Organizational Perspective Research Articles

Rotational training structures and national employment in public health education: an organizational perspective

IntroductionPostgraduate medical education (PGME) relies on structured training rotations and workplace-based learning (WBL) to provide comprehensive clinical training and professional development. Emphasizing WBL, PGME integrates theoretical knowledge with practical skills through direct patient care involvement, underscoring the pivotal role of training institutes in supporting these initiatives. While curricular changes in PGME have been extensively studied in clinical teaching hospitals, PGME programs in public health (PGME-PH) remain underexplored, yet their multidisciplinary nature post-COVID-19 underscores the urgency for effective curricular reforms. This study explores how training institutions offering PGME-PH navigate the adoption of structured training rotations and a transition to a national employer by examining organizational perspectives to enhance sustainability and integration of educational innovations in this unique context.MethodsSemistructured interviews were conducted with 14 participants from 8 training institutions offering PGME-PH in the Netherlands between October and November 2022 to explore their experiences with the implementation of a rotational training structure. The interviews were guided by the Consolidated Framework for Implementation Research (CFIR).ResultsThe analysis identified three pivotal themes influencing sustainable implementation and ownership: influence, communication, and motivation. Participants expressed concerns about reduced influence in organizing PGME-PH and noted significant communication challenges, such as ambiguity in roles, program frameworks, and financial aspects. Despite these obstacles, participants showed strong motivation for education and underscored the importance of collaboration and shared responsibility.ConclusionThe successful implementation of structured training rotations was negatively impacted by training institutions’ experience of limited influence and communication challenges. This led to diminished ownership of the new PGME-PH curriculum, potentially affecting its long-term sustainability. Despite these challenges, participants maintain high motivation for educational delivery. Enhancing sustainable implementation requires fostering ownership, promoting collective responsibility, establishing clear communication channels, and nurturing motivation. These factors are crucial for ensuring the success and longevity of educational programs such as PGME-PH.

Exploring Opportunities and Challenges for the Spread, Scale-Up, and Sustainability of mHealth Apps for Self-Management of Patients With Type 2 Diabetes Mellitus in the Netherlands: Citizen Science Approach.

Technologies evolve at a breakneck pace, and the success of mobile health (mHealth) for people with type 2 diabetes mellitus (T2DM) depends on whether health care professionals, care management, government regulators, and consumers will adopt the technology as a viable solution to enhance patient self-management. In this study, we explored the challenges of the implementation of mHealth apps in care for patients with T2DM and determined to what extent these challenges complicate the dissemination, limit scale-up, and influence the sustainability of technological interventions for patients with T2DM. The nonadoption, abandonment, and challenges to scale-up, spread, and sustainability (NASSS) framework served as the basis for our study. The 7 domains of the NASSS framework were explored with a citizen science approach using questionnaires, semistructured in-depth interviews, and focus groups together with patients with T2DM, care professionals, technology developers, policy officers, and a patient organization. Regarding the domain "condition," being aware of their condition and changing lifestyle were crucial for patients with T2DM to get to grips with their life. The rapid development of health apps for T2DM was highlighted in the domain "technology." Users should be aware of these apps and know how to use them. The domain "value proposition" included the patient perspective and elaborated on personal values, as well as care professionals who focus on personalized care and pressure on health care. Regarding the "adopters," it is crucial to know who needs to use and introduce the apps. Responsibility, a shared vision, and resistance among care professionals were mentioned as important determinants for "organization." Finally, the domain "wider system" showed the importance of involving multiple institutes, care guidelines, and reimbursements. This study investigated the implementation of mHealth apps in an early stage of the implementation process. Key stakeholders were involved, who attributed to the possibilities and limitations of the implementation. It is crucial to have a clear vision from an organizational perspective and specific prerequisites for implementation strategies at micro, meso, and macro levels. Essential strategies at the national level include guidelines for regulations, privacy, and security; the integration of mHealth into T2DM care guidelines; and sufficient reimbursement by health insurers.

