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Health systems worldwide are hampered by disconnects between governance, management, and operations, which negatively impact on their ability to deliver efficient, effective, and safe healthcare services. This paper shows how insights from the Viable System Model (VSM) can help us to conceptualise health system disconnects impacting specialist clinical services and develop solutions to address organisational fragmentation.

A case study of a specialist clinical service was undertaken, where the VSM was used to guide semi-structured interviews and workshops with clinicians and managers and analysis of findings.

The VSM provides a coherent way to conceptualise the disconnects and identify their structural underpinnings. Three novel organisational pathologies emerged from the study.

This New Zealand-based study was undertaken during the COVID-19 pandemic and a period of major health system reform, introducing uncertainty into service provision that may have impacted stakeholders’ views.

The three novel pathologies affect how health systems define their services, their understanding of the management function, and the importance of coordination. The resulting clarity of functioning could improve service quality, staff and patient satisfaction, and the effectiveness and efficiency of healthcare service delivery.

This study contributes to the VSM literature on organisational pathologies by providing three novel pathologies for a perspective that may be useful beyond healthcare and invites consideration of health system disconnects as a coherent field of study.

This viewpoint introduces a “Readiness Self-Assessment Guide” that can be used as a diagnostic tool to help health service governors and managers, particularly in Low-Middle Income Countries, or those in the early stages of developing their governance program.

The approach uses the conceptual framework for governance developed by Barbazza and Tello (2014).

The Guide is based on five foundational elements or components of governance that frame the actual governance activities. The self-assessment process uses a sequence of real-world examples to help users of the Guide assess their organization’s “readiness” or current capacity to strengthen quality. A simple scoring process allows users to rate their organization’s progress through potential evolutionary steps. The resulting analysis is intended to be the starting point of a structured discussion among team members about priorities, enabling factors and constraints.

Assessment of the institutional context is a fundamental step that will enable quality teams to select the appropriate tools for their priority concerns. This Readiness Self-Assessment Guide can be used as part of that diagnostic assessment.

This paper is empirically derived from the author’s experience as a consultant helping health service organizations and governing authorities to develop health governance programs in several countries.

This paper aims to identify the key issues that healthcare knowledge-intensive organizations (KIPOs) should focus on to define themselves as socioenvironmentally and governance responsible for integrating environmental, social, and governance (ESG) logic into their business strategy. At the same time, this provides an understanding of how healthcare KIPOs contribute to achieving the Sustainable Development Goals of the 2030 Agenda.

Taking a cue from the model developed by the World Economic Forum, an “ESG Processing Map” was constructed to identify qualitative disclosures that a healthcare company should consider when implementing sustainability logic. The aspects investigated were processed, considering national and international standards, frameworks and disclosures. The social network analysis technique was used to systemize and combine the outcomes of these processes and analyze their consistency with sustainable development.

Through the “ESG Processing Map,” 13 areas of action and 27 topics specific to the health sector were defined on which to intervene in sustainability in order to concretely help HCOs to place specific corrective and improvement actions over time concerning socioenvironmental and governance aspects.

The paper provides contribute, on the one hand, to enriching and updating the academic literature on ESG logic in a still underexplored field and, on the other hand, to provide these types of organizations with a “compass” to guide and orient their business strategies towards sustainability.

This article aims to address the need for a more structured partnership between civilian and military healthcare, particularly in the context of cross-border threats in the EU. While both systems are driven by the same goal of providing high-quality healthcare services and achieving optimal patient outcomes, they operate under different national approaches and resources.

Two recent crises are presented as examples that highlight the necessity of cooperation between civilian and military medical systems. The Covid-19 Pandemic and the Ukrainian Conflict are described based on the experience gathered by the author as a member of the NATO Centre of Excellence for Military Medicine and form the base to shape a broader perspective on the future of civil-military interaction in healthcare at the European Union level.

The ability to deliver coordinated responses during crises depend on the level of interoperability, preparation and mutual understanding. To improve synergies, a structured partnership should be established, prioritizing common standards of care and shared best practices. Integrating military and civilian healthcare pathways can be especially beneficial in situations where patients are moved from the point of injury or sickness across different military and civilian structures to receive the most appropriate treatment and rehabilitation for their conditions.

The relationship between military and civilian healthcare systems is often discussed at multinational level, but a clear focus is lacking concerning their shared mission, distinct functions and potential for cross-border collaboration.

This study aims to analyze the influence of the dimensions of Sharia hospital service standards, religiosity commitment and trust of Muslim patients on attitudes and satisfaction, as well as the implications of loyalty.

This study was carried out by analyzing data obtained from a survey with purposive sampling techniques with 425 patients in an Indonesian-certified Sharia hospital and analyzing it using partial least squares structural equation modeling software to test the path modeling and the relationship between the instruments.

This study shows that hospital amenities, doctor’s services, nurses’ services, health-care technicalities and hospital environmental and administrative behavior affect patient satisfaction. In addition, religiosity and trust in encouraging patient attitudes determine patient satisfaction. High satisfaction points will increase loyalty to Sharia hospitals.

This study encourages managers to maximize the quality of humanist Islamic medical services and the infrastructure of comfortable facilities. In addition, hospitals need to improve their holistic atmosphere, technical services and administrative behavior so that they can become essential value for hospital marketing – the development of competence and ethical behavior of health workers through various training programs internally and externally.

This study presents the determination of Sharia hospital service standards accompanied by a commitment to religiosity and trust as a psychological perspective of Muslim patients on attitudes and satisfaction and its implications on the brand loyalty of Indonesian Sharia hospitals that have been officially certified.

Spoken service language is critical for service experiences and human welfare in many service settings. However, little is known about how spoken service language can enhance customer well-being in transformative service contexts. This paper explores spoken service language and well-being for customers experiencing vulnerability in a transformative service context, informed by an empirical account of the human welfare service of residential aged care.

