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Article
Publication date: 13 May 2021

Signe Vikkelsø, Mikkel Stokholm Skaarup and Julie Sommerlund

Innovation partnerships are a popular model for organizing publicly supported innovation projects. However, partners often have different timelines and planning horizons…

603

Abstract

Purpose

Innovation partnerships are a popular model for organizing publicly supported innovation projects. However, partners often have different timelines and planning horizons, understanding of purpose and concepts of value. This hybridity poses organizational challenges pertaining to trust, goal setting, learning and coordination, which may lead to “mission drift,” i.e. compromising or displacement of intended goals. Despite the risk mission drift poses, its underlying dynamics are not sufficiently understood, and the means to mitigate it are unclear. This study aims to address these questions.

Design/methodology/approach

Through eight broad and one deep case study of innovation partnerships funded by Innovation Fund Denmark (IFD), the authors investigate how partnerships reconcile multiple expectations and interests within the IFD framework and how this might lead to mission drift. The authors draw upon existing theories on the organizational challenges of innovation partnerships and supplement these with new empirically based propositions on the risk of mission drift.

Findings

This study identifies a core tension between partnership complexity and the degree of formalization. Depending on how these dimensions are combined in relation to particular goals, the partnership mission is likely to become narrower or more unpredictable than intended. Thus, the authors theorize the significance of partnership composition and requisite formalization for a given innovation purpose.

Originality/value

This study contributes to the theoretical understanding of mission drift in innovation partnerships by opening the organizational black box of partnerships. The findings underscore the value of explorative case studies for specifying the contingencies of organizational design and governance mechanisms for different innovation goals.

Details

European Journal of Innovation Management, vol. 25 no. 5
Type: Research Article
ISSN: 1460-1060

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Available. Content available
Article
Publication date: 8 August 2008

Signe Vikkelso and Peter Kjaer

1091

Abstract

Details

Journal of Health Organization and Management, vol. 22 no. 4
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 1 June 2010

Signe Vikkelsø

This paper seeks to explore the challenges and transformations in healthcare resulting from building information infrastructures for patient‐centred care.

1475

Abstract

Purpose

This paper seeks to explore the challenges and transformations in healthcare resulting from building information infrastructures for patient‐centred care.

Design/methodology/approach

Four types of information infrastructures are analysed with special attention given to the efforts and controversies related to their mobilization and to their consequences for patient‐centred care. Data are gathered through a literature review and by empirical research.

Findings

The development of information infrastructures for patient‐centred care requires mobilization of technical, legal, clinical and ethical standards as well as a change in organizational and professional boundaries. Furthermore, the mobilization of information infrastructures entails unexpected transformation in the nature of patients, professionals, health records and consultations.

Practical implications

Patient‐centred information infrastructures call for institutional innovation and decision making regarding basic structures and relationships in healthcare. At the same time, the ambitions of patient‐centred care should be broad enough to learn from the consequences of emerging infrastructures for the patient and professional identities and for the quality of care.

Originality/value

The paper contributes to the understanding of healthcare governance by conceptualizing and empirically exploring the role of information infrastructure as a formative part of patient‐centred care.

Details

International Journal of Public Sector Management, vol. 23 no. 4
Type: Research Article
ISSN: 0951-3558

Keywords

Available. Open Access. Open Access
Article
Publication date: 10 July 2017

Louise Christensen

The purpose of this paper is to explore how a study of a practice can lay the foundation to describe this very practice whilst transformations of it were taken place. Descriptions…

10901

Abstract

Purpose

The purpose of this paper is to explore how a study of a practice can lay the foundation to describe this very practice whilst transformations of it were taken place. Descriptions of changes to the practice of social work which was observed empirically serve as a starting point for experimenting with how social scientists, though often exploring transformative study objects, can remain focused on describing the object, under study.

Design/methodology/approach

The study was done through circa one year of fieldwork conducted with participant observation in two Danish municipal units offering services to socially marginalized people and interviews with social workers and employees in drug/alcohol treatment and psychiatric units.

Findings

The object of study within social sciences, though changing, is able to be described. Through the theories of “Social Navigation” (Vigh) and “Strategy and Tactics” (de Certeau), the practice of social work can be described as one concrete bounded practice but one which is performed within a transformative/changeable environment that are capable of influencing it. In this case, the experience of a changeable seascape might serve as a metaphor for how study objects change within an environment of change; how they can be viewed as “motion within motion” (Vigh).

Originality/value

Even though fields such as anthropology and organizational studies seem to rid themselves from their objects of study (culture and organization, respectively) and dissociate themselves from descriptions thereof these objects might still be of value to us. Even though the objects of study in postmodern anthropology and organizational studies are defined as unbounded, anti-essential, ephemeral, ever-changing non-objects, this might not be the entire picture. Despite their ever-changing shape, we might still be able to study and describe them if we take their changeable form and environment into account.