How to Keep Doing What You Like Doing: A Qualitative Study of Active Older Adults’ Insights on the Facilitators and Barriers to Maintenance of Physical Activity (From the MOVEAGE-Act Project)

While the facilitators/barriers for the initiation of physical activity (PA) are well documented, there is less known about these facilitators/barriers for maintenance of PA in the older population in general and not following an intervention. This study aimed to explore older adults’ perspectives on the facilitators/barriers to maintaining PA. The study used a descriptive qualitative design, with three focus groups, one in Ireland and two in France. Participants were community-dwelling older adults (≥60 years) 66% were female, recruited through older adult websites. Findings were analyzed thematically using a Socio-Ecological Model as a framework. Thirty-three older adults participated, and 88% met the international physical activity guidelines of 150 minutes of moderate activity per week. From intrapersonal and interpersonal perspectives, enjoyment, social engagement, adapting physical activity for their age, establishing routines/habits, and combining PA with other activities and interests were all key facilitators in PA maintenance. From the policy, environmental and organizational perspectives, limited policies or their implementation, activity-related factors (insufficient information on activities, age appropriateness and availability of suitable activities, accessibility, inadequate support), and social connectedness were identified. Multiple interrelationships across the different social-ecological perspectives emerged. It was evident for PA maintenance that a balance is needed between having activities that are enjoyable and yet challenging and being able to adapt them to age-related changes such as loss of function and confidence. In addition, it was apparent that older adults were more likely to engage in PA if it had a social element and if they had access to relevant information and safe, age-appropriate activities and support. These factors should be further incorporated into PA promotion, activities, and policies to maximize PA maintenance. Barriers may lead to non-maintenance of healthy aging targets, with implications for health service economies and older adults’ health.

Advancing food systems governance: Perspectives of Canadian civil society organizations

ABSTRACT Civil society organizations (CSO) engaged in food systems work have grown substantially in number, scale, and scope. Many of these CSOs are seizing opportunities to engage with the globalized industrial food system in efforts to promote greater equity and sustainability and have realized that addressing issues at a systemic level demand engaging with governance. Despite increasing scholarly attention to food systems and to CSO engagement with governments, the diversity of governance arrangements remains understudied. In this paper, we explore the meanings and perspectives of food systems governance from the standpoint of CSOs leaders across Canada and Indigenous territories. Drawing on 70 semi-structured interviews, we argue that CSOs play a central role in advancing food systems governance by how they frame and act on food issues. We point to CSOs understandings and engagement with food systems governance as broader and more nuanced than what has previously been documented in the literature. A more discerning and comprehensive understanding of how CSO actors describe and advance food systems governance helps articulate how CSOs are scaling-up place-based work, modelling new forms of governance, and ultimately, impacting decision-making structures.

Reshaping the Irish Economy: The Impact of International Mergers and Acquisitions on the Irish Technology Sector (2021-2023)

Purpose: This dissertation examines the impact of international mergers and acquisitions (M&A) on the Irish technology sector between 2021 and 2023. It aims to assess how M&A activities have reshaped corporate strategies, influenced organizational culture, and contributed to the broader economic landscape, while identifying challenges and opportunities for involved firms. Methodology: A mixed-methods approach was employed, integrating quantitative survey data from technology sector professionals and qualitative insights from structured interviews with senior executives of companies engaged in M&A. The survey captured organizational perspectives on strategic realignment, cultural integration, employee morale, and economic implications. The interviews offered deeper context on leadership decisions, cultural adaptation, and strategic shifts post-acquisition. Findings: The research reveals that successful post-M&A outcomes were strongly linked to strategic realignment toward global expansion, product innovation, and operational efficiency. Firms leveraging M&A synergies experienced improved market positioning, faster innovation cycles, and streamlined operations. However, challenges such as cultural integration and maintaining employee morale were significant hurdles. Ireland's regulatory environment emerged as a facilitator, ensuring smooth transitions and compliance, although increased global competition posed both challenges and growth opportunities for local firms. Unique Contribution to Theory, Policy, and Practice: This study advances academic discourse by highlighting the interplay between strategic realignment, cultural integration, and regulatory frameworks in post-M&A success. It provides actionable recommendations for technology firms to optimize integration strategies and for policymakers to maintain a supportive yet competitive regulatory environment. The findings also lay the groundwork for future longitudinal studies and cross-industry comparisons to deepen understanding of M&A dynamics.

Social prescribing initiatives connecting general practice patients with community-based physical activity: A scoping review with expert interviews.

