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Change in ownership among U.S. community hospitals has been frequent and, not surprisingly, remains an important issue for both researchers and public policy makers. In the past, investor-owned hospitals were long suspected of pursuing financial over other goals, culminating in several reviews that found few differences between for-profit and nonprofit forms (Gray, 1986; Sloan, 2000; Sloan, Picone, Taylor, & Chou, 2001). Nevertheless, continuing to the present day, several states prohibit investor-ownership of community hospitals. Conversions to investor-ownership are only one of six types of ownership change, however, with relatively less attention paid to the other types (e.g., for-profit to nonprofit, public to nonprofit). This study has two parts. We first review the literature on the various types of ownership conversion among community hospitals. This review includes the rate at which conversions occur over time, the relative frequency in conversions between specific ownership categories and the observed effects of conversion on hospital operations (e.g., strategic direction and decision-making processes) and performance (e.g., access, quality, and cost). Overall, we find that the impact of ownership conversion on the different measures is mixed, with slightly greater evidence for positive effects on hospital efficiency. As one explanation for these findings, we suggest that the impact of ownership conversion on hospital performance may be mediated by changes in the hospital's strategic content and process. Such a hypothesis has not been proposed or examined in the literature. To address this gap, we next study the role of strategic reorientation following hospital conversion in a field study. We conceptualize ownership conversion within a strategic adaptation framework, and then analyze the changes in strategy content and process across sixteen hospitals that have undergone ownership conversions from nonprofit to for-profit, public to for-profit, public to nonprofit, and for-profit to nonprofit. The field study findings delineate the strategic paths and processes implemented by new owners post-conversion. We find remarkable similarity in the content of strategies undertaken but differences in the process of strategic decision making associated with different types of ownership changes. We also find three main performance effects: hospitals change ownership for financial reasons, experience increases in revenues and capital investment post-conversion, and pursue labor force reductions post-conversion. Membership in a multi-hospital system, however, may be a major determinant of both strategy content and decision-making process that is confounded with ownership change. That is, ownership conversion may mask the impact of system membership on a hospital's strategic actions. These findings may explain the pattern of performance effects observed in the literature on ownership conversions.

The way organizations cope with uncertainty in strategic decision making is prominently discussed. Concepts such as heuristics and simple rules are gaining increasing attention in strategic management research. However, despite their importance, little is known how heuristics and simple rules operate. Our qualitative study reveals that, first, strategic decisions consist of three basic elements: single rules, rule patterns, and emotional handling. Second, we find that firms develop generalizable rule patterns which follow a sequential order of inter-linked rules. Based on the findings we introduce the concept of organizational heuristics as inter-linked rule patterns drawing on organizational experience.

Strategic decisions leaders make involving organizational changes such as mergers and acquisitions (M&A), divestitures, and downsizing, which can influence and/or interact with other organizational factors. For example, within the context of M&A, changes impact financial performance, firm behaviors, and organizational culture. In addition, strategic decisions for these types of change can also interrelate with other more intrapersonal factors, including both leaders’ and employees’ health and well-being. Employee stress, also referred to as “merger syndrome,” outlines individual negative impacts of the changes including, but not limited to, cynicism and distrust, change wariness, and burnout, all accumulating to psychological effects including increases in detachment to work, stress, and sick leave. In this chapter, the authors outline the different impacts M&A phases have on stress and well-being and how they interrelate with the strategic decisions leaders make. The authors also outline future research opportunities and practical implications for how leaders and employees could better manage future major changes such as M&A activities.

This study explores how top management teams make strategic decisions. The findings indicate that the top management team performs a variety of monitoring and control functions within most firms, but that a single team with stable composition does not make strategic choices in most organizations. Instead, different groups, with members from multiple organizational levels, form to make various strategic decisions. A stable subset of the top team forms the core of each of these multiple decision‐making bodies. The findings offer a possible explanation for inconsistent findings in the top management team literature, and suggest several new directions for future senior team research.

This paper proposes an integrated knowledge visualization and digital twin system for supporting strategic management decisions. The concepts and applications of strategic architecture have been illustrated with a concrete real-world case study and decision rules of using the strategic digital twin management decision system (SDMDS) as a more visualized, adaptive and effective model for decision-making.

This paper integrates the concepts of mental and computer models and examines a real case's business operations by applying system dynamics modelling and digital technologies. The enterprise digital twin system with displaying real-world data and simulations for future scenarios demonstrates an improved process of strategic decision-making in the digital age.

