The unintended negative consequences of knowledge translation in healthcare: A systematic scoping review

Knowledge translation represents an avenue to address the oft-cited chasm between what should and what does happen in healthcare. Knowledge translation encompasses myriad processes through which different knowledges coalesce to inform practice. However, some reports suggest that experiences with knowledge translation are less than favourable. To better understand these experiences, a systematic scoping review of academic literature was conducted to unveil the unintended negative consequences of knowledge translation and how they were addressed. After screening 9,598 publications, six reported evidence of unintended negative consequences. The most prevalent was emotional labour - negative emotional or psychological sequelae, depression, anxiety, powerlessness, and frustration. These consequences were experienced by knowledge translation brokers, knowledge translation recipients, and knowledge translation producers. All but one publication offered some discussion of strategies to manage or mitigate these unintended negative consequences, including co-design, collaboration, and supported dialogue. These findings suggest there is limited research that explicates the unintended negative consequences of knowledge translation. Given the importance of knowledge translation, this review indicates there is considerable opportunity to advance it, in a better-informed way. Only by considering the unintended negative consequences of knowledge translation can they be identified, addressed, and potentially moderated, if not averted.

Daily Job Crafting and Adaptive Performance During Organizational Change: The Moderating Role of Managers’ Influence Tactics

Is job crafting relevant for adaptive performance in the absence of managers’ effective influence tactics and the presence of ineffective tactics? Based on job demands-resources and conservation of resources theories, we examined whether employee daily job crafting behaviors (i.e., resources seeking, challenges seeking, demands reducing) interact with overall managers’ influence tactics during times of organizational change in explaining change outcomes. Twenty-nine hotel employees completed a questionnaire to evaluate their managers’ influence tactics, and then a diary for five consecutive workdays to assess daily job crafting behaviors and daily adaptive performance during a large-scale change. Multilevel analyses revealed that daily seeking resources related positively to adaptive performance particularly when specific managers’ influence tactics were low. These findings imply that employees compensate for the absence of managers’ influence tactics by seeking resources in order to facilitate their own adaptation to organizational changes.

Relation between Organizational Capacity for Change and Readiness for Change

Readiness for change is seen as an important prerequisite increasing chances for change success. While assessing the readiness level allows for tailoring of the interventions and the change process, it requires time and planning. When organizations face increasing levels of unpredictability and need to adapt to fast environmental shifts, linear causal models to plan and implement changes become harder to follow. Emergent changes also barely accommodate planning and assessing readiness levels. Multiple and overlapping change initiatives become the norm rather than an exception, thus exert additional pressure on organizations hoping to start with assessing and developing readiness. Applying dynamic capabilities lens allows addressing such challenges through the concept of organizational capacity for change. This article reviews theoretical and empirical research advances to answer two questions. First, how do readiness and organizational capacity for change differ? A review of theoretical assumptions, dimensions and antecedents is employed to delineate the two constructs. Second, what is the relationship between the two constructs? The analysis is guided by an organizational change typology to highlight their applicability to selected types of change. The research concludes that capacity for change differs and can complement readiness in helping organizations navigate unpredictable environments.

Change of tourism organizations: Implications from a review of cultural tourism research

Change has been universally acknowledged as the perpetual theme for routine organizational life. As cultural tourism, a major element of global tourism consumption accounting for 40% of tourism employment, is becoming increasingly flourishing and promising, tourism organizations are also obliged to implement a series of organizational changes to adapt to the trending culturalization in the tourism domain. In light of this, this research, by outlining important sub-themes and trends of cultural tourism research, tracks the evolution of cultural tourism as a research field over the previous decades so as to analyze existing interconnections between the systematic review and tourism organizational change. Based on these interconnections, the research also manages to propose several potential implications for tourism organizations to optimize their future implement of daily organizational changes for the sake of adaptative survival and development.