The World Health Organization states that physical inactivity is one of the leading behavioural risk factors for disability and mortality in Europe. Social prescribing holds promise as a possible solution by connecting patients from general practice to community-based physical activity. Although research within social prescribing exists, the process of connecting general practice patients to community-based physical activity is not well investigated. This scoping review aimed to summarise and synthesise knowledge on social prescribing provided by health professionals in general practice towards community-based physical activity. A systematic search for literature in PubMed, Embase, Scopus, SportsDiscus and other sources was conducted to identify initiatives connecting general practice to community-based physical activity. Semi-structured interviews were then conducted with subject-specific national experts. Finally, preliminary findings from the literature and the interviews were used in a co-creation process with experts to synthesise and finalise the results of a thematic analysis across data sources. Based on 19 records, five expert interviews and subsequent co-creation, we identified three themes: (a) barriers and facilitators, (b) organisational perspectives and (c) value-based considerations. This review illuminates the complex nature of social prescribing programmes that connect general practice patients to community-based physical activity in Denmark. It also presents practical and fundamental considerations when applying social prescribing across different settings.

Exploring University Staff Views on Providing Continuing Education for Professional Engineers in Denmark: Using the Q Methodology

This article reports on a study examining 28 university engineering educators’ viewpoints on how to provide continuing education for professional engineers in a Danish university context. The Q methodology was adopted to collect and analyze data qualitatively and quantitatively. Three significantly different viewpoints were identified, prioritizing (1) a continuing engineering education (CEE) business model as an institutional priority, (2) organizational structure, and (3) pedagogy inspired by problem-based learning (PBL). The study also captured consensus on the importance of identifying the industry’s need for CEE organizations. The results reveal that CEE development needs to address diverse voices from different stakeholders, including leadership, academic faculty, and administrators; thus, suggestions from an organizational change perspective are proposed in four key aspects of CE organizations.

Do Economic Growth Targets Hinder Green Innovation? Evidence from Chinese Heavy-Polluting Enterprises

This article reports on a study examining 28 university engineering educators’ viewpoints on how to provide continuing education for professional engineers in a Danish university context. The Q methodology was adopted to collect and analyze data qualitatively and quantitatively. Three significantly different viewpoints were identified, prioritizing (1) a continuing engineering educa-tion (CEE) business model as an institutional priority, (2) organizational structure, and (3) pedagogy inspired by problem-based learning (PBL). The study also captured consensus on the importance of identifying the industry’s need for CEE organizations. The results reveal that CEE development needs to address diverse voices from different stakeholders, including leadership, academic faculty, and administrators; thus, suggestions from an organizational change perspective are proposed in four key aspects of CE organizations.

Supporting New Ways of Working for Social Workers Through High Performance Work Practices: Sustaining Professional Identity

ABSTRACTIn our study, we examine implementation of strength‐based practice (SBP) that invokes a new way of working for social workers in England. We note two antecedent conditions to support new ways of working. First, hybrid managers, who combine professional and organizational perspectives, act as a conduit for implementation of new ways of working through supporting implementation of high performance work practices (HPWPs). Second, the financial context faced by social care providers influences whether new ways of working, and HPWPs associated with this, aim to improve productivity, or enhance capability and commitment of social workers. We identify three HPWPs that support the new way of working because they align with professional identity of social workers. First, hybrid manager jobs were designed to afford opportunity for recruitment of appropriately able social workers to enact strategic influence over SBP implementation. Second, intervention to support peer‐to‐peer learning enhanced the ability of social workers to deliver SBP, and also motivated social workers toward SBP implementation because they retained professional autonomy in developing their practice. Third, performance management intervention was developmental rather than judgmental, designed to enhance ability of social workers to deliver SBP. Similar to the peer learning intervention, it remained within control of social workers, hence motivated them to engage with SBP.

