative leadership style and employee loyalty, negatively affecting job performance. The current study contributes to the existing leadership literature by showing that participatory leaders do not behave similarly across various degrees of institutional theory complexity. The findings suggest that the higher the complexity of institutionalism, the wider the gap between leaders and subordinates, so implementing the participative style may become problematic in some circumstances.

Knowledge management in sport mega-events: A systematic literature review

Introduction

The aim of this study was to conduct a systematic review to describe and explore the current state-of-the-art of sport mega-event knowledge management research.

Methods

Following the PRISMA protocol, the authors conducted a systematic search of academic and gray literature in sport, social sciences, and humanities databases. From the initial 1,751 studies reviewed, 16 met the inclusion criteria.

Findings

In these studies, knowledge management in sport mega-events was mainly researched in the context of the Olympic Games. Compared with other events, the Olympic Games built a more formal knowledge management programme, which may explain why it attracted more attention.

Discussion

Most of the studies highlighted the importance of tacit knowledge and individuals, as well as the needs of different stakeholder groups. Findings showed that social, cultural, political, and historical differences between hosts weaken the effect of knowledge management. Many of the published empirical studies are descriptive investigations and lack support of related theories or conceptual frameworks. The impacts of knowledge management process on the host regions and knowledge transfer between events and local stakeholders have been little explored.

MacIntyre, Weber and institutional logics

This paper explores "what more and what else" MacIntyre's concepts can contribute, specifically as applied to neoinstitutional theory and especially institutional logics. Drawing on the common influence of Max Weber's work as further developed by Friedland, MacIntyre's concept of eudaimonia being furthered by the pursuit of internal goods supported by external goods is used to develop a typology of goods. This typology is then deployed to show how the differing institutional logics of, for example, the market and the family have differing rationalities with differing emphases on internal and external goods, and consequently differing moral content. A simple picture of the market economy is then developed to show how such MacIntyrean concepts can be used to address the critique of a lack of morality in neoinstitutional theory. Conversely, the analytical framework provided by the institutional logics perspective is used to show how MacIntyrean concepts can be applied practically in a way that provides an interesting perspective on the current world.

Quality assessment, inclusive community development, and collective learning: An institutional perspective from Germany

This article reviews the German discourse on quality of life, quality assurance, and outcome measurement in services for persons with intellectual disabilities. Following institutional assumptions of path dependencies in organizational development, it is argued that concepts such as quality assurance must be understood in the context of the national support system development. For the Federal Republic of Germany, it can be noted that previous approaches to quality assurance of services based on measurement and evaluation tools have not been the drivers of innovation for inclusion. The driving forces behind reforms in the field of disability originated from the three angles of the social service structure (people with disabilities, statutory welfare agencies, and service providers). Policies of key actors were not part of a consistent reform strategy. However, the main elements of the inclusive philosophies of the disability rights movement became hegemonial and led to national legislation that prioritizes person-centered support arrangements in inclusive settings. With regard to governance arrangements in Germany and the idiosyncrasies of local disability fields, it is suggested that there should be a conceptualization of quality assurance in a multilevel approach as “local quality dialogues for collective learning.”

[Innovation Crisis in Public Theatre? A Longitudinal Study of Theaters in North Rhine-Westphalia, 1995-2018]

This paper examines cultural innovations in German public theaters, using North Rhine-Westphalia (NRW) as the most populated region as an example. While existing analyses, including social structure-centered audience research, have focused on the demand side, diagnosing in particular the steady decline and aging of the cultural audience, our analysis addresses the supply side, especially the number of premieres and new productions as well as their adoption into the repertoire. The paper shows that recent efforts by public theaters on the municipal or regional level to increase both the number of venues and the number of plays have not been sufficient to stabilize the declining audience. Too few new plays are scheduled, of which even fewer make it into the long-term repertoire. Our results suggest that theaters can retain their capability for renewal only by staging significantly more new plays, thus attracting new audiences. With regard to such renewal, decentralized competition as a characteristic of the NRW theater landscape seems a favorable institutional context.

Increasing Access to Organization Theories for Implementation Science

Background

Organization theories offer numerous existing, highly relevant, yet largely untapped explanations of the organizational dynamics underlying evidence-based intervention (EBI) implementation. Rooted in ideas regarding power, autonomy, and control, organization theories can explain how and why organizations adopt, implement, and sustain EBI use. Although they have gained visibility, organization theories remain underused in implementation research, perhaps due to their inaccessibility to implementation scientists. To improve access to organization theory among implementation scientists, we summarized organization theories with relevance to implementation science.

