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The purpose of this paper is to discuss the changing patterns of users’ behavior in the health care service system. Although patient engagement and health services’ co-production are understood as essential ingredients in the recipe for sustainable health systems, some determinants to patient involvement are still widely neglected by both policy makers and health care professionals. Among others, inadequate health literacy performs as a significant barrier to patient empowerment.

A survey aimed at objectively measuring health literacy-related skills was administered to a random sample of 600 Italian patients. The Italian version of the Newest Vital Sign (NVS) was used to assess the ability of the respondents to deal with written health information. Moreover, the respondents were asked to self-report their ability to navigate the health system. It was presumed that inadequate health literacy as measured by the NVS is related with impaired self-reported functional, interactive, and critical health-related competencies, paving the way for the inability and the unwillingness of patients to be involved in the health care provision.

About half of the sample showed inadequate health literacy. However, poor NVS scores were only slightly associated with limited self-reported functional, interactive, and critical health-related competencies. In general, patients with inadequate health-related skills were not likely to be engaged in the provision of health services. Elderly, people suffering from financial deprivation and less educated individuals were found to be at special risk of living with limited health literacy.

Limited health literacy is a common and relevant issue among people dealing with the health care service system. The impaired ability to collect, process, and use health information produces barriers to patient engagement and prevents the evolution of patients’ behavior toward health care co-production.

Health literacy is a widely overlooked issue in the Italian national health system. This paper contributes in shedding light on the determinants and effects of health literacy of Italian hospital patients. Besides, some insights on the validity of the methodological tools typically used to assess health-related skills are provided.

In light of the new way of interpreting work spearheaded by Generation Z, the objectives of this study are to investigate (1) whether young entrepreneurs identify their start-ups with “zebras” – that is, as a concrete response to the evanescence and fantasy of “unicorns” based on the simultaneous pursuit of profit and social value, mutualism and resilience – and (2) whether they adopt a “teal” organizational configuration – that is, one characterized by evolutionary purpose, self-management and wholeness.

Through a qualitative approach with 41 interviews, this study focuses on start-uppers and companies that are particularly innovative and promising in the Italian context, as selected by Forbes magazine in its ranking of the brightest entrepreneurs, leaders and stars under 30.

The results suggest that young entrepreneurs recognize the importance of the common themes of the zebra movement and therefore identify their startups with zebras. More specifically, Generation Z entrepreneurs: (1) pursue a dual (economic and social) purpose, (2) are mutualistic and (3) build their organizations with resilience and capital efficiency. In addition, the interviews show that the organizational approach taken follows the paradigm of teal organizations, particularly in terms of evolutionary purpose, distributed leadership and decision-making power, and employee wholeness and empowerment.

This is the first study to analyze the evolutionary trends of animal entrepreneurial “species” led by Generation Z entrepreneurs and organized on the basis of the teal paradigm.

The purpose of this study, which is grounded in decision-making theory, is to explore whether the occurrence of meaningful coincidences can positively influence executive confidence during periods of crisis.

Through a qualitative study with 24 interviews, this study focuses on Italian hospitality facilities in the Campania Region of southern Italy to explore how an executive confidence led by meaningful coincidences can influence managerial decisions during crisis situations. Data are analyzed through a deductive coding for qualitative analysis.

The framework proposes the connection by coincidences and confidence, emphasizing the process through which meaningful coincidences can positively influence executive confidence and managerial decision-making. The insights that emerge suggest a number of positive and beneficial aspects for decision-making during a period of crisis such as the COVID-19 pandemic.

To the best of the authors’ knowledge, this is the first study in the literature aimed at investigating, by means of qualitative methodologies, the positive outcomes of executive confidence in decision-making led by meaningful coincidences during crisis periods in the specific context of the Italian hospitality industry.

This paper explores total quality management (TQM) soft domain efficacy in social care organizations to determine the extent to which an organization's project success may stem from soft TQM critical success factors (CSFs).

Non-structured interviews were conducted with 16 managers overseeing the prosthetic device regeneration project of the Italian local health unit (located in Salerno) to explore which soft factors could contribute to the success of a social care multifunctional organization.

Organizations' handling of certain projects, such as pivoting on soft TQM issues, may allow them to be configured as multiservice organizations. Therefore, a conceptual model of a multiservice social care organization is proposed.

From a managerial perspective, this study presents an interesting success case of a multiservice social care organization with a total annual expenditure of €20 million on prosthetic assistance. Preliminary data show a 13% reduction in public expenditure for Salerno's local health unit via a refurbishment project.

The paper contributes to the soft TQM literature debate: although Italian local health professionals appear aware of soft TQM issues' implementation and consciously apply them in their organization and projects, this occurs more with specific CSFs emerging from the literature. Therefore, this article paves the way for further quantitative and theoretical investigations on the adoption of TQM soft issues in social care organizations' performance measurement.