Phronetic improvisation: A virtue ethics perspective

Traditional approaches to organizational improvisation treat it as a merely functional response to environmental constrains and unforeseen disruptions, neglecting its moral dimension, especially the valued ends improvisers aim to achieve. We attempt to address this gap by drawing on virtue ethics. In particular, we explore how phronetic improvisation is accomplished by drawing on the diary of an emergency-room physician, in which she describes her (and colleagues’) experience of dealing with Covid-19 in a New York Hospital, during the first spike in March–April 2020. We argue that improvisation is phronetic insofar as practitioners actively care for the valued ends of their practice. In particular, practitioners seek to phronetically fulfil the internal goods of their practice, while complying with institutional demands, in the context of coping with situational exigencies. Phronetic improvisation involves paying attention to what is salient in the situation at hand, while informed by an open-ended commitment to valued ends and constrained by scarce resources, and driven by a willingness to meet what is at stake through adapting general knowledge to situational demands. Such an inventive process may involve reshaping the original internal goods of the practice, in light of important institutional constrains.

Impacts of digital business on global value chain participation in European countries

As the first empirical study of the nonlinear effects of digital business on global value chains (GVC), we provide insight into the nonlinear effects of digital business on the global value chain (GVC) values. We employ four indicators, including the value of online selling, sales through E-commerce, and customer relationship management (CRM) usage, to capture the prevalence of digital business in the economy. By testing a sample of 25 European countries that have been analyzed using various econometric techniques over the period 2012-2019, our estimation results confirm that GVC values are a U-shaped function of digitalization. That is, an increase in digitalization pervasiveness initially induces more significant risks and uncertainties, hindering European countries from getting involved in or scale-up within the GVC. However, a rise in digitalization pervasiveness goes beyond a specific threshold, which facilitates GVC activities as more opportunities are created. Furthermore, our findings suggest that digital business contributes significantly to reducing the adverse influences of global uncertainty on the GVC values, while the marginal effects of digital business on GVC values become more pronounced in countries with the most advanced institutional structure.

Capabilities for enhancing supply chain resilience and responsiveness in the COVID-19 pandemic: exploring the role of improvisation, anticipation, and data analytics capabilities

Purpose

This study aims to identify critical capabilities to address unforeseen and novel disruptions, such as those instigated by COVID-19, and explore their role as essential enablers of supply chain resilience and responsiveness, leading to improved performance.

Design/methodology/approach

The structural equation modeling technique was employed for analyzing the proposed associations using survey data from 206 manufacturers operating during the COVID-19 pandemic in a developing country, Pakistan.

Findings

Key findings show how improvisation and anticipation act distinctly yet jointly to facilitate supply chain resilience and responsiveness during the COVID-19 pandemic. Also, data analytics capability positively affects anticipation and improvisation, which mediate the effect of data analytics on supply chain resilience and responsiveness.

Research limitations/implications

The findings contribute to the theoretical and empirical understanding of the existing literature, suggesting that a combination of improvisation, anticipation and data analytics capabilities is highly imperative for enhancing supply chain resilience and responsiveness in novel and unexpected disruptions.

Originality/value

This is the first study to examine the impact of data analytics on improvisation and anticipation and the latter as complementary capabilities to enhance supply chain resilience and responsiveness. The empirical investigation explores the interplay among data analytics, improvisation, and anticipation capabilities for enhancing supply chain resilience, responsiveness, and performance during the unforeseen and novel disruptions, such as brought to bear by the COVID-19 pandemic.

Development and implementation processes of digitalization in engineer-to-order manufacturing: enablers and barriers

This study seeks to gain knowledge about key conditions in the process of digitalization using a socio-technical systems design as a theoretical framework and a case-study approach. Semi-structured interviews with 15 relevant stakeholders are conducted to learn about barriers to and enablers of the development and implementation process in a manufacturing company. After conducting a thematic analysis, eight higher-ranked themes relevant to the digitalization process are identified. These are grouped to describe the overarching phenomena, resulting in four enablers (shared trust, shared visual understanding, shared user perspective, and shared learning) and four barriers (trusting the system, understanding benefits, perspective of economics, and learning to manage scope). The study takes a holistic view of digitalization in its investigation of the development and subsequent implementation processes. The findings contribute to the literature via three key takeaways for stakeholders of a digitalization process in manufacturing. First, it is vital to understand and strengthen the role of the key enablers identified in this paper. Second, managers should observe and identify barriers in their own organizations, related both to technical and social aspects. Third, some of the enablers described in this paper can serve managers as helpful tools to approach the expected barriers to digitalization. This paper also challenges the research literature by arguing that research conducted on digitalization that sets new standards and premises for the working life in industry needs to use up-to-date socio-technical design concepts and theories.