Methods

Led by the Cancer Prevention and Control Research Network (CPCRN) Organization Theory for Implementation Science workgroup, we employed a modified Delphi process to reach a consensus among 18 experts at the intersection of organization and implementation science regarding organization theories with relevance to implementation science. From texts that described the organization theories, using standardized abstraction forms, two investigators independently abstracted information regarding constructs, propositions regarding how or why constructs might influence implementation, the potential relevance of organization theories' propositions for implementation, and overviews of each theory. The investigators then reconciled discrepancies until reaching consensus. A third investigator reviewed reconciled abstraction forms for accuracy, coherence, and completeness.

Findings

We identified nine organization theories with relevance to implementation science: contingency, complexity, institutional, network, organizational learning, resource dependence, sociotechnical, and transaction cost economics. From the theories, we abstracted 70 constructs and 65 propositions. An example proposition from institutional theory is: "Coercive, mimetic, and normative pressures contribute to organizations…within an organizational field [becoming increasingly similar]." These propositions can be operationalized as levers to facilitate EBI implementation.

Conclusions

To increase use in the field, organization theories must be made more accessible to implementation scientists. The abstraction forms developed in this study are now publicly available on the CPCRN website with the goal of increasing access to organization theories among an interdisciplinary audience of implementation scientists through the CPCRN Scholars program and other venues. Next steps include consolidating organization theory constructs into domains and translating the resulting framework for use among researchers, policymakers and practitioners, aiding them in accounting for a comprehensive set of organization theory constructs thought to influence EBI implementation.

Resilience building during the management of the COVID‐19 crisis in Lithuania: Major breakthroughs and incremental change

Modern societies are facing an increasing number of transboundary systemic threats. The sudden spread of the coronavirus disease 2019 (COVID‐19) pandemic has once again highlighted concerns about governments' capacity to deal with disruptions and stressed the need for more resilient governance arrangements. Besides the usual policymaking, the latter might emerge from decisions, made during the crisis management as well. Building on ideas of the new institutionalism, more specifically, the normative logic of appropriateness and the rational logic of consequentiality, we examine how different mechanisms in varying contexts lead to different types of resilience building. Based on the results of pattern matching applied to the Lithuanian case of COVID‐19 crisis management in 2020, we argue that in environments where the logic of consequentiality was dominant, resilience was mostly strengthened because of major breakthroughs, stemming from coercive pressures as well as top‐down policy action from the centre of government. In contrast, more incremental developments contributed to resilience building through normative or mimetic pressures, professionalization, network‐based and bottom‐up practices in environments, where the logic of appropriateness prevailed. We claim that, while the logic of consequentiality helps to strengthen resilience in the context of turbulence, the logic of appropriateness is especially important for ensuring its sustainability.

Norms, rules and policy tools: understanding Article 5.3 as an instrument of tobacco control governance

INTRODUCTION

Article 5.3 of the WHO Framework Convention on Tobacco Control, elaborated via its implementation guidelines, can be understood as a policy instrument comprising norms, rules and policy tools designed to shape practices of policy making and minimise tobacco industry interference.

METHODS

This qualitative research is based on in-depth interviews with officials from diverse government sectors and non-governmental organisations across countries (Ethiopia, India, Uganda) that have adopted measures to implement Article 5.3.

RESULTS

The data highlight varied perceptions and knowledge of Article 5.3 norms between health and non-health sectors. Health officials typically link its core norm of a fundamental conflict between public health and industry interests to the governance norm of protecting public health policies from industry interference. While officials in sectors beyond health broadly endorsed this core norm, they exhibited more limited awareness of Article 5.3 and its model of governance. The results examine how rules to implement Article 5.3 have been codified, but identify the absence of policy tools necessary to operationalise rules and norms. This limitation, alongside restricted awareness beyond health departments, suggests that political commitments to implement Article 5.3 will have limited impact on practices of stakeholder consultation and policy engagement with the tobacco industry.

CONCLUSION

Conceptualising Article 5.3 as a policy instrument helps to explain how its rules and policy tools interact with each other and with broader governance processes. This framework has the potential to enhance understanding of Article 5.3 and help identify opportunities and constraints in its implementation.

