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The patient flow performance achievable by care pathways is constrained by competing flow and resource efficiency, which can negatively impact improvements. This paper probes the divergence between resource and flow efficiency and how care pathways can lead to improved patient flow. By framing the problem through the lens of paradox theory, a set of design principles is proposed to assist decision-makers in care pathway implementation. Implications are derived for research and practice.

The authors used conceptual research to develop design principles for care pathways based on a systematic review of relevant care pathway research. The initial search contained 515 unique articles, resulting in a final sample of 56 studies.

When applying care pathways, patient flow may be negatively affected in relation to the dimensions of bottlenecks, non-value-adding activities, and variability. However, the findings also indicate methods that can be applied to manage organizational paradoxes, which can contribute to more efficient patient flow along each of the three dimensions.

The study is limited to care pathways and therefore could have missed relevant studies in similar fields, such as care coordination.

Health care managers, politicians, and IT developers can apply the proposed design principles when developing, implementing, and improving care pathways and supporting technologies.

While existing research has studied care pathways from a medical perspective, this is the first paper to the author’s knowledge that addresses care pathways directly by considering paradox theory and in light of the operations management literature.

This paper aims to make sense of the social enterprise in a frame of social procurement and conceptualise it as a provider of public welfare based on bibliometric material. Comprehensively, it contributes to developments in social procurement, which has received limited attention.

Scoping literature from Web of Science and using bibliometric methods, the paper identifies and qualitatively explores the literary intersections between social enterprise and social procurement.

Of the 183 articles, four literary clusters are revealed illustrating scholarly intersections and a detailed exploration of social enterprise as a public provider. The alignment and themes of the clusters further indicate the application of, and role played by, social enterprise in social procurement. Collectively, they reveal the dominance of social enterprise in this dyadic relationship and a minor undertaking of research in social procurement.

This “sense-making” groundwork forms a foundational step in developing our understanding of procurements through social enterprises. Furthermore, a positioning and conceptualisation of social enterprise accredits their utility and applicability in delivering public benefits. In this way, the paper informs and supports scholarly and practice-based interest into social enterprises for the delivery of public services.

The paper presents the first bibliometric conceptualisation of social enterprise in relation to social procurement and offers detailed insights through the bibliometric clusters. Furthermore, the paper contributes to the underdeveloped social dimension of procurement and bridges the gap between two distinct fields of scholarship: public management and administration and social entrepreneurship.