The Digital Undertow: How the Corollary Effects of Digital Transformation Affect Industry Standards

Digital transformation research shows how waves of digitalization produce strategic changes within and across firms, enabling new forms of value creation. We argue that different but no less important processes of digital transformation are generated by the undertow produced by these waves. Digital undertow, a corollary effect of waves of digitalization, profoundly influences how firms operate by transforming the industry standards that coordinate and regulate their core business activities. This is producing what we refer to as digital displacement, a process that is significantly challenging the capacity of standards to effectively manage industry operations in the digital age.

Entrepreneurship-driven organizational transformation for sustainability: a sensemaking lens

Purpose

This paper adopts a sensemaking lens to explore the process of entrepreneurship-driven organizational transformation for sustainability.

Design/methodology/approach

Analysis is based on an in-depth case study of a large European meat company. Sensemaking by top and middle managers is analyzed over the period of 18 months.

Findings

The findings show how, over time, bidirectional sensemaking, that is, sensemaking for and of sustainability-oriented entrepreneurship, directed and accelerated organizational transformation for sustainability. The case company transformed with regard to organizational strategy, structure, operations and identity. The process revealed temporally different involvement of top and middle managers in sensemaking.

Originality/value

This paper offers unique insights into fast and emergent sustainability-oriented change in an established organization within a highly topical context. The results highlight how continuous and increasingly shared sensemaking can help top and middle managers navigate organizational change for sustainability in dynamic environments over time.

Digital transformation shaping structural pillars for academic entrepreneurship: A framework proposal and research agenda

Digital technology always accelerates change, altering organisations culturally, socially and technically. These modifications are known as "digital transformation" (DT). On a much greater scale than DT, the world was changed in 2020 by the COVID-19 pandemic, which re-organised society in the way of thinking, acting, producing, consuming and creating new business. Higher Education Institutions (HEIs) were no different, since these institutions had to make changes to the student-lecturer interaction; teaching-learning, where DT had a relevant role, above all in academic entrepreneurship. Therefore, this study aims to propose a framework showing the structural pillars of the link between digital transformation (DT) and academic entrepreneurship (AC) (DT-AC Framework). This framework identifies the new patterns, methods, skills and other discoveries in aspects such as management, information systems and culture sciences. The intention is not to analyse how the COVID-19 pandemic imposed global structural changes, but because of it, lecturers and students found their DT accelerated and intensified, and so it is necessary to investigate the pillars supporting academic entrepreneurship. The results show that DT was already emerging as a basic element of academic entrepreneurship before the pandemic, but the process has speeded up. This bibliometric study indicates the structural pillars that support entrepreneurship following the Covid19 pandemic, as created from DT in universities, providing an extensive systematic review that indicates the cause and effect of the academic entrepreneurship process.

We Are All Theorists of Technology Now: A Relational Perspective on Emerging Technology and Organizing