State and citizen responsiveness in fighting a pandemic crisis: A systems thinking perspective

Management scholars have recognized organizational responsiveness among the essential capabilities of social organizations. It becomes essential for a social change to occur during a crisis, where the uncertainty or environmental dynamism is high. However, a social change cannot be successful unless constituent subsystems of a social organization exhibit responsiveness. Using systems theory, we conceptualize 'nation' as a social system and examine its responsiveness towards environmental uncertainly, taking an example of the COVID-19 pandemic. How can state and citizen community responsiveness help fight a pandemic crisis? We test these direct and moderating effects on data representing 14 countries. We perform a hierarchical regression analysis on the restructured, balanced country-wise panel data. Our findings highlight the importance of state and community interaction effects in controlling pandemic growth. Accordingly, we claim that only a collaborative approach by citizen communities with the respective governments will enable handling an uncertain situation.

The Institutionalization of Kübler-Ross's Five-Stage Model of Death and Dying

Kübler-Ross's five-stage model of death and dying-denial, anger, bargaining, depression, and acceptance-is one of the most popular theoretical models to come out of the 20th century. How did an obscure theory of the dying process come to dominate our understanding of emotional processes altogether? Building on previous work in the sociology of knowledge, I analyze the diffusion and institutionalization of Kübler-Ross's five-stage model in scientific and journalistic fields. Specifically, I analyze all 3216 citations of Kübler-Ross in the New York Times and the Web of Science database using qualitative and quantitative text analysis. I demonstrate how early scientific interest and commercial promotion led to adoption in popular culture, and document how the five-stage model expanded to cover everything from rent prices to COVID-19. I also argue that renewed interest in Kübler-Ross's work may signal contemporary attempts to mine the tradition for meaningful understandings of death and dying.

Does context count? The association between quality of care and job characteristics in residential aged care and hospital settings: a systematic review and meta-analysis

BACKGROUND AND OBJECTIVES

Within residential aged care settings, reduced quality of care (QOC), abuse, and neglect have been global phenomena which require urgent intervention. As the reported rate of these problems is much higher in aged care compared to hospital settings, we investigated whether differing job design characteristics between the two settings might explain the difference.

RESEARCH DESIGN AND METHODS

We used a meta-analysis to compare differences in the relationships between high job demands, low job resources, and job strain with QOC and counter-productive work behaviors (CWBs) across aged care and hospital settings.

RESULTS

Data was extracted from 42 studies (n=55 effects). QOC was negatively correlated with high job demands (ρ̅ =-.22, 95% CI: -.29:-.15, k=7), low job resources (ρ̅ = -.40, 95% CI:-.47:-.32, k=15), and job strain (ρ̅ =-.32, 95% CI: -.38:.-.25, k=22), CWBs had a positive relationship with job demands (ρ̅ =.35, 95%CI: .10:.59, k=3) and job strain (ρ̅ =.34, 95% CI: .13:.56, k=6). The association between poor QOC and low job resources was stronger in aged care (r=-.46, 95% CI:-.55:-36, k=8) than in hospital settings (r= -.30, 95% CI:-.41:-.18, k=7).

DISCUSSION AND IMPLICATIONS

Our findings suggest that relationships between low job resources and poor quality of care are exacerbated in residential aged care contexts. To improve care outcomes, stakeholders should improve job resources such as skill discretion, supervisory supports, and increased training and staffing levels in residential aged care.

Health concerns among waste collectors during pandemic crisis

The COVID-19 pandemic has negatively affected the economic, social, and psychological aspects globally. COVID-19 can possibly spread through municipal solid waste (MSW) if it is collected, bagged, transported, and disposed inappropriately. Such situation has posed significant challenges to MSW management (MSWM), which has led waste personnel under massive pressure. This study aims to examine the health-protective behavior of sanitation workers/MSW collectors (MSWCs) during the COVID-19 crisis. Quantitative data were collected by using a self-administered survey from 418 MSWCs working in Mainland China. The study extended the traditional health-belief model and proposed education and training as a facet of the behavioral model. Result showed that education and training were a significant predictor of health-protective behavior. Moreover, the moderating incremental influence of regulative assistance significantly affected the behavioral mapping of MSWCs. This study contributes to the literature by mapping the concerns, risks, and challenges experienced by MSWCs in times of a health crisis. Policymakers should specially consider the safety and hygiene concerns of frontline workforce in the whole chain of waste management (including the outsourced operations of MSWM). Lastly, the adoption of smart communication with the frontline workforce (i.e., MSWCs) is in dire need to maintain trust and avoid rumors and misconceptions during the time of a pandemic situation.