Details

Journal of Organizational Ethnography, vol. 6 no. 2
Type: Research Article
ISSN: 2046-6749

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Publication date: 1 January 2012

Paul Du Gay and Signe Vikkelsø

For many years within Organization Studies, broadly conceived, there was general agreement concerning the pitfalls of assuming a ‘one best way of organizing’. Organizations, it…

Abstract

For many years within Organization Studies, broadly conceived, there was general agreement concerning the pitfalls of assuming a ‘one best way of organizing’. Organizations, it was argued, must balance different criteria of (e)valuation against one another – for example ‘exploitation’ and ‘exploration’ – depending on the situation at hand. However, in recent years a pre-commitment to values of a certain sort – expressed in a preference for innovation, improvisation and entrepreneurship over other criteria – has emerged within the field, thus shifting the terms of debate concerning organizational survival and flourishing firmly onto the terrain of ‘exploration’. This shift has been accompanied by the return of what we describe as a ‘metaphysical stance’ within Organization Studies. In this article we highlight some of the problems attendant upon the return of metaphysics to the field of organizational analysis, and the peculiar re-emergence of a ‘one best way of organizing’ that it engenders. In so doing, we re-visit two classic examples of what we describe as ‘the empirical stance’ within organization theory – the work of Wilfred Brown on bureaucratic hierarchy, on the one hand, and that of Paul Lawrence and Jay Lorsch on integration and differentiation, on the other – in order to highlight the continuing importance of March's argument that any organization is a balancing act between different and non-reducible criteria of (e)valuation. We conclude that the proper balance is not something that can be theoretically deduced or metaphysically framed, but should be based on a concrete description of the situation at hand.

Details

Managing ‘Human Resources’ by Exploiting and Exploring People’s Potentials
Type: Book
ISBN: 978-1-78190-506-7

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Article
Publication date: 8 August 2008

Ebba Sjögren

The purpose of the paper is to inquire into how decisions about public fiscal responsibility for pharmaceutical spending are made and justified when there is a lack of coherent…

505

Abstract

Purpose

The purpose of the paper is to inquire into how decisions about public fiscal responsibility for pharmaceutical spending are made and justified when there is a lack of coherent, unambiguous and undisputed evidence about the material characteristics of pharmaceutical use.

Design/methodology/approach

This is an exploratory, single‐organisation case study of a Swedish governmental agency tasked with deciding whether prescription pharmaceuticals are included or excluded from the public pharmaceutical benefits scheme. A comparison is made of two intra‐organisational decision‐making processes based on interviews, document studies and participant observations undertaken over a period of two years.

Findings

The study shows that providing foundation for making decisions involves attempts to remove ambiguity among multiple knowledge claims about pharmaceuticals' characteristics. Three means of removing ambiguity are outlined. In addition, a fourth means of dealing with ambiguity is identified, when efforts to achieve coherence among multiple sources of knowledge fail. In this case ambiguity about pharmaceuticals' characteristics may be delegated to the individual medical professional to decide about treatment for specific patients.

Research limitations/implications

The limited empirical material provides no statistical generalisability of the findings. However, the study has theoretical implications for understanding decision‐making processes in health care institutions.

Originality/value

The paper provides a detailed empirical account of a newly created health care assessment organisation similar to those created in other countries to tackle problems of resource allocation.

Details

Journal of Health Organization and Management, vol. 22 no. 4
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 8 August 2008

Brit Ross Winthereik

The paper seeks to examine how an online maternity record involving pregnant women worked as a means to create shared maternity care.

701

Abstract

Purpose

The paper seeks to examine how an online maternity record involving pregnant women worked as a means to create shared maternity care.

Design/methodology/approach

Ethnographic techniques have been used. The paper adopts a theoretical/methodological framework based on science and technology studies.

Findings

The paper shows how a version of “the responsible patient” emerges from the project which is different from the version envisioned by the project organisation. The emerging one is concerned with the boundary between primary and secondary sector care, and not with the boundary between home and clinic, which the project identifies as problematic and seeks to transgress.

Research limitations/implications

The pilot project, which is used as a case, is terminated prematurely. However, this does not affect the fact that more attention should be paid to the specific redistribution of responsibilities entailed in shared care projects. Rather than seeking to connect all actors in an unbounded space, shared care might instead suggest a space for patients and professionals to experiment with new roles and responsibilities.

Practical implications

When designing coordination tools for health care, IT designers and project managers should attend to the specific ways in which boundaries are inevitably enacted and to the ways in which care is already shared. This will provide them with opportunities to use the potentials of new identities and concerns that emerge from changing the organisation of healthcare in relation to IT design.