Technologies are changing at a rapid pace and in unpredictable ways. The scale of their impact is also far-reaching. Technologies such as artificial intelligence, data analytics, robotics, digital platforms, social media, blockchain, and 3-D printing affect many parts of the organization simultaneously, enabling new interdependencies within and between units and with actors that many organizations have typically considered to be outside their boundaries. Consequently, today’s emerging technologies have the potential to fundamentally shape all aspects of organizing. This article introduces the special issue “Emerging Technologies and Organizing.” We treat these new technologies as “emerging” because their uses and effects are still varied and have yet to stabilize around a recognizable set of patterns and because the technologies themselves are, by design, always changing and adapting. To theorize the relationship between emerging technologies and organizing, we draw on relational thinking in philosophy and sociology to develop a relational perspective on emerging technologies. Our goal in doing so is to create a new way for organizational scholars to incorporate the ever-increasing role of technology in their theorizing of key organizational processes and phenomena. By developing a relational perspective that treats emerging technologies not as stable entities, but as a set of evolving relations, we provide a novel way for organizational scholars to account for the role of technology in their topics of interest. We sketch the outlines of this relational perspective on emerging technologies and discuss the implications it has for what organizational scholars study and how we study it.

Crisis behaviors as drivers of value co-creation transformation

Purpose

The paper aims to conceptualize how behavioral shifts in times of crisis drive the transformation of value co-creation.

Design/methodology/approach

Referencing two empirical contexts, the paper explores how digital service platforms facilitate changes in actors’ mental models and institutional arrangements (legal, social, technological) that drive transformation of value co-creation in service ecosystems.

Findings

The proposed conceptual framework contributes to existing research by identifying micro-level changes in actors’ mental models and macro-level changes in institutional arrangements enabled by digital service platforms in service ecosystems. In particular, the framework identifies motivation, agility and resistance as moderators of behavioral shifts in times of crisis. This account offers a finer-grained theorization of the moderating factors and underlying mechanisms of service ecosystem transformation but does not extend to the ensuing “new normal.”

Practical implications

The proposed framework indicates how digital platforms support shifts in actors’ behavior and contribute to the transformation of value co-creation. While the enablers are situation-specific and may therefore vary according to the prevailing conditions, the actor-related concepts advanced here seem likely to remain relevant when analyzing the transformation of value co-creation in other crisis situations.

Originality/value

The new conceptual framework advanced here clarifies how behavioral shifts during a crisis drive the transformation of value co-creation and suggests directions for future research.

Co-Opting Regulation: Professional Control Through Discretionary Mobilization of Legal Prescriptions and Expert Knowledge

The governance of front-line professionals is a persistent organizational problem. Regulations designed to make professional work more legible and responsive to both organizational and public expectations depend on these professionals’ willing implementation. This paper examines the important question of how professional control shapes regulatory compliance. Drawing on a seventeen-month ethnographic study of a bioscience laboratory, we show how professionals deploy their discretionary judgment to assemble environmental, health, and safety regulations with their own expert practices, explaining frequently observed differential rates of regulatory compliance. We find that professional scientists selectively implement and blend formal regulations with expert practice to respond to risks the law acknowledges (to workers’ bodies and the environment) and to risks the law does not acknowledge but professionals recognize as critical (to work tasks and collegiality). Some regulations are followed absolutely, others are adapted on a case-by-case basis; in other instances, new practices are produced to control threats not addressed by regulations. Such selective compliance, adaptation and invention enact professional expertise: interpretations of hazard and risk. The discretionary enactment of regulations, at a distance from formal agents, becomes part of the technical, practical, and tacit assemblage of situated practices. Thus, paradoxically, professional expert control is maintained and sometimes enhanced as professionals blend externally imposed regulations with expert practices. In essence, regulation is co-opted in the service of professional control. This research contributes to studies of professional expertise, the legal governance of professionals in organizations, regulatory compliance, and safety cultures.

Personal Achievement Goals, Learning Strategies, and Perceived IT Affordances

What people perceive when they interact with technologies are not the features and functionalities of the technology but rather the behaviors it affords them. Affordance perception determines how organizational information technology (IT) is used by employees and the benefits they provide to organizations and their members. In this article, we explain how employees who pursue different personal goals and use various learning strategies come to perceive different IT affordances. We identify three distinct pathways: (1) performance-avoidance goals are positively associated with surface processing, which leads to perceptions of common in-role IT affordances; (2) performance-approach goals are positively associated with surface processing and effort regulation and these learning strategies lead to perceptions of common and specialized in-role IT affordances; and (3) mastery goals are associated with deep processing, effort regulation, and peer learning, which are positively associated with perceptions of specialized in-role and extra-role IT affordances. By identifying the different pathways to perceived affordances, the article identifies potential interventions that can help managers steer employees toward certain affordances and away from other, less desirable affordances.