On the professional authority of quality engineers and the gaps in their epistemic and organizational authority

The authority of quality engineers as a profession is a contested issue that relates both to the occupation’s internal regulation and to the professional status of quality engineers within the organizations for which they work. In this article, we examine the professional authority of quality engineers from both these perspectives. The issue is addressed first through a conceptual framework, followed by a presentation of an empirical study in which seven experienced quality professionals were interviewed and completed questionnaires. We focus on the situation in Israel as a case study, but our insights are relevant to quality engineers throughout the world. We demonstrate limitations with regard to both (1) the epistemic authority (expertise) of quality engineers vis-à-vis their status as a professional association and (2) the organizational authority of quality engineers vis-à-vis their organizational role as quality managers. These limitations can be attributed to the occupation’s status as a semi-profession; the level of expertise required is not fixed or uniform; the authority of a quality engineer varies from one organizational structure to another. In addition, individual quality engineers are accorded different levels of influence, usually at the discretion of their employing organizations. For these reasons, the expertise of quality engineers as a professional group remains an open issue.

Stakes, positions and logics: An institutional field analysis of cross-border health IT policy

The concepts field and habitus are used widely and variably in institutional theory. The intellectual antecedents are found in the work of the French Sociologist, Pierre Bourdieu. This study presents a field-level analysis of pan-European policy on cross-border health information technology. Using field theory and institutional theory, we situate field as a multi-level concept which extends institutional and organizational levels of analysis. Empirical data is gathered from European policymakers, health professionals and patient advocacy groups on the diffusion of supra-national health information technology across European Member States. Findings reveal four scenarios depicting field tensions, as ideological and practical imperatives of supra-national health information technology policy mis-align with Member State health systems. This study has implications for policy-makers and other stakeholders, who seek to narrow the digital divide across health fields and sub-fields.

New avenues for HRM roles: A systematic literature review on HRM in hybrid organizations

In recent decades, the emergence of hybrid organizational forms has placed new demands on the role of human resource management (HRM) contributing to organizational goals. Moreover, research emphasizes that the increasing hybridity of contexts, stakeholder requirements, and goals lead to organizational tensions that, if not properly addressed, can lead to organizational downfall. However, although organization and management research recognize the importance of elaborating HRM roles for hybrid contexts, drawing upon findings from the hybrid literature has been widely neglected. Thus, by mapping the research landscape regarding hybridity, this article provides insight into the configuration of organizational HRM roles and functions that contribute to the development of hybrid goals and are associated to the management of tensions. Significantly, this article introduces three specific HRM roles— hybrid strategist, capability adapter, and identification generator—as essential HRM roles for hybrid contexts.

Challenges to ensuring valid and useful waiting time monitoring - a qualitative study in Swedish specialist care

BACKGROUND

Access to health care is an essential health policy issue. In several countries, waiting time guarantees mandate set time limits for assessment and treatment. High-quality waiting time data are necessary to evaluate and improve waiting times. This study's aim was to investigate health care providers and administrative management professionals' perceptions of validity and usefulness of waiting time reporting in specialist care.

METHODS

Semi-structured interviews (n = 28) were conducted with administrative management and care professionals (line managers and care providers) in specialized clinics in the Stockholm Region, Sweden. Clinic-specific data from the waiting time registry was used in the care provider interviews to assess face validity. Clinics were purposefully sampled for maximum variation in complexity of care, volume of production, geographical location, private or public ownership, and local waiting times. Thematic analysis was used.

RESULTS

The waiting time registry was perceived to have low validity and usefulness. Perceived validity and usefulness were interconnected, with mechanisms that reinforced the connection. Structural and cognitive barriers to validity included technical and procedural errors, errors caused by role division, misinterpretation of guidelines, diverging interpretations of nonregulated cases and extensive willful manipulation of data.

CONCLUSIONS

We identify four misconceptions underpinning the current waiting time reporting system: passive dissemination of guidelines is sufficient as implemented, cognitive load of care providers to report waiting times is negligible, soft-law regulation and presentation of outcome data is sufficient to drive improvement, and self-reported data linked to incentives poses a low risk of data corruption. To counter low validity and usefulness, we propose the following for policy makers and administrative management when developing and implementing waiting time monitoring: communicate guidelines with instructions for operationalization, address barriers to implementation, ensure quality through monitoring of implementation and adherence to guidelines, develop IT ontology together with professionals, avoid parallel measurement infrastructures, ensure waiting times are presented to suit management needs, provide timely waiting time data, enable the study of single cases, minimize manual data entry, and perform spot-checks or external validity checks. Several of these strategies should be transferable to waiting time monitoring in other contexts.

