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This manuscript discusses the main findings gathered through a systematic literature review aimed at crystallizing the state of art about evidence-based management (EBMgt) in healthcare. The purpose of this paper is to narrow the main gaps in current understanding about the linkage between sources of evidence, categories of analysis and kinds of managerial decisions/management practices that different groups of decision-makers put in place. In fact, although EBMgt in healthcare has emerging as a fashionable research topic, little is still known about its actual implementation.

Using the Scopus database as main source of evidence, the authors carried out a systematic literature review on EBMgt in healthcare. Inclusion and exclusion criteria have been crystallized and applied. Only empirical journal articles and past reviews have been included to consider only well-mature and robust studies. A theoretical framework based on a “process” perspective has been designed on these building blocks: inputs (sources of evidence), processes/tools (analyses on the sources of evidence), outcomes (the kind of the decision) and target users (decision-makers).

Applying inclusion/exclusion criteria, 30 past studies were selected. Of them, ten studies were past literature reviews conducted between 2009 and 2014. Their main focus was discussing the previous definitions for EBMgt in healthcare, the main sources of evidence and their acceptance in hospitals. The remaining studies (n=20, 67 percent) were empirical; among them, the largest part (n=14, 70 percent) was informed by quantitative methodologies. The sources of evidence for EBMgt are: published studies, real world evidence and experts’ opinions. Evidence is analyzed through: literature reviews, data analysis of empirical studies, workshops with experts. Main kinds of decisions are: performance assessment of organization units, staff performance assessment, change management, organizational knowledge transfer and strategic planning.

This study offers original insights on EBMgt in healthcare by adding to what we know from previous studies a “process” perspective that connects sources of evidence, types of analysis, kinds of decisions and groups of decision-makers. The main findings are useful for academia as they consolidate what we know about EBMgt in healthcare and pave avenues for further research to consolidate this emerging discipline. They are also useful for practitioners, as hospital managers, who might be interested to design and implement EBMgt initiatives to improve hospital performance.

This paper aims to investigate the performances of decision-making process of emergency department’s nurses involved in the triage level assessment.

The authors developed a case study in two public hospitals in the South of Italy. The authors administered 25 clinical cases to nurses responsible of priority code assignment in the triage station. The authors simulated the attribution of the priority levels, and through a semi-structured questionnaire, the authors collected data and information about the cognitive process adopted for the final choice.

The quantitative and qualitative data allowed the authors to verify that there is an impact of the organizational context on heuristics used in the decision-making process.

The research limitations are that empirical data have been collected only in two emergency departments.

The practical implications of this paper are that organizations for improving business performances must consider the judgements are often the results of heuristics embedded in a specific structure of social and physical environment, according with the “ecological view” of rationality.

The authors’ methodological approach contributes to analyze the performances of the triage process, verifying if the eventual errors are linked to individual or organizational factors, but above all how organizational constraints influence decision-making processes in organizations and, consequently, business performances.

The purpose of this paper is to present a social network approach for identification of micro-organizational re-design interventions to make more efficient and fluid the knowledge flow in a rehabilitation multidisciplinary team. The structural information of different kinds of knowledge networks within a team is augmented with additional analyses aimed at collecting information about the ways through which participants use knowledge, the motivation behind knowledge exchange, and the non-human knowledge sources used by subjects to perform their work. This paperwork was supported by CNCSIS – UEFISCDI, project number PNII – IDEI 810/2008.

The authors propose a definition of knowledge network including human and non-human knowledge source (documents and knowledge repositories) as it is more adequate for the analysis of knowledge flows in multidisciplary medical teams. The mapping and analysis of the network are carried out through: elicitation of knowledge flows between people within and outside the team through a structured questionnaire; mapping of the knowledge flows toward non-human knowledge sources; and identification of critical aspects and proposal of re-engineering interventions to make knowledge flow more efficient and effective.

The analysis of the critical aspects emerged in the field study identifies a number of opportunities to improve the efficiency and effectiveness of knowledge sharing through the re-design of the team network. The re-design interventions concern three main features of knowledge network: “knowledge centralization,” “Over-reliance on External experts,” “Unshared knowledge tools and sources.”

The originality of the work resides in applying social network analysis (SNA) for healthcare management settings, proving evidence and guidelines to show how healthcare organizations can benefit from the adoption of SNA-based approaches.

The purpose of this paper is to investigate the influence of organizational factors on individual decision-making under conditions of uncertainty and time pressure. A method to assess the impact of individual and organizational factors on individual decisions is proposed and experimented in the context of triage decision-making process.

The adopted methodology is based on the bias-variance decomposition formula. The method, usually applied to assess the predictive accuracy of heuristics, has been adjusted to discriminate between the impact of organizational and individual factors affecting heuristic processes. To test the methodology, 25 clinical scenarios have been designed and submitted, through simulations, to the triage nurses of two Spanish hospitals.

Nurses’ decisions are affected by organizational factors in certain task conditions, such as situations characterized by complete and coherent information. When relevant information is lacking and available information is not coherent, decision-makers base their assessments on their personal experience and gut feeling.

Discriminating between the influence of organizational factors and individual ones is the starting point for a more in-depth understanding of how organization can guide the decision process. Using simulations of clinical scenarios in field research does not allow for capturing the influence of some contextual factors, such as the nurses’ stress levels, on individual decisions. This issue will be addressed in further research.

Bias and variance are useful measurements for detecting process improvement actions. A bias prevalence requires a re-design of organizational settings, whereas training would be preferred when variance prevails.