Managing the Transition to a Dual Business Model: Tradeoff, Paradox, and Routinized Practices

Building on an in-depth study of a manufacturing company’s shift from a product to a product-service business model, we explore how single-focus companies transition to a dual orientation. Although companies generally use highly sophisticated practices to manage a dual orientation, those that transition to one successfully start with less sophisticated practices. Early on, the use of simple tradeoff practices, which maintain the product and service logics, helps single-focus companies explore the emergent tensions that their transition to a dual orientation causes. Conversely, adopting more sophisticated practices at this early stage overwhelms them. At a later stage, these companies’ growing understanding of the tensions allows them to experiment with more comprehensive paradox practices that transcend the product and service logics. Conversely, maintaining simple practices at this stage prevents them from gaining the solution experience required to complete the transition. The evolutionary process culminates in sophisticated routinized practices that institutionalize recurrent tensions’ solution, while allowing for further experimentation to deal with new tensions. The different practices’ appropriate sequence and pacing during the evolutionary process facilitate companies’ transition to a dual orientation.

User Competence with Enterprise Systems: The Effects of Work Environment Factors

Enterprise system users are required to improve competence to gain the system’s value. The development of user competence to effectively use a complex system is socially constructed. Based on the job demands-resources model, we propose and empirically validate how two types of work contextual factors, namely, job demands and job resources, are directly and interactively related to user competence. Results of a longitudinal survey from users in six organizations suggest that all three job resource factors considered—leader–member exchange, traditional support structures, and peer support structure—allow users to acquire both the technical and business knowledge needed for effective application of the system for work. But, work overload, as the job demand factor, has no significant effect on user competence. Further analysis shows the relationship between work overload and user competence is moderated by leader–member exchange, but not the two support structures. Our findings are of great importance for practice, as they suggest job resources are conducive to the development of user competence, whereas work overload is an inevitable, acute problem.

Strategic improvisation: an introductory conceptual framework

Purpose

By exploring “what is strategic improvisation in organizations?” the authors respond to advances in strategic improvisation (SI) conceptualization with an emphasis on the challenges of combining unplanned but deliberate responses to relentlessly changing environments, in which strategy becomes increasingly improvised.

Design/methodology/approach

An integrative review was conducted with the potential to develop new theoretical approaches to research problems. This literature review resulted in an introductory SI framework.

Findings

The authors propose a SI conceptual framework combining foundation, structuration and capillarization. While foundations comprise extemporaneity, novelty and intentionality, considered as triggers for the manifestation of SI, in this study structuration refers to the combination of a minimal structure and a reassessment process in response to unexpected situations. Capillarization means interaction patterns characterized as spontaneous, dynamic and collaborative. This framework leads to the definition of SI as an impromptu deliberate action stream, combining unplanned responses with intentional actions sustaining the convergence of strategy and operation, to integrate and reconfigure resources at the strategic level.

Practical implications

SI in practice considers reconfiguring the internal and external forces to deal with unexpected events and impromptu deliberate responses to face rapidly changing environments. This would enable practitioners and managers to prepare for eventualities that evolve dynamically and spontaneously, and unpredictable imminent global crises.

Originality/value

The authors conducted the first study mapping improvisation as a strategic organizational level phenomenon. SI is recognized as operating across levels, from the tactical and functional to the strategic.

Mindfully performed organisational routines: reconciling the stability and change duality view

Purpose

The purpose of this paper is to provide a process model on how mindfully performed organisational routines can simultaneously enable organisational stability and organisational change.

Design/methodology/approach

Via conceptual analysis, the authors develop several propositions and a process model integrating the theory of mindfulness and performative aspects of organisational routines with organisational stability and change. To do so, the authors review the literature on organisational routines, mindfulness, stability, inertia and change.