Analyzing the barriers to blockchain adoption in educational sectors: a comprehensive literature review using the Technology-Organizational-Environment (TOE) framework

Purpose This study aims to investigate the challenges associated with the integration and implementation of blockchain technology in the education sector. The primary objective is to identify and categorize these challenges using the Technology-Organization-Environment (TOE) framework, shedding light on the technological, organizational and environmental factors that influence the adoption of blockchain solutions in educational settings. Design/methodology/approach A comprehensive literature review was conducted across multiple databases including Science Direct, Web of Science, Springer, IEEE Xplore and MDPI. The selected articles were analyzed based on the TOE framework to categorize challenges from the technological, organizational and environmental perspectives. The methodology involves a systematic search, analysis and synthesis of relevant articles to provide an in-depth understanding of the challenges hindering blockchain adoption in education. Findings This review revealed a predominant focus on technological challenges, emphasizing scalability issues, integration complexities, security and privacy concerns and data immutability. However, there is a notable research gap in the exploration of organizational and environmental challenges. The scarcity of studies addressing these perspectives may impact acceptance and resistance to blockchain adoption in educational settings. Originality/value This study contributes to the literature by systematically categorizing and analyzing the challenges associated with blockchain implementation in education using the TOE framework. It identifies the need for further research on organizational and environmental aspects, addressing a significant gap in the current scholarship on blockchain adoption in educational institutions.

Shaping triumph from within: an investigation into employee-based brand co-creation, motivation drivers and enhanced job-related organisational performance

PurposeDrawing on the co-creation literature and self-determination theory, this study takes a broader organisational perspective linking employees’ motivational antecedents (corporate brand socialization, employee brand identification and impression management) and employee-based brand co-creation (EBBC), with three employee-level outcomes: sales performance, employee resilience and adaptive selling. We therefore bridge the complex nexus between employees and organisational performance.Design/methodology/approachSurvey data of 313 employees across industries and different-sized business-to-business (B2B) companies in China were collected. We used AMOS 21 to carry out structural equation modelling (SEM) for testing the main hypotheses.FindingsThe results reveal that EBBC is driven by external, internal and self-related motivations and leads to an increase in the three employee performance-related outcomes. The results further indicate that employees’ social media usage exerts contrasting moderating effects for each of the three motivational antecedents: While it strengthens the effect of employee identification on EBBC, it weakens the effect of corporate brand socialization on EBBC and exerts no effect on the relationship between impression management and EBBC.Practical implicationsThis study confirms the effectiveness of EBBC in improving performance outcomes for B2B employees, particularly sales performance, resilience and job satisfaction, all of which are crucial for employee success. On the basis of our findings, in terms of employee satisfaction and performance, and in addition to conventional strategies and incentives, B2B organisations should encourage employee co-creation activities as outlined above, since such activities tend to impact these outcomes positively.Originality/valueThis study features and substantiates the self-related goal initiatives in EBBC, such as developing a sense of self-promotion desires and uncovers a moderator of the relationships between motivational antecedents and EBBC. These findings highlight the managerial relevance of specific motivational and psychological pathways in building employee brand co-creation behaviours, employee outcomes and organisational performance via employee sales.

Exploring telemedicine and organizational challenges in the healthcare system: a qualitative analysis using Grounded Theory.

Telemedicine is a context-specific intervention that implies significant procedural changes in a health organization. The objective of the study is to explore healthcare professionals' usage of and perceptions towards telemedicine technology and identify the perceived factors and related process change, influencing the effective adoption of telemedicine from an organizational perspective. The study includes multi-disciplinary commentaries of a purposive sample of 31 healthcare professionals, conducted through semi-structured qualitative interviews and employs Grounded Theory and Thematic Analysis techniques to analyze the data. Telemedicine is perceived as a highly beneficial digital intervention in healthcare, focusing on the delivery of effective healthcare, and promoting healthcare equity. Healthcare professionals showed their willingness to assimilate technology into clinical decision-making, resulting in better treatment outcomes, and recommended its' adoption into mainstream healthcare as a viable approach to providing remote healthcare. The key organizational issues with telemedicine adoption were system requirements, network connectivity, non-standardized medical records, and legal bottlenecks, that can be addressed by improving infrastructural convenience, optimizing service processes, imparting training, and adopting better technical measures. The focus is on exploring factors significant for the adoption of telemedicine technology from the perspective of multi-specialties in a health organization, rather than a specific specialty, as studied in previous scholarly work. This study contributes to the theory by proposing a conceptual framework on critical factors for telemedicine adoption, integrating the theory of planned behavior (TPB) and diffusion of innovation (DOI).

Youth engagement in global conservation governance.