The Relationship Between States' Staffing Regulations And Hospitalizations Of Assisted Living Residents

Assisted living provides housing and long-term care services to more than 811,000 older adults in the United States daily and is regulated by the states. This article describes changes in the specificity of state regulations governing the staffing in assisted living settings (that is, requirements for sufficient staffing or staffing ratios or levels) between 2007 and 2018 and the association between these changes and rates of hospitalization among a national sample of assisted living residents, including a subgroup with dementia. We found that increased regulatory specificity for direct care workers (for example, a change from requiring "sufficient" direct care worker staffing to requiring a specific staffing ratio or level) was associated with a 4 percent reduction in the monthly risk for hospitalization among residents in our sample and a 6 percent reduction among the subgroup with dementia. However, an increase in regulatory specificity for licensed practical nurses was associated with a 2.5 percent increase in the monthly risk for hospitalization and a 5 percent increase among the subgroup with dementia. Given that no federal requirements exist for the number of staff members or composition of staff in assisted living, these findings can inform states' policy decisions about staffing requirements for assisted living settings.

Competing revolutionaries: Legitimacy and leadership in revolutionary situations

When the Arab Spring gave way to demonstrations in Syria in 2011, the Kurds in the country were also full of hope. While they were going into the streets, the Kurdish political parties were debating what their people should do and offering competing visions for the future. Then in July 2012, the regime unexpectedly withdrew its forces from the Kurdish regions (Rojava). Suddenly, a revolutionary situation emerged in Rojava: a mobilized population and several political parties claiming leadership and offering competing political projects for a new society. Among these parties, only the Democratic Union Party (PYD) managed to move into the power vacuum and establish its control over large areas. Its rivals were unable to stop the rapid rise of this relatively young organization and fast erosion of their own base. How did the PYD manage to become the dominant organization even though it had rarely drawn attention before the civil war? This question raises the larger problem of how a revolutionary organization becomes the dominant one among competitors. Even though multiple organizations competing in a single revolution is a recurrent phenomenon, we still lack a comprehensive framework specifically focusing on this issue. In this paper, I argue for an approach based on legitimation: for people to follow a certain organization over others, they should see it as a legitimate leader. Bringing together the insights of the political and organizational legitimacy literatures, I identify three processes of legitimation for revolutionary organizations: ideological/normative congruence, effective organizational capacity, and accumulation of prestige. Drawing upon participant observation and 30 in-depth interviews with Kurdish individuals collected during fieldwork in Iraq, Germany, and the United States between 2016 and 2019, I demonstrate that the PYD has outperformed its contenders and managed to legitimate its leadership through these three processes.

How Structural Empowerment Boosts Organizational Resilience: A case study in the Dutch home care industry

Previous work has demonstrated that structural forms of empowerment tend to enhance individual and team resilience. However, there is hardly any knowledge about how structural empowerment affects organizational resilience. Moreover, a widespread (though largely untested) assumption is that, in adverse times, power and authority need to be centralized at the top to enhance organizational resilience. This paper explores the effects of empowerment on organizational resilience in an in-depth case study of a Dutch home care organization, in which employees are structurally empowered. The findings from this case study suggest that structural empowerment positively affects organizational resilience, but that this effect is contingent upon a climate of psychological safety as well as top management’s sustained commitment to structural empowerment. We move beyond the extant conceptualization of psychological safety by demonstrating its inter-level nature in the context of structural empowerment, which operates across organizational levels when employees also engage in discussions on tactical and strategic issues. Overall, this study provides an in-depth understanding of how organizations can enhance their resilience by empowering their members, thus also challenging the common wisdom about centralizing power in adverse times.

Who are these emerging markets anyway? A taxonomic approach integrating institutional and culturalist perspectives

To date there has been little to no widespread, universally accepted and theoretically driven examination of what an emerging market is and how best to capture its principle characteristics. Major international organizations, institutions, and scholars, all classify these countries utilizing a multitude of different perspectives. Applying institutional theory as a framework yet bowing to the unique pervasiveness of culture research, this study develops a more nuanced reclassification of emerging markets. Utilizing cluster analysis and dendogram interpretation, the application of this multidimensional and multidisciplinary framework results in eight categories of emerging markets and shows how social, political, economic, and spatial can contribute to the emergent status of a country. This study also serves as a vehicle to show how both the institutional and culturalists perspectives on international business management and strategy can be combined. These theoretically grounded findings from the study provide new boundary conditions for national contexts to be applied in future international business research and further inform international management and strategy stakeholders of a means to reduce the clouds of uncertainty surrounding these countries.

Does Use of Emotion Increase Donations and Volunteers for Nonprofits?

