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During the 1990s, Italian healthcare organisations (HOs) underwent a process of corporatisation, and the most innovative HOs introduced the balanced scorecard (BSC) to address the need for broader accountability. Currently, there is a limited understanding of the dynamics and outcomes of such a process. Therefore, this study aims to explore whether the BSC is still considered an effective performance management tool and analyse the factors driving and hindering its evolution and endurance in public and non-profit HOs.

We conducted a retrospective longitudinal analysis of two pioneering cases in the adoption of the BSC: one in a public hospital and the other in a non-profit hospital. Data collection relied on accessing institutional documents and reports from the early 2000s to the present, as well as conducting semi-structured interviews with the internal sponsors of the BSC.

We found evidence of three main categories of factors that trigger or hinder the adoption and development of the BSC: (1) the role of the internal sponsor and professionals’ commitment; (2) information technology and the controller’s technological skills; and (3) the relationship between the management and professionalism logics during the implementation process. At the same time, there is no evidence to suggest that specific technical features of the BSC influence its endurance.

The paper contributes to the debate on the key factors for implementing and sustaining multidimensional control systems in professional organisations. It emphasises the importance of knowledge-based assets and distinctive internal capabilities for the success of the business. The implications of the BSC legacy are discussed, along with future developments of multidimensional control tools aimed at supporting strategy execution.

Information technology (IT) is an important enabler of organization models (OM) and of innovative strategies, as it fosters information integration and streamlines information flows. Two case studies offer evidence about the strategic use of IT innovation (i.e., digital signature) to foster successful OM and partnerships in health care, while results from a survey and some case studies show how institutional reforms can foster the diffusion of mature technologies (i.e., ERP) as an adaptive strategy of health care organizations. Leadership and clear vision lead to consistency between OM and technology and foster the exploitation full benefits associated with innovation.

Care integration has been the hallmark of most proposed solutions to current and prospective challenges of health systems. However, it is an imprecise umbrella term encompassing heterogeneous models and little substantive knowledge exists on the basic mechanisms leading to positive outcomes. This study aims to address this gap by identifying the environmental conditions and the configurations of factors associated with service delivery success in integrated care initiatives.

On the basis of an extensive literature review, an analytical framework aimed at structuring and interpreting the relations between contextual, cultural and organizational factors and the outcomes of integrated care initiatives is proposed. The framework is applied to four successful cases of care integration in the USA, Canada, Italy and Switzerland.

The results suggest that positive outcomes mainly depend on the correct matching of macro‐level factors with a balanced mix of operating means at the micro‐level, rather than on the intense focus on any one element of the framework.

The analysis infers, from a small‐purposive sample, that successful initiatives are a matter of appropriate configuration of contextual, organizational and technical factors. Generalizability of results would benefit from additional international cases and using the framework on decentralized health systems.

This framework can guide future research efforts in the field as it is adaptable and relatively easy to operationalize. It can also be a useful tool for practitioners and policy‐makers, to bring structure and reduce the complexity of efforts aimed to design, evaluate and improve integrated care initiatives.

In 2009, the Health Information Technology for Economic and Clinical Health Act (HITECH) was signed into law. This Act, part of the broader “stimulus” legislation, represents the U.S.'s largest investment in health information technology (HIT) to date. More importantly, it sets a vision and provides a plan intended to transform the U.S. health care system to a safer, more efficient place to receive care. To that end, the Act seeks to fundamentally change the path HIT applications' adoption and implementation was taking to ensure that “meaningful use” and interoperability are achieved. However, such bold and sweeping changes will not come without unintended consequences, and their broad scope makes measuring the new public policy's success a challenge.

The purpose of this viewpoint paper is to introduce the special issue and outline its major themes.

The public governance literature is described, and the necessity for analysing challenges for accountability and accounting in the public sector is elaborated upon, as a precursor to introducing the contributions to this special issue.

The public governance turn in public management and policy studies has often meant that accounting and accountability issues have been overlooked. This special issue reminds us that they are central in public governance and networks, and that accounting cannot be dismissed as only a “technical” issue since it is central in power relationships, building trust, ensuring transparency and improving decision making for both internal and external stakeholders.

This special issue of Qualitative Research in Accounting & Management aims to stimulate qualitative research on how accounting and accountability are being shaped by the new public governance paradigm and, in turn, contribute to shaping it.

The articles included in this special issue focus on reforms and innovations that have been adopted based on the assumption that improving mechanisms of public governance and accountability will result in better public sector performance. The different aspects of governance and accounting changes will also be of interest to politicians, managers, citizens, and those who seek accountability from public sector organisations.

The paper offers a systematic empirical examination of the innovative experiences of different governments to strengthen transparency, openness and participation, and to enhance the capacity to manage, steer and monitor contracts, partnerships and relationships with private and public sector entities.

The purpose of this paper is to contribute to the understanding of the relationship between different types of organizational culture (hierarchical, clan or group, market or rational and adhocratic) and sustainability through three dimensions (economic, environmental and social) in ecotourism businesses in Oaxaca and Chiapas, Mexico.

In this research 80 questionnaires were administered in the form of face-to-face interviews to ecotourism business owners'. Through a discriminant analysis and the theoretical support of the competing values framework (CVF), the prevailing types of culture were identified, and their influence was analysed through a regression analysis.

The results show that ecotourism businesses which are driven by hierarchical culture tend to have a greater focus on economic sustainability, while those businesses with a market or rational culture show a positive and significant influence on environmental sustainability. Likewise, businesses with adhocratic culture achieve sustainability holistically; however, the data reveal that clan or group culture is not associated with social sustainability.

This study offers empirical research that explains the relationship between organizational culture and sustainability. Additionally, it contributes to the study of environmental management issues in the ecotourism sector.