Findings

First, the authors demonstrate that, based on levels of mindfulness employed, performative aspects of organisational routines can be categorised as mindless, mindful and collectively mindful (meta-routines). Second, in the process model, the authors position the mindless performance of routines as enabling organisational stability, mediated through inertial pressure and disabling change, mediated through constrained change capacities. Finally, the authors state that engaging routines with mindfulness at an individual (mindful routines) or collective (meta-routines) level reduces inertia and facilitates change. Such simultaneous engagement leads to either sustaining stability when required or implementing continuous organisational change.

Research limitations/implications

The framework uses continuous, versus episodic, change; future research can consider the model’s workability with episodic change. Future research can also seek to empirically validate the model. The authors hope that this model informs research in organisational change and provides guidance on addressing organisational inertia.

Originality/value

To the best of the authors’ knowledge, this study is the first to categorise the performative aspects of organisational routine based on the extent of mindfulness employed and propose that mindfulness-based practice of routines stimulates either inertia-induced or inertia-free stability and continuous change.

Fostering Cultures of Sustainability in a Multi-Unit Office Building: A Theory of Change

Psychological approaches to fostering sustainability are heavily focused on individual behaviors and often insufficiently address the physical and social contexts individuals are embedded in. This limits the ability to create meaningful, long-lasting change, as many of day-to-day behaviors are social practices embedded in broader cultural norms and systems. This is particularly true in the work context, where organizational cultures heavily condition both the actions of individual employees and the collective actions of organizations. Thus, we argue cultures, not behaviors, must become the focus of sustainability change efforts. In this paper, we present a theory of change aimed at fostering strong organizational cultures of sustainability (COS) within a high-performance multi-tenant office building. Our theory takes a systems perspective that incorporates the social and physical aspects of the work environment, and views culture change as a co-creative exercise involving engagement of multiple stakeholders. The paper concludes with implications for practice and research.

A conceptual model of Lean culture adoption in healthcare

Purpose

This work seeks to offer a greater understanding of Lean healthcare implementation challenges conceptually taking a situated cultural organizational change perspective.

Design/methodology/approach

A descriptive model of healthcare organizations’ Lean adoption trajectories is built using ripple and bridging modelization strategies from elements of three classic organizational change theories and knowledge from Lean, organizational culture, healthcare and operations management literature.

Findings

The “contingent Lean culture adoption” (CLCA) model suggests five theoretical trajectories the healthcare organizations may experience when conducting a Lean transformation. These trajectories evolve from a new concept of Lean cultural friction (LCF) which represents cultural friction that a healthcare organization encounters toward an ultimate Lean culture proficiency state through time. From high to low initial LCF, a healthcare organization may in its Lean proficiency course end up in three states: lower, similar or higher LCF situation.

Research limitations/implications

The CLCA model demonstrates the potential to be developed into a framework and possibly a Lean cultural friction theory pending further qualitative and quantitative validation.

Practical implications

The CLCA model may help healthcare managers to use more appropriate cultural change strategies during their organization’s Lean journey.

Originality/value

This work enriches the concept of Lean cultural change which may apply not only to healthcare organizations but also to other ones. It suggests the existence of a healthcare organization Lean culture proficiency archetype and introduces the notion of Lean cultural friction.

Cognitive-affective appraisal of technostressors by ICT-based mobile workers and their impacts on technostrain