The main contribution of this work concerns the novel interpretation of bias and variance concepts to assess organizational factors’ influence on heuristic decision-making processes, taking into account the level of complexity of decision-related tasks.

This research aims to shed new lights on the most shared constructs developed on Innovation Ecosystems, Entrepreneurial Ecosystems and Technology Transfer Ecosystem proposing an additional stand-alone ecosystem.

This research is built upon a qual-quantitative analysis of an empirical case. The latter analysis is performed through a single case study methodology on the San Giovanni Hub of the Federico II University of Naples.

Evidences show how a technological hub orchestrates three main ecosystems for the knowledge exploitation: the technology transfer ecosystem, devoted to gather knowledge form universities' labs towards industries; the innovation ecosystem, able to manage the exploration and exploitation of new knowledge and techniques; the entrepreneurial ecosystem, that supports startup/spinoff creation process.

Limitations mainly concern the fact that it is centred on just one case study.

Practical implications imply new opportunities of collaboration involving different stakeholders as university administrators, researchers, businesses and policymakers, creating a supportive environment for innovation.

The research offers a new vision about the role of Universities as creators and enablers of ecosystems pursuing diverse value propositions. The Academic Innovation Ecosystem is a new conceptualization of this role played by a university, and it can convey innovation and entrepreneurial attitude within its ecosystem leveraging on the transfer of university knowledge and technology.

The purpose of this paper is to explain the emergence of collaboration networks in entrepreneurial clusters as determined by the way entrepreneurs exchange knowledge and learn through business transactions needed to implement temporary supply chains in networks of co-located firms.

A socio-computational approach is adopted to model business transactions and supply chain formation in Marshallian industrial districts (IDs). An agent-based model is presented and used as a virtual lab to test the hypotheses between the firms’ behaviour and the emergence of structural properties at the system level.

The simulation findings and their validation based on the comparison with a real world cluster show that the topological properties of the emerging network are influenced by the learning strategies and decision-making criteria firms use when choosing partners. With reference to the specific case of Marshallian IDs it is shown that inertial learning based on history and past collaboration represents in the long term a major impediment for the emergence of hubs and of a network topology that is more conducive to innovation and growth.

The paper offers an alternative view of entrepreneurial learning (EL) as opposed to the dominant view in which learning occurs as a result of exceptional circumstances (e.g. failure). The results presented in this work show that adaptive, situated, and day-by-day learning has a profound impact on the performance of entrepreneurial clusters. These results are encouraging to motivate additional research in areas such as in modelling learning or in the application of the proposed approach to the analysis of other types of entrepreneurial ecosystems, such as start-up networks and makers’ communities.

Agent-based model can support policymakers in identifying situated factors that can be leveraged to produce changes at the macro-level through the identification of suitable incentives and social networks re-engineering.

The paper presents a novel perspective on EL and offers evidence that micro-learning strategies adopted and developed in routine business transactions do have an impact on firms’ performances (survival and growth) as well as on systemic performances related to the creation and diffusion of innovation in firms networks.

This paper aims to present a methodology for the mapping and evaluation of suppliers’ competencies and know-how. The authors operationalize the concept of organizational competence and provide companies with a customized management tool to map suppliers’ critical competencies for screening strategic from non-strategic suppliers and providing inputs for suppliers’ development.

Competencies assessment, carried out through a fuzzy knowledge management system (VINCI), is performed through the aggregation of indicators related to the control of critical resources, the degree of implementation of critical processes, the competitive positioning and the financial situation of a supplier. Competencies description and operationalization are based on the bottom-up elicitation of the subjective knowledge managers actually use to assess suppliers’ capability. Such subjective knowledge is then validated and formalized through a top-down approach based on strategic literature.

The authors tested VINCI on a sample of 38 suppliers of a large company. The results show that the methodology provides its users with a highly customizable knowledge map and its associated decision support tool that keeps into account the peculiar strategic needs of the company in the management of an existing portfolio of suppliers.

VINCI outcomes can be used to perform benchmarking analyses, define entry criteria and thresholds for suppliers’, identify improvement targets and service levels to be considered in the definition of supply contracts, supporting the alignment of supplier’s management with business strategy.

The most important original contribution of this work resides in the operationalization and measurements of firms’ competencies based on the elicitation of subjective knowledge that managers use in the actual assessment. A further distinctive feature of this paper is that the method is applied to small and medium companies, whereas large part of the literature on core or organizational competencies assessment is focused on large companies.

The purpose of this paper is to set out a methodological framework to investigate how the integration of an activity-based costing (ABC) logic into the pre-existent accounting system supports healthcare organizations in identifying the inefficiencies related to their diagnostic therapeutic pathways (DTP) and related reengineering interventions.

The BPM-ABC methodological framework has been applied to the case of a specific surgery pathway, at the Orthopaedic Division of a University Hospital in Italy.

The case-study described in the paper points out: first, how the Business Process Management (BPM)-ABC methodology is able to produce significant information about consumed resources and the costs of the activities, useful to highlight opportunities for DTPs improvement; second, the barriers related to a pre-existing accounting system based on cost centres that can hinder the implementation of the BPM-ABC model.

The case study points out the role of the ABC as a management tool for supporting decision-making processes. The ABC allows inferring information for two purposes. First, ABC supports a cost containment process as it allows highlighting the most cost-consuming activities and resources. Second, the ABC allows identifying reengineering paths, distinguishing between incremental and radical ones.

This study represents a remarkable reference raising the awareness of the pivotal role accounting systems play in the management of the organizational processes.