Youth are increasingly recognized for their important role in shaping environmental decisions surrounding conservation. Regrettably, youth who are crucial decision-makers are often excluded from environmental governance spaces due to structural barriers, both economic and political. As highlighted by recent environmental justice literature, this marginalization hinders their active participation in the decision-making process. The recent publication of the International Union for Conservation of Nature (IUCN) Youth Strategy 2022-2030 has brought prominent environmental organizations into the debate. The IUCN World Conservation Congress (WCC) presents a useful example from which to understand how youth access and participate in decision-making at the highest level of governance in a prominent global conservation organization. We used event ethnography and participant observation methods to study the WCC Forum in Marseille, France (2021). We sought to examine the geopolitical intricacies of power and the underlying inequalities at the root of youth engagement, or lack thereof. We considered the IUCN's engagement with youth, outlining the process from previous resolutions and recommendations to the publication of the IUCN Youth Strategy in 2022. The results from the youth narratives we compiled showed that youth are not a monolith, that tokenism should be challenged, and that youth have agency but require support. We argue that when youth are mobilized in metalevel decision-making spaces, their engagement is stratified and unequal. We situated youth engagement in decision-making through the perspective of environmental organizations as a contribution to environmental governance and youth literature.

Managers' Experience of the Response of the Health System to the Covid-19 Pandemic for Inpatient Geriatric Care: Lessons About Organisation and Resilience.

Effective management of crises is a major challenge for healthcare organisations and their managers. Research suggests that to respond to evolving and unpredictable crises, such as the Covid-19 pandemic, an organisation needs the capability to continually adapt to the changing situation using relevant knowledge. However, there are few empirical studies using an organisational resilience perspective to understand how a health system responds to this type of crisis. This study aimed to describe managers' perspectives on what influenced the response to the Covid-19 pandemic in the Region Stockholm healthcare system for older people. Data collection was conducted through in-depth semi-structured interviews with assistant managers (n=3) and managers of inpatient geriatric services outside of acute care hospitals (n=8), managers of three acute care hospitals (n=3); and the crisis management team for geriatric services (n=3). Data was analysed using qualitative content analysis. Crisis management of geriatric care in the Stockholm healthcare system during the Covid-19 pandemic's first 15months was influenced by a combination of service specific aspects, 'Internal flexible responses', collaborative aspects, 'Coordination within the system', and governance aspects 'Adaptive steering'. This study contributes to empirical knowledge about organisational resilience. Managers' responses are facilitated when the governance allow them more flexibility in their internal responses and enable their cross-organisational collaboration. A coordinating function across healthcare services is an important enabler in a crisis when the function has well-established, trustful prior collaborations with the services.

E-commerce transformation: A literature review from an institutional and organizational perspective

E-commerce transformation: A literature review from an institutional and organizational perspective

Triple-loop learning as a framework for advancing health systems science in medical education: a transformational change approach

Purpose The American Medical Association has recently adopted health systems science (HSS) as the third pillar of medical education to provide comprehensive and holistic patient care. The purpose of this paper is to propose a novel organizational learning perspective in considering how medical schools can facilitate a transformational HSS curriculum change. Design/methodology/approach This is a conceptual paper seeking to present triple-loop learning as a potential approach to HSS curriculum change. Findings Due to its potential for structural accountability and sustainability stemming from the inclusion of diverse voices, the authors argue that HSS curriculum change, guided by the principles of triple-loop learning, is likely to lead to the development of medical curricula that are more adaptive and responsive to the constantly changing health-care landscape. The authors advocate for the deliberate inclusion of stakeholders who have historically been excluded or marginalized in the HSS curriculum change process, such as patients and those in sentinel roles (e.g. nurses, social workers). The authors also suggest an integrated, multilevel transformation that involves collaboration among medical schools, accreditation organizations, licensing boards and health-care systems. Originality/value To the best of the authors’ knowledge, this paper represents the first attempt to apply the theory of triple-loop learning in the context of HSS curriculum change. It highlights how this critical systemic learning approach uniquely contributes to HSS curriculum change, and subsequently to the necessary, larger cultural changes demanded in medical education as a whole.

Examining Use of Force Outcomes in Police Calls for Service: Evidence From Cincinnati

This study explores the correlates of use of force (UOF) in police responses to calls for service (CFS), drawing on situational, community, and organizational perspectives. Linear probability models were used to analyze CFS and UOF records for Cincinnati Police Department (CPD) from October 2014 to July 2021, along with sociodemographic and crime data aggregated to census tracts. The type of CFS, as well as quicker response times and police-initiated actions, were associated with UOF. Broader situational variables (including nighttime, alcohol consumption, and high activity periods), tract-level crime and sociodemographic characteristics, and year showed little statistical association. The study finds modest evidence of organizational influences on UOF outcomes, in the form of variation by police district.