BACKGROUND: ICT based mobile working gives organizational flexibility, productivity and performance but at the same time it can lead to techno-stress and technostrain perceptions. A high level of technostrain amongst ICT-based mobile workers would impact their well-being, leading to lesser than expected gains from such organizational ICT investments. Given this paradox, we examine the actual transactional and relational stressor-strain coping response processes in this novel context. OBJECTIVE: The broad research aim of this paper is to explain the relative importance of the cognitive and affective processes used amongst ICT-based mobile workers when coping with technostressors. METHODS: Specifically, based on technology frames literature, we develop dual-path serial mediation models, showing the relationships between technostress-technostrain via two processes: (a) the primary cognitive appraisal process mobilization (threat/opportunity technology frame) and (b) the secondary affective resource process mobilization (affect towards ICT use) to account for technostrain perceptions. We use survey data from 165 ICT-based mobile managers from diverse work settings to empirically confirm the theorized models. RESULTS/CONCLUSIONS: A predominant cognitive ‘threat frames’ leads to increase in technostrain, which decreases if ‘affective resource’ is available for coping. This relationship is inverse in the case of ‘opportunity frames’ path, as technostrain perceptions decreases with and without affective resource mobilization. Implications to theory, practice and methods are also discussed.

Caring for Computers: The Hidden Work of Clinical Nurses during the Introduction of Health Information Systems in a Teaching Hospital in Taiwan

Implementing health information systems for enhancing patient care and management occurs worldwide. Discovering how nurses, as important system end-users, experience technology-reliant clinical practice involved focus groups (n = 25) and in-depth individual interviews with nurses (n = 4) and informatics staff (n = 3) in a major Taiwanese medical center. This qualitative study explores the unintended effects of these systems on nurses’ role and clinical practice. First, nurses’ additional role caring for computer devices supporting patient care involves highly-demanding invisible effort, especially when tackling system malfunctions affecting patients with urgent conditions. Second, nurses are resourceful in developing solutions to protect patients during unexpected technical malfunctions. Third, troubleshooting using telephone technical support as the first resort is problematic. It is argued that computerization requires nurses to care for co-clients: patients and computers. Managing technical malfunctions is an unintended consequence for nurses, reflecting the hidden work required by new technology.

Designing and undertaking randomised implementation trials: guide for researchers

Implementation science is the study of methods to promote the systematic uptake of evidence based interventions into practice and policy to improve health. Despite the need for high quality evidence from implementation research, randomised trials of implementation strategies often have serious limitations. These limitations include high risks of bias, limited use of theory, a lack of standard terminology to describe implementation strategies, narrowly focused implementation outcomes, and poor reporting. This paper aims to improve the evidence base in implementation science by providing guidance on the development, conduct, and reporting of randomised trials of implementation strategies. Established randomised trial methods from seminal texts and recent developments in implementation science were consolidated by an international group of researchers, health policy makers, and practitioners. This article provides guidance on the key components of randomised trials of implementation strategies, including articulation of trial aims, trial recruitment and retention strategies, randomised design selection, use of implementation science theory and frameworks, measures, sample size calculations, ethical review, and trial reporting. It also focuses on topics requiring special consideration or adaptation for implementation trials. We propose this guide as a resource for researchers, healthcare and public health policy makers or practitioners, research funders, and journal editors with the goal of advancing rigorous conduct and reporting of randomised trials of implementation strategies.

Appropriating Information Technology Artefacts through Trial and Error: The Case of the Tablet

The concept of appropriation is of paramount importance for the lasting use of an Information Technology (IT) artefact following its initial adoption, and therefore its success. However, quite often, users' original expectations are negatively disconfirmed, and instead of appropriating the IT artefact, they discontinue its use. In this study we examine the use of IT artefacts following negative disconfirmation and use Grounded Theory Method techniques to analyse 136 blogposts, collected between March 2011 - July 2017, to investigate how users appropriate or reject the tablet when technology falls short of users' expectations. Our findings show that users overcome negative disconfirmation through a trial and error process. In doing so, we identify that users appropriate the tablet when the attained benefits significantly outweigh the risks or sacrifices stemming out of its use. We discuss our contribution within the context of the appropriation literature, and highlight that the success of IT lies with the user's success in identifying personal use scenarios within and across diverse contexts of use.

