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Strategy has become one of the most overused and misused words in our business vocabulary. Chief executives love to talk about strategy because “it's the thing to do.” Managers love the word because it makes them sound more professional. Planners love “strategy” because it allows them to establish their own unique identity within the corporation. Which managers can stand before their subordinates, peers, or bosses and admit to not having a strategy?

Many U. S. businesses face slower economic growth, increased foreign competition, and customers who are increasingly sensitive to price. As a result, a brilliant strategy is no longer enough to guarantee marketing success. Rather, U.S. corporations are increasingly focusing on developing an operational competitive advantage in R&D manufacturing, sales, and marketing. In response to this challenge, strategic planners at such corporations as Xerox, Ford, and GTE have begun to introduce a new planning tool called “benchmarking.”

The value of competitive intelligence is recognized by everyone from CEOs to line managers. However, very few firms actively link their planning process with their competitive analysis. Moreover, managers in those few firms that do have an active competitive intelligence program are often disappointed with the quality of information they receive.

This chapter describes two change efforts involving participatory action research within the pharmacy operations division of Kaiser Permanente. Focus is on a parallel learning mechanism that has been used to support communications and change during two large-scale information technology interventions. It begins with basic background information on participatory action research in organizations. Since the case setting is Kaiser Permanente, the chapter provides some information on the U.S. healthcare industry context and then shifts to Kaiser’s communication forum, a learning mechanism that has been in place for 35 years. Cognitive, structural, and procedural aspects of the learning mechanism are explored, and the chapter features interviews with some of the key forum players. Both in the forum’s infancy and in its current more institutionalized state, the pharmacy organization has been in crisis. Implications for the use of parallel learning structures on a long-term basis to support long-term participatory action research are explored along with contributions to theory on insider/outsider action research.

How do organizations act as entrepreneurs and what are the outcomes of their innovations? This paper intersects two broad areas of organizational research: the sociology of entrepreneurship and the study of organizational forms. A case study of Kaiser Permanente's role as an institutional entrepreneur in the creation of the health maintenance organization form illuminates the benefits and pitfalls of institutional entrepreneurship – in this case, the act of turning identity into form. Examining organizations as institutional entrepreneurs also raises questions and challenges for future research about both entrepreneurs and models of organizing.

The paper aims to assess the potential of aircraft operation from city centres to achieve shortened travel times and the involved aircraft design process.

The paper describes the methodical approach and iterative procedure of the design process. An assessment of potential technologies is conducted to provide the required enhancements to fulfil the constraints following an inner-city operation. Operational procedures were analysed to reduce the noise propagation through flight path optimization. Furthermore, a ground-based assisted take-off system was conceived to lower required take-off field length and to prevent engine sizing just for the take-off case. Cabin design optimization for a fast turnaround has been conducted to ensure a wide utilization spectrum. The results prove the feasibility of an aircraft developed for inner city operation.

A detailed concept for a 60-passenger single aisle aircraft is proposed for an Entry-Into-Service year 2040 with a design range of 1,500 nautical miles for a load factor of 90 per cent. Although the design for Short Take-off and Landing and low noise operation had to be traded partly with cruise efficiency, a noteworthy reduction in fuel burn per passenger and nautical mile could be achieved against current aircraft.

The findings will contribute to the evaluation of the feasibility and impact of the Flightpath 2050 goal of a 4-h door-to-door by providing a feasible but ambitious example. Furthermore, it highlights possible bottlenecks and problems faced when realizing this goal.

The paper draws its value from the consideration of the overall sizing effects at aircraft level and from a holistic view on an inner-city airport/aircraft concept design for a 4-h door-to-door goal.

This chapter examines why U.S. offshore wind farms do not exist and identifies sites most suitable for development based on European offshore wind farms. A survey of current literature indicates that U.S. development is stalled due to a lack of government and financial support. The literature identifies common attributes associated with the successful deployment of European offshore farms and provides a basis for a multi-criteria decision analysis of potential U.S offshore wind farm sites. A review of European wind farms indicates that a small, 10–50 MW farm located in shallow waters of less than 20 m might be more successful than previous U.S. development efforts. The review also identifies common European attributes deemed critical for success. These attributes are modified, taking into account unique U.S. factors, and a set of nine critical attributes are derived for use in a multi-criteria decision analysis model of suitable U.S. locations. The nine critical attributes (wind quality, water depth, shore distance, state support, public support, industrial support, population density, weather, and energy costs), along with associated utility function values, are applied to 23 past and current proposed U.S. sites. The model identified three sites, in Galveston Island, TX, Port Isabel, TX, and Block Island, RI, as being most favorable for a small wind farm.

This experimental study investigates the connotative (measured) meaning of the concept “auditor independence” within three audit engagement case contexts, including two acknowledged in the literature to represent significant potential threats to independence. The study’s research design utilises the measurement of meaning (semantic differential) framework originally proposed by Osgood et al. (1957). Findings indicate that research participants considered the concept of independence within a two factor cognitive structure comprising “emphasis” and “variability” dimensions. Participants’ connotations of independence varied along both these dimensions in response to the alternative experimental case scenarios. In addition, participants’ perceptions of the auditor’s independence in the three cases were systematically associated with the identified connotative meaning dimensions.

The dynamics of the physician knowledge system in the Southern California Region of Kaiser Permanente are explored. The framing and analysis use concepts from the knowledge management literature and network theory. The criticality of this issue to the establishment of sustainable healthcare relates to the lynchpin nature of embedding evidence-based knowledge in healthcare practice and the simultaneous challenge of combining this with clinical knowledge that derives from practice.

The case study is compiled from longitudinal interviews with over 40 physicians and other stakeholders and an examination of archival information including published articles generated by the learning system.

The socio-technical approach to building this learning system was critical given the expectations of physicians for autonomy in making clinical decisions with respect to their patients. This robust learning system builds on rich professional and organizational networks, is led by physicians, and builds on and extends the foundation of evidence relating to quality and value. The goals of the physician practice and a robust measurement and feedback system provide focus for the learning system.

Accelerating the incorporation of evidence-based practice and increasing the scope and reach of the learning system entails building physician networks, having a robust system for critically examining and extending evidence, and a clear linkage to valued outcomes.

This detailed examination of the dynamics of knowledge absorption extends understanding of the capacity of medical care systems to absorb evidence-based knowledge.

Since 1973, the pharmacy operations division of the Kaiser Permanente Medical Care Program (KPMCP) has used long-term action research programs as the principal method for orchestrating change. This chapter covers the evolution of action research theory within large, complex organizations, with particular attention to health care organizations. Four case examples from KPMCP are discussed in depth and mapped to the recently advanced Roth model of insider action research. This model considers external and internal business context, the perceived need to create new organizational capabilities, as well as insider action research theory and learning mechanisms used in change programs. Issues posed by the Roth model are explored, and new theory is advanced regarding the need for a long-term perspective, the advantages and difficulties posed when managers act as insider action researchers, and the quality of data gathering that takes place during insider action research change programs.