One name for two concepts: A systematic literature review about meta‐organizations

AbstractExisting literature on meta‐organization is divided into two distinct streams in organizational and management studies, with different definitions and boundaries, potentially leading to inconsistencies and theoretical misalignment. Can we disambiguate the conceptualizations of meta‐organizations, and what insights can be gleaned from this clarification? Using a systematic review of the meta‐organization literature, we propose a novel classification, distinguishing between meta‐organizations as ‘meta‐level actors’, rooted in the organizational perspective, and meta‐organizations as ‘orchestrated systems’, grounded in the management perspective. While synthesizing current knowledge about meta‐organizations, we highlight the commonalities, divergences and specificities of both perspectives. We contribute to the literature on meta‐organizations by bringing greater clarity to the field, by disambiguating the uses of meta‐organization, by outlining a state of the art for both new categories and by providing a detailed research agenda. We also provide fundamental insights about two distinct ways of meta‐organizing, that is creating order among and beyond single organizations through collectively decided social orders and orchestrated social orders.

Developing A Conceptual Model of Factors Influencing Express Delivery Packaging Recycling Behaviors of E-Commerce Enterprises in China

The rapid growth of the e-commerce industry has led to a significant increase in express delivery service volumes, resulting in substantial environmental pollution and resource depletion from express delivery packaging (EDP) waste. Recycling express delivery packaging (EDPR) has become a critical global concern, particularly in China, the largest contributor to EDP waste for decades. Despite numerous government regulations aimed at promoting recycling behavior to support carbon peaking and neutrality targets, China’s recycling rate remains low, at just 25%-30%, compared to rates as high as 65% in EU countries, with some exceeding 80%. Drawing on Structuration Theory (ST), this study posits that the authority effect positively influences the recycling behavior of e-commerce organizations. It also examines the mediating role of recycling intention in the relationship between authority effect and recycling behavior and the moderating role of social sanction on recycling intention and behavior. This research aims to develop a comprehensive model for understanding the factors influencing EDPR and offers valuable insights from an organizational perspective. The findings will guide future empirical studies and help policymakers devise more effective strategies by understanding the impacts of authority and social sanction on recycling behavior.

What Does Employee Silence Mean? the Role of Organizational Climate and Burnout

The avoidance of employees to express and share their ideas and opinions about organizational issues leads to the multidimensional concept of employee silence. From an organizational perspective, it is necessary to take in consideration that individuals tend to remain silent about situations that are less positive in the organization. But silence is not just the absence of voice or communication. Silence prevents individuals from carrying out their work in the most appropriate way, can act as a barrier to organizational change and can influence the employee well-being. Acquiescent silence is the retention of information considered relevant, based on resignation and submission (passive retention) and quiescent silence comes from fear of the negative consequences from sharing information, being used as a form of self-protection. Prosocial silence is related to altruistic motives and opportunistic silence is used to obtain personal advantages. It becomes relevant to determine the factors associated with this silence and what are the implications of employee silence on employee well-being. Thus, the objectives of this study are i) to study the of employee silence motives, ii) to understand whether two of the dimensions of the authentizotic organizational climate (leader´s trust and credibility and opportunities for learning and personal development) are antecedents of employee silence and iii) to study the consequences of employee silence motives on burnout. A quantitative study is conducted, using a questionnaire survey applied to a sample of 222 individuals, working in different portuguese organizations. The confirmatory factor analysis identifies four employee silence motives. The regression analyses highlighted that authentizotic psychological climate dimensions, namely learning and personal development opportunities, were predictors of the three dimensions of employee silence: quiescent silence, aquiescent silence and opportunistic silence. Regarding the impact of employees’ silence on burnout, aquiescent silence stood out as the main predictor of different burnout dimensions: emotional exhaustion, personal accomplishment and depersonalization. Finally, it can be concluded that acquiescent silence seems to stand out as the silence variable most explained by authentizotic organizational climate and the one that most explains the appearance of burnout. The findings can be used by human resources managers.