Startup Responses to Unexpected Events: The impact of the relative presence of improvisation

This study seeks to advance the literatures on organizational improvisation and unexpected events. It tackles the question of whether the relative presence of improvisation during a startup’s response to an ordinary, unexpected event affects the value of that response, an issue of clear importance given the ubiquity of unexpected events in startups. Improvisation in practice typically involves varying degrees of predesigned and extemporaneously designed activity. The study explores the dangers of simultaneously mixing predesigned actions and improvisational activity. It develops theory in the context of startups’ action streams in response to 141 unexpected events identified by field informants. Results from hypothesis tests support theory that the relative presence of improvisation in an action stream in response to an unexpected event will have a U-shaped impact on its success resolving that event: a mixed presence shows relatively poorer outcomes than either concentrated predesigned action or a high presence of improvisation. The study also extends prior work by theorizing and finding evidence that two sources of organizational memory—firm-specific experience (proxied by organizational age) and nonfirm-specific experience (proxied by founders’ business experience prior to founding)—moderate the value of the presence of improvisation in response to unexpected events in different ways, consistent with greater challenges to rapidly integrating varied knowledge. Finally, it contributes to understanding of improvisation patterns in response to ordinary, unexpected events, suggests areas for additional research, and offers managerial implications for startups such as the value of deliberately raising shared awareness of shifts to organizational improvisation.

Understanding Evidence-Based Practice (EBP) Implementation in HCOs Through the Lens of Organizational Theory

Despite the increasing use of theory in the field of implementation science over the past decade, the literature has largely focused on using deterministic frameworks to retrospectively understand "what" factors are essential for the effective implementation of evidence-based practices (EBPs). On the other hand, gaps remain in using organizational theory to prospectively understand "how" successful EBP implementation occurs in health-care organizations (HCOs). This article discusses the theoretical and empirical contributions of two selected recent exploratory research works, which provide a starting point for addressing the identified gaps in the literature, with the purpose of deriving implications for theory, practice, and future research in implementation science. The selected works used the theory of "effective knowledge sharing network structures in professional complex systems (PCS)," developed through an integration of organizational theories, to design prospective interventions for enabling EBP implementation in HCOs. In doing so, these studies have helped explain "how" inter-professional knowledge exchange and collective learning occurred, to enable successful EBP implementation in HCOs. Correspondingly, the selected works have served a dual purpose in: 1) identifying evidence-based management (EBM) practice strategies for successful EBP implementation; while 2) further developing the theoretical literature on "effective knowledge sharing networks in PCS." Importantly, by addressing the identified gaps in the literature, the selected works serve to either complement or supplement existing theoretical approaches in implementation science. To this effect, they provide unique insights for theory, practice, and research in implementation science, including insights into a potential "dual-role" for the future implementation researcher-one of advancing implementation science, while working to strengthen implementation practice. Based on these contributions, it could be argued that the selected works provide a starting point for a new research stream that has the potential to occupy a distinct position in the taxonomy of theoretical approaches used in implementation science.

Leveraging service design for healthcare transformation: toward people-centered, integrated, and technology-enabled healthcare systems

Purpose

This paper explores how service design can contribute to the evolution of health service systems, moving them toward people-centered, integrated and technology-enabled care; the paper develops a research agenda to leverage service design research for healthcare transformation.

Design/methodology/approach

This conceptual study starts by analyzing healthcare challenges in terms of demographic trends and economic constraints, along with the problems of lack of people-centricity, dispersion of care and slowness in incorporating emerging technologies. Then, it examines the theoretical underpinnings of service design to develop a framework for exploring how a human-centered, transformative and service systems approach can contribute to addressing healthcare challenges, with illustrative cases of service design research in healthcare being given.

Findings

The proposed framework explores how a human-centered service design approach can leverage the potential of technology and advance healthcare systems toward people-centered care; how a transformative service design approach can go beyond explanatory research of healthcare phenomena to develop innovative solutions for healthcare change and wellbeing; and how a service systems perspective can address the complexity of healthcare systems, hence moving toward integrated care.

Originality/value

This paper systematizes and develops a framework for how service design can contribute to healthcare transformation. It identifies key healthcare application areas for future service design research and pathways for advancing service design in healthcare by using new interdisciplinary bridges, methodological developments and theoretical foundations.