Promoting health literacy, i.e. the ability to access, collect, understand and use health-related information, is high on the health policy agenda across the world. The digitization of health-care calls for a reframing of health literacy in the cyber-physical environment. The article systematizes current scientific knowledge about digital health literacy and investigates the role of health-care organizations in delivering health literate health-care services in a digital environment.

A literature review was accomplished. A targeted query to collect relevant scientific contributions was run on PubMed, Scopus and Web of Science. A narrative approach was undertaken to summarize the study findings and to envision avenues for further development in the field of digital health literacy.

Digital health literacy has peculiar attributes as compared with health literacy. Patients may suffer from a lack of human touch when they access health services in the digital environment. This may impair their ability to collect health information and to appropriately use it to co-create value and to co-produce health promotion and risk prevention services. Health-care organizations should strive for increasing the patients’ ability to navigate the digital health-care environment and boosting the latter’s value co-creation capability.

Tailored solutions should be designed to promote digital health literacy at the individual and organizational level. On the one hand, attention should be paid to the patients’ special digital information needs and to avoid flaws in their ability to contribute to health services’ co-production. On the other hand, health-care organizations should be involved in the design of user-friendly e-health solutions, which aim at engaging patients in value co-creation.

This contribution is a first attempt to systematize extant scientific knowledge in the field of digital health literacy specifically focused on the strategies and initiatives that health-care organizations may take to address the limited digital health literacy pandemic.

School quality relies on the educational institutions’ ability to establish an environment which enhances the pupils’ social and emotional well-being. School bullying negatively affects the school climate; hence, it is likely to trigger side effects on pupils’ behaviors and performances. This is especially true when socially disadvantaged students are concerned, such as those with a migrant background. The purpose of this paper is to provide an overview of school bullying among pupils with a migrant background living in Italy and suggests several insights to address this relevant school quality issue.

A mixed quantitative research has been designed to investigate the relationship between school bullying, victims’ socio-demographic attributes, school behaviors and school performances. Secondary data were collected from the study on the Integration of Second Generations performed in 2015 by the Italian Institute of Statistics.

Verbal and relational bullying were prevailing. Physical bullying was also recurring, but it primarily concerned male pupils. Bullied students were more likely to self-report lower school performances; moreover, they showed greater willingness to dropout from school. Victims of school bullying suffered from social exclusion; they were also used to perform working activities beyond mandatory schooling. They expressed lower trust in their teachers as compared with their peers.

School bullying is thought to deteriorate the school climate and, consequently, to impair educational services’ quality. Timely management interventions are needed to address school bullying and to prevent its negative effects.

This study conceives school bullying as a critical quality issue and paves the way for further developments intended to enhance school services’ effectiveness.

How can a manager lead an organization or a team in a particularly turbulent time? How can management cope with chaos and uncertainty? Drawing on behavioral strategy theory, this study aims at investigating how hubristic managers can enable organizations to thrive, even over small time periods, in chaotic and uncertain contexts and settings.

This study uses a qualitative methodology to explore the possible positive effects of hubris in a behavioral strategy. In particular, 45 interviews with leaders and followers of particularly high-performing secondary schools have been administered to try to fully understand the origin, process and performance evolution of organizations led by hubristic managers.

The results showed that, in chaotic and uncertain times, hubris can prove to be a trump card for managers in dealing with the pitfalls and uncertainties of the context in which the organization operates. Three major attributes were identified – overconfidence and over-persistence, recklessness and contempt for critical feedback – defining the positive behavioral strategies implemented by hubristic managers during the COVID-19 pandemic.

To the best of the authors’ knowledge, this study is the first to highlight, by means of qualitative methodologies, the positive managerial hubristic-behavioral strategy during turbulent times in the school sector.

The purpose of this paper is to interpret employees’ resistance using the perspective of a Foucaultian/post-structuralist approach in critical management studies. The authors examine the relationship between management of diversity, based on employment contract, emotional construction of identity and processes of resistance. The authors explore the ways in which temporary agency nurses understand and experience their contract, respond to tensions regarding temporary employment, develop collective emotions and show processes of resistance.

The study adopted an interpretive and qualitative approach. The authors analysed empirical material collected in the Haematology Department of a hospital in Naples, Italy, to illustrate actual experiences in the workplace.

Fear turns out to be the discursive resource through which resistance is actually exerted. Through emotions, temporary nurses build a community of coping and enhance their collective identity. They use fear to develop solidarity and to mobilize collective resistance in the workplace. Although no traditional resistance behaviours are reported, they aim to undermine the reputation of top managers and challenge and re-write the prevailing discourses of the organization.

The paper contributes to the critical literature because the authors analysed a relationship that is rarely theoretically and empirically examined in literature, that between employment contract, collective identity-building dynamics and processes of resistance. We showed that the creation of a community of coping enabled minorities to voice their distance from and opposition to management.