Nonprofits offer services to disadvantaged populations, mobilize collective action, and advocate for civil rights. Conducting this work requires significant resources, raising the question: how do nonprofits succeed in increasing donations and volunteers amid widespread competition for these resources? Much research treats nonprofits as cold, rational entities, focusing on overhead, the "price" of donations, and efficiency in programming. We argue that nonprofits attract donors and volunteers by connecting to their emotions. We use newly available administrative IRS 990 e-filer data to analyze 90,000 nonprofit missions from 2012 to 2016. Computational text analysis measures the positive or negative affect of each nonprofit's mission statement. We then link the positive and negative sentiment expressed by nonprofits to their donations and volunteers. We differentiate between the institutional fields of nonprofits-for example, arts, education, social welfare-distinguishing nonprofits focused on social bonding from those focused on social problems. We find that expressed positive emotion is often associated with higher donations and volunteers, especially in bonding fields. But for some types of nonprofits, combining positive sentiment with negative sentiment in a mission statement is most effective in producing volunteers. Auxiliary analyses using experimental and longitudinal designs provide converging evidence that emotional language enhances charitable behavior. Understanding the role of emotion can help nonprofit organizations attract and engage volunteers and donors.

Advancing understanding and identifying strategies for sustaining evidence-based practices: a review of reviews

BACKGROUND

Implementation science has focused mainly on the initial uptake and use of evidence-based practices (EBPs), with less attention to sustainment-i.e., continuous use of these practices, as intended, over time in ongoing operations, often involving adaptation to dynamic contexts. Declining EBP use following implementation is well-documented yet poorly understood. Using theories, models, and frameworks (TMFs) to conceptualize sustainment could advance understanding. We consolidated knowledge from published reviews of sustainment studies to identify TMFs with the potential to conceptualize sustainment, evaluate past uses of TMFs in sustainment studies, and assess the TMFs' potential contribution to developing sustainment strategies.

METHODS

We drew upon reviews of sustainment studies published within the past 10 years, evaluated the frequency with which included articles used a TMF for conceptualizing sustainment, and evaluated the relevance of TMFs to sustainment research using the Theory, Model, and Framework Comparison and Selection Tool (T-CaST). Specifically, we examined whether the TMFs were familiar to researchers, hypothesized relationships among constructs, provided a face-valid explanation of relationships, and included sustainment as an outcome.

FINDINGS

Nine sustainment reviews referenced 648 studies; these studies cited 76 unique TMFs. Only 28 TMFs were used in more than one study. Of the 19 TMFs that met the criteria for T-CaST analysis, six TMFs explicitly included sustainment as the outcome of interest, 12 offered face-valid explanations of proposed conceptual relationships, and six identified mechanisms underlying relationships between included constructs and sustainment. Only 11 TMFs performed adequately with respect to all these criteria.

CONCLUSIONS

We identified 76 TMFs that have been used in sustainment studies. Of these, most were only used once, contributing to a fractured understanding of sustainment. Improved reporting and use of TMFs may improve understanding of this critical topic. Of the more consistently used TMFs, few proposed face-valid relationships between included constructs and sustainment, limiting their ability to advance our understanding and identify potential sustainment strategies. Future research is needed to explore the TMFs that we identified as potentially relevant, as well as TMFs not identified in our study that nonetheless have the potential to advance our understanding of sustainment and identification of strategies for sustaining EBP use.

"I Trust in Staff's Creativity"-The Impact of COVID-19 Lockdowns on Physical Activity Promotion in Nursing Homes Through the Lenses of Organizational Sociology

Objectives: The health-enhancing benefits or regular physical activity (PA) reach into old age. With the emergence of the coronavirus disease of 2019 (COVID-19) pandemic and the associated national lockdowns and restrictions, nursing home residents were restrained from being physically active. In our study, we aimed to assess the impact of the COVID-19-related restrictions on PA promotion in nursing homes from an organizational-sociological lens. Methods: We collected data in eight nursing homes in Germany. Data collection included (i) semistructured interviews focusing on COVID-19-related restrictions and their effects on nursing homes from the home administrators' perspectives; (ii) open-ended surveys with nursing home staff and relatives focusing on daily routines and contact restrictions; and (iii) collection of documents such as care concepts, mission statements, and weekly activity plans. We analyzed all data with a reflexive thematic analysis approach. Results: We identified three stages of COVID-19-related changes in nursing homes that impacted PA promotion, as follows: (1) external closure and search for emergency control, (2) organizational adaptations to create a livable daily life in the internal environment, and (3) slow reintegration of interactions with the external organizational environment. Document analysis revealed that PA promotion was not part of decision programs or internal staff work descriptions. Rather, PA promotion was delegated to external service providers. The assignment of PA promotion to external providers was not structurally anchored in decision programs, which makes PA promotion not sustainable, particularly during unforeseen events that limit access to the organization. During the pandemic, executive staff believed in internal staff to buffer competencies with regard to PA promotion. Thus, executive staff often considered PA promotion relevant, even during the pandemic, but thought that PA promotion is a task that can be fulfilled by unqualified but motivated internal staff. Conclusion: While our study participants showed a high level of coping-capacity belief, it remains unclear which long-term impacts of COVID-19 on PA promotion in nursing homes are to be expected. At the practice level, executive staff in nursing homes that aim to promote PA within their organization should become aware that PA promotion needs to be incorporated into organizational structures to be implemented and continued in challenging times such as in a pandemic.