Situated within transformative service research (TSR), this study was guided by a theoretical framework of service language and adopts a strengths-based approach to customer experiences of vulnerability. A qualitative multiple case study methodology was applied to explore carers’ perspectives on spoken service language and well-being from three residential aged care homes in Australia.

The findings demonstrate five spoken service language practices and four principles of spoken service language for well-being that co-create customer well-being and support the alleviation of customer experiences of vulnerability. Conceptualised as transformative spoken service language, the spoken service language practices and principles collectively recognise, support and leverage residents’ capabilities and uplift customer well-being, by enacting a process of mattering highly salient to transformative service contexts.

This study is the first to conceptualise how employee spoken service language can be used to support customer well-being and enhance transformative value for customers experiencing vulnerability to align with the goals of TSR. Practically, the study advocates for a greater awareness and more considered use of transformative spoken service language in human welfare and other transformative service contexts.

Over the last two decades, most organizations have considered technologies to drive digital transformation, and the recent pandemic has brought significant changes in the healthcare sector. Therefore, this study explores the technological nexus in supporting digital transformation as a process to govern the healthcare sector more effectively.

This study uses quantitative and qualitative methods to analyse the impact of ArogyaSetu (a health and wellness app) on India’s digital transformation process. The study involves 212 responses to understand how the app enables digital transformation and its impact on governance, healthcare systems and stakeholders. Additionally, 31 semi-structured interviews were conducted to validate the quantitative study’s findings.

Referring quantitative part of research design, ArogyaSetu has had a positive impact on the digital transformation of India’s healthcare industry, which has in turn affected stakeholders and improved governance. Moreover, qualitative findings suggest that a governance system like ArogyaSetu can aid in the development of dynamic capabilities within the healthcare system and governance.

This study adds to our understanding of the digital transformation of healthcare by examining it through the lens of dynamic capability. In this framework, “sense” refers to the stakeholders, “seize” the healthcare system and “transform” governance. The study also provides practical implications for managers, academics and government administrators responsible for digital healthcare transformation.

The paper identifies and explores the perspectives of middle school educators regarding the benefits and challenges of an ongoing, emerging school–university partnership. Over five years, professors at one comprehensive, Midwestern university, formed a partnership with a local middle school. While progress has been made to develop the partnership, the authors recognized a lack of shared governance (Essential 7). In particular, they were unsure the partnership was mutually beneficial. The authors interviewed teachers, the principal, assistant principals, guidance counselors, the instructional coach and the youth service center director to gain their perspectives on the partnership.

The authors used an intrinsic, evaluative case study to examine educators perceptions of the benefits and challenges of the partnership (Guba & Lincoln, 1981; Patton, 2002). This approach was used because within this bounded system the authors have an interest in obtaining information to help improve the program and partnership.

Results suggest the partnership was beneficial in a number of ways including hiring of and offering fresh ideas to teachers. Educators also felt there were many benefits for university candidates. Challenges included scheduling, technology access and candidate disposition. Implications are discussed.

Inherent within the research methodology, researchers’ inclusion in the data collection process may affect participants responses.

Researchers discuss the implications of this work, including the role of hiring candidates and clear articulation of a mission for the partnership.

This work adds to research on school site stakeholders’ perspectives on the value of school–university partnerships and includes teachers and the schools’ entire leadership team.

The purpose of this research study was to examine school leaders’ critical perspectives about the nature of their partnerships with K-12 schools and two Educator Preparation Programs (EPP).

Data were collected through interviews with K-12 school leaders to obtain partners’ critical perspectives about school–EPP partnerships. The interviews were coded thematically and oriented around the central concept of working to represent the interplay of the participants and their collaborators’ perceptions of the nature and dimensions of school–EPP partnerships.

The analysis resulted in the construction of a mosaic of school leaders’ collective lived experiences using a statewide conceptual framework as a guide. Four themes emerged from our interviews with school partners: (a) the need for dynamic, responsive and synergistic partnerships; (b) the need to monitor and maintain the underlying structure and integrity of the partnership; (c) the culture of interns as colleagues or as visitors; and (d) the need to innovate.

Four themes emerged from our interviews with school partners: (1) the need for dynamic, responsive and synergistic partnerships; (2) the need to monitor and maintain the underlying structure and integrity of partnerships; (3) the culture of interns as colleagues or interns as visitors; and (4) the need to innovate.

The purpose of this study is to examine the moderating effect of an exogenous corporate governance shock that curbs Chief Executive Officers’ (CEOs) power on the relationship between CEO narcissism and earnings management practices.

The authors performed a quasi-experiment using a differences-in-differences approach to examine Brazil’s duality split regulatory change on 101 Brazilian public firms during the period 2010–2022.

The main findings indicate that the introduction of duality split curtails the positive influence of CEO narcissism on earnings management, suggesting that this corporate governance regulation may act as a complementary corporate governance mechanism in mitigating the negative consequences of powerful narcissistic CEOs. Further robustness checks indicate that the results remain consistent after using entropy balancing and alternative measures of CEO narcissism.

In emerging markets, where governance systems are frequently perceived as less than optimal, policymakers and regulatory authorities can draw insights from this enforcement to shape governance systems, reducing CEO power and, consequently, improving the quality of financial reporting.

To the best of the authors’ knowledge, this is the first study to examine whether a duality split mitigates the influence of CEO narcissism on earnings management. Thus, this study contributes to the corporate governance literature that calls for research on the effectiveness of external corporate governance mechanisms in emerging markets as well as the CEO narcissism literature that calls for research on moderating factors that could curtail negative consequences of narcissistic CEO behavior.