Originality/value

The paper shows that “unshared” care does not exist; care is always shared among human and nonhuman actors. It also points to the value of studying how boundaries are enacted in projects that seek to create continuity across boundaries.

Details

Journal of Health Organization and Management, vol. 22 no. 4
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 8 August 2008

Tone Opdahl Mo

The paper seeks to explore whether the development in department management in Norwegian hospitals after the unitary management reform in 2001 constitutes a development in the…

1501

Abstract

Purpose

The paper seeks to explore whether the development in department management in Norwegian hospitals after the unitary management reform in 2001 constitutes a development in the direction of general management

Design/methodology/approach

Interviews were conducted with ten managers from different levels in a large Norwegian university hospital in 2001‐2002, as a unitary management model was implemented.

Findings

There is an emerging change of practice among the physician managers according to this study. The manager function is more explicit and takes a more general responsibility for the department and the professions. However, the managerial function is substantiated by conditions related to the professional field of knowledge, which gives legitimacy within a medical logic. Contact with the clinic is stressed as important, but it is possible to adjust both amount and content of a clinical engagement to the demands of the new manager position. This has both a symbolic and a practical significance, as it involves both legitimacy and identity issues.

Practical implications

The paper shows that the institutionalised medical understanding of management has a bearing on managerial reforms. Managerial changes need to relate to this if they are to have consequences for the managerial roles and structures on department level in hospitals.

Originality/value

The paper suggests that the future development of this role will depend on the way the collectivist and individualist aspects of responsibility are handled, as well as on the further development of managerial knowledge of physicians.

Details

Journal of Health Organization and Management, vol. 22 no. 4
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 8 August 2008

Viola Burau and Karsten Vrangbæk

The paper aims to account for the substance of non‐linear governance change by analysing the importance of sector‐specific institutions and the pathways of governing they create.

862

Abstract

Purpose

The paper aims to account for the substance of non‐linear governance change by analysing the importance of sector‐specific institutions and the pathways of governing they create.

Design/methodology/approach

The analysis uses recent reforms of the governance of medical performance in four European countries as a case, adopting an inductively oriented approach to comparison. The governance of medical performance is a good case as it is both, closely related to redistributive policies, where the influence of institutions tends to be pertinent, and is subject to considerable policy pressures.

Findings

The overall thrust of reforms is similar across countries, while there are important differences in relation to how individual forms of governance and the balance between different forms of governance are changing. More specifically, sector‐specific institutions can account for the specific ways in which reforms redefine hierarchy and professional self‐regulation and for the extent to which reforms strengthen hierarchy and affect the balance with other forms of governance.

Originality/value

The recent literature on governance mainly focuses on mapping out the substance of non‐linear change, whereas the development of explanations of the substance of governance change is less systematic. In the present paper, therefore, it is suggested coupling the notion of non‐linear change with an analysis of sector specific institutions inspired by the historical institutionalist tradition to better account for the substance of non‐linear governance change. Further, the analysis offers interesting insights into the complexity of redrawing boundaries between the public and the private in health care.

Details

Journal of Health Organization and Management, vol. 22 no. 4
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 8 August 2008

Annegrete Juul Nielsen, Morten Knudsen and Katrine Finke

Since the emergence of new public health in the 1970s, health has not merely been considered the absence of disease, but physical, mental and social wellbeing. This article seeks…

740

Abstract

Purpose

Since the emergence of new public health in the 1970s, health has not merely been considered the absence of disease, but physical, mental and social wellbeing. This article seeks to analyzes the implications of this broad concept of health at an organizational level.

Design/methodology/approach

The paper presents a qualitative case study of boundary drawing in a Danish municipal agency in charge of planning and conducting health promoting and disease preventing activities from 1989 to 2005. The theoretical framework draws on Niklas Luhmann's organization theory.

Findings

Two different organizational answers were found to the challenges inherent in the broad concept of new public health. First, the organization tried to increase its size and incorporate as many aspects of the environment as possible. This expansive strategy jeopardised the identity of the organization. Second, the organization tried to keep clear and tight boundaries and from this position irritate entities in the environment. This limitative strategy made the organization spend relatively more energy on organizing and controlling itself than on public health work.

Practical implications

The case study shows how a broad concept of health makes boundary management topical in organizations dealing with health promotion and disease prevention. Organizations in charge of public health activities need to reflect on how they can create intelligent compensations for the disadvantages involved in an expansive or a limitative strategy.

Originality/value

The broad concept of health inherent in new public health has been widely accepted and yet its challenges to organizational boundary drawing have attracted little attention. This paper provides an analysis of these challenges.

Details

Journal of Health Organization and Management, vol. 22 no. 4
Type: Research Article
ISSN: 1477-7266

Keywords

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