Covid-19 and the Epigenetics of Learning

Covid-19 is a natural phenomenon that has rapidly upended much of the cultural infrastructure of societies across the globe. Education, which in recent years increasingly tied itself to notions of global culture and markets, is deeply threatened by these changes to the natural environment. This paper makes the case that the relationship between nature and culture in education requires a deep level analysis of the biological and physical substrate of human learning. Only with a sufficiently fundamental level of analysis can society reorganise its systems of learning and scientific inquiry to this rapidly changing environment. Drawing on evolutionary biology, we argue that institutional and individual structures and processes are recapitulations of evolutionary cellular development. Understanding the impact of Covid-19 on cells presents an invitation to consider the larger-scale cultural recapitulations of similar mechanisms and structures, and this has implications for the ways education might most effectively deploy technology. Whilst universities seek to maintain their existing structures, practices and business models, a cellular evolutionary approach points to the necessity for fundamental rethinking of intellectual life and learning. We consider the parameters of effective educational organisation in a post-Covid-19 world. As the richness and variety of the physical campus is removed, viable educational relationships will necessitate deeper intellectual connections and personal inquiries than are currently permitted in the transactional processes of education.

ENABLING THE UTILIZATION OF POTENTIALLY DISRUPTIVE DIGITAL INNOVATIONS BY INCUMBENTS: THE IMPACT OF CONTEXTUAL, ORGANISATIONAL, AND INDIVIDUAL FACTORS IN REGULATED CONTEXTS

Incumbents’ inertia in the face of disruptive innovations has been emphasised in prior literature. The relevance of inertia is particularly topical in the context of digital transformation. However, incumbents may be able to invest in disruptive digital innovations appropriately if they possess the motivation and ability to do so. In this paper, I use three streams of research in order to investigate contextual, organisational, and individual antecedents of incumbents’ motivation and ability to adopt and use potentially disruptive digital innovations in health care: institutional theory, the resource-based view, and technology acceptance literature. I employ factor analyses and logistic regressions to test the impact on the adoption and usage of telemedicine applications using a dataset of 9,196 European general practitioners. I examine B2B as well as B2C applications in order to determine the effect of the antecedents on different business models. My findings suggest that only isomorphic pressure, complementary assets, and perceived output quality significantly influence both adoption and usage as well as B2B and B2C business models in the same way. Formal institutions and individual factors yield ambiguous results. These findings provide important implications for the understanding of incumbents’ response to potentially disruptive digital innovations in regulated contexts.

Coalitions and Public Action in the Reshaping of Corporate Responsibility: The Case of the Retail Banking Industry

This paper addresses the question of whether and how public action via civil society and/or government can meaningfully shape industry-wide corporate responsibility (ICR) behaviour. We explore how, in principle, ICR can come about and what conditions might be effective in promoting more ethical behaviour. We propose a framework to understand attempts to develop more responsible behaviour at an industry level through processes of negotiation and coalition building. We suggest that any attempt to meaningfully influence ICR would require stakeholders to possess both power and legitimacy; moreover, magnitude and urgency of the issue at stake may affect the ability to influence ICR. The framework is applied to the retail banking industry, focusing on post-crisis experiences in two countries-Spain and the UK-where there has been considerable pressure on the retail banking industry by civil society and/or government to change behaviours, especially to abandon unethical practices. We illustrate in this paper how corporate responsibility at the sector level in retail banking is the product of context-specific processes of negotiation between civil society and public authorities, on behalf of customers and other stakeholders, drawing on legal and other institutions to influence industry behaviour.

Rationales of gender diversity management policies and practices in India: an exploratory empirical study in the Indian IT/ITeS industry

Purpose

The Indian context is marked with weak anti-discrimination laws and patchy implementation of protection of civil rights of women at workplaces. The purpose of this paper is to unearth the rationales of the adoption of gender diversity management policies and practices in India, in the absence of laws and regulations.

Design/methodology/approach

Inspiration is drawn from previous studies on diversity management in other national contexts, and a survey methodology was adopted. The lead researcher administered the questionnaires personally to all respondents to ensure that the understanding of the questions is uniform across respondents as gender diversity management is a relatively new concept in India.

Findings

Size of the organisation (number of full-time employees), the influence of external organisations and perceived enhanced organisational flexibility were found to explain the adoption of gender diversity management policies and practices in the Indian IT/ITeS industry. Findings also indicate that Indian subsidiaries of foreign multinationals tend to adopt more gender diversity management policies and practices as compared to Indian-owned organisations.

Research implications

This study provides evidence that organisations do not always enact structures or behaviours in the pursuit of normative rationality and also consider the economic value of them, establishing an organisational agency in adopting legitimated norms or practices. The study also shows that gender diversity management policies and practices are not only dependent on the enactment of laws but also are adopted because of the economic benefit perceived.

Originality/value

Diversity management policies and practices have been mostly studied in national contexts with anti-discrimination laws or affirmative action programs and have been claimed to be a successor of equal employment opportunity (EEO) policies. In the absence of stringent laws to reduce or eliminate discrimination against women employees in Indian workplaces, this study contributes to the literature by determining whether the business case for gender diversity drives the adoption of gender diversity management in the Indian context.

Big-data business models: A critical literature review and multiperspective research framework

The emergence of “big data” offers organizations unprecedented opportunities to gain and maintain competitive advantage. Trying to exploit the strategic business potential embedded in big data, many organizations have started to renovate their business models or develop new ones, giving rise to the phenomenon of big-data business models. Although big-data business model research is still in its infancy, a significant number of studies on the topic have been published since 2014. We thus suggest it is time to perform a critical review and assessment of the literature at the intersection of business models and big data (analytics), thereby responding to recent calls for further research on and sustained analysis of big-data business models. In particular, our review uses three major criteria (big-data business model types, dimensions, and deployment) to assess the state of the big-data business model literature and identify shortcomings in this literature. On this basis, we derive and discuss five central research perspectives (supply chain, stakeholder, ethics, national, and process), providing guidance for future research and theory development in the area. These perspectives also have practical implications on how to address the current big-data business model deployment gap.

Making it real: the institutionalization of collaboration through formal structure

Collaboration has achieved widespread acceptance as an indispensable element of healthcare delivery in recent decades, despite modest evidence for its impact on healthcare outcomes. Attempts to understand this seeming paradox have been based mostly in functionalist or conflict-theoretical approaches. Currently lacking, however, is an articulation of how collaborative ideals are embedded in broadly shared beliefs about what healthcare is and how it operates. In this article, we examine how language used in the CanMEDS competency framework and in two guides for Family Health Teams construct idealized versions of rational, autonomous physicians and primary care organizations, respectively. Informed by phenomenological sociology and neo-institutional theory, we characterize these documents as elements of formal structure, the putative "blueprints" for healthcare planning and activity. Drawing on this analysis, we argue that these documents and "collaborative" formal structures in general, not only function as tools to make healthcare more collaborative, but also create an appearance of "real" collaboration, independently of the realities of practice. We argue that they thus instill confidence that the current healthcare system functions according to deep-seated societal values of justice and progress. We conclude by emphasizing the potentially distorting influence of this on efforts to understand and improve healthcare.

Corralling Organizational Institutionalism

In this essay, I respond to Alvesson, Hallett, and Spicer’s recent piece focusing on the problems stemming from organizational institutionalism’s unprecedented growth and proliferation. I focus my attention specifically on the current definitional problems in the literature and offer some suggestions for how scholars in the area might address these issues in the future.

Institutions: Everywhere But Not Everything

Recent critiques by Alvesson, Hallett, and Spicer have characterized neo-institutional theory (NIT) specifically as confronting a mid-life crisis and institutional theory (IT) more generally as uninhibited. While offering valid points, these critiques lack a fundamental understanding of how organizational institutionalism (OI) has become distinct from NIT. In contrast to NIT’s master hypothesis of isomorphism and focus on structural determinism, OI has made remarkable progress in explaining institutional variation and change. Notably, like organization theory more generally, OI is not a coherent theory, but rather a big tent community with its own set of internal differences, and at times confusing concepts. Rather than abandoning the concept of institutions, we suggest continued progress in OI requires greater clarification. Institutions are everywhere, but not everything, so it is important for researchers to specify which institutions are being studied, distinguish between institutions and culture, and ascertain the relationship between institutions and organizations.