The findings reveal that data analytics and the visualized enterprise digital twin system offer better practices for strategic management decisions in the dynamic and constantly changing business world by providing a constant and frequent adjustment on every decision that affects how the business performs over both operational and strategic timescales.

In the digital age and dynamic business environment, the proposed strategic architecture and managerial digital twin system converts the existing conceptual models into an advanced operational model. It can facilitate the development of knowledge visualization and become a more adaptive and effective model for supporting real-time management decision-making by dealing with the complicated dependence of constant flow of data input, output and the feedback loop across business units and boundaries.

Strategic decisions represent the most important product of managerial endeavors; and strategic choice is the most critical variable in strategic management. This article advances a set of foundations in which the effectiveness of a total organization may be ascertained from the effectiveness of the strategic decisions made by its senior executives. A categorization of strategic decision effectiveness is presented that is derived from managerial attitudes toward a given strategic choice and the process from which it originates.

The purpose of this paper is to examine strategic decisions surrounding critical events to show how the decision-making processes evolve and how the dominant logic changes vis-à-vis those decisions. Further, this study explores the processes of managerial decision making focusing on spatial and temporal cognition dimensions.

The methodology adopted in this study is a case study using the retrospective processual analysis approach. Data were collected using both primary and secondary sources. In all, 40 years of secondary data on key critical events and decision making were collected using a range of secondary sources. Those events were further examined using 49 in-depth semi structured interviews.

The findings of this study explain the relationship between operant conditions, strategic actions and outcomes of strategic decisions by highlighting the significance of knowledge strategy, strategic agility and intentionality in shaping and reshaping managers’ dominant logic. Further, the authors show that the dominant coalition, among other factors, plays an important role in building decision-making capacity and in the formation and transformation of an existing dominant logic.

The study identified a number of limitations. First, the issue of generalization as the data were collected from only two case study companies. Second, in some cases respondents were asked to respond to research questions using “memory of the events” which took place a long time ago, hence the issue of credibility. Further, sometimes respondents reported information collected through hearsay. To overcome the limitations of this research, the authors made all efforts to ensure that the data collected were reliable and credible such as by using diverse data sources, confirmation of events at multiple level and personal observations.

The study identifies and explains a number of factors which influence decision making. The authors also present the revised dominant logic model which can act as a tool in managerial decision making.

The paper shows how managerial decision making changes knowledge strategy, which in turn leads to changes in existing dominant logic or the creation of a new dominant logic, hence looking at the issues of decision making using an evolutionary perspective. Second, the paper empirically tests and explains the relationship between intentionality, actions and organizational outcomes using spatial and temporal learning. Finally, the use of the longitudinal retrospective processual analysis and events analysis, is a novel way of understanding a particular phenomenon.

This study aims to explore and clarify the mechanism by which cognitive heuristics influence strategic decision-making during the coronavirus disease 2019 (COVID-19) pandemic in an emerging economy.

Data collection was conducted through a survey completed by 213 top-level managers from firms located in the twin cities of Pakistan. A convenient, purposively sampling technique and snowball method were used for data collection. To examine the relationship between cognitive heuristics and strategic decision-making, hypotheses were tested by using correlation and regression analysis.

The article provides further insights into the relationship between cognitive heuristics and strategic decision-making during the COVID-19 pandemic. The results suggest that cognitive heuristics (under-confidence, self-attribution and disposition effect) have a markedly negative influence on the strategic decision-making during the COVID-19 pandemic in an emerging economy.

The article encourages strategic decision-makers to avoid relying on cognitive heuristics or their feelings when making strategic decisions. It provides awareness and understanding of cognitive heuristics in strategic decision-making, which could be very useful for business actors such as managers and entire organizations. The findings of this study will help academicians, researchers and policymakers of emerging countries. Academicians can formulate new behavioural models that can depict the solutions to dealing with an uncertain situation like COVID-19. Policymakers and strategic decision-making teams can develop crisis management strategies based on concepts from behavioral strategy to better deal with similar circumstances in the future, such as COVID-19.

The paper’s novelty is that the authors have explored the mechanism by which cognitive heuristics influence strategic decision-making during the COVID-19 pandemic in an emerging economy. It adds to the literature in strategic management, explicitly probing the impact of cognitive heuristics on strategic decision-making; this field is in its initial stage, even in developed countries, while little work has been done in emerging countries.

The peer review history for this article is available at https://publons.com/publon/10.1108/IJSE-10-2021-0636.

Strategic decision importance has rarely been investigated as a decision-specific characteristic in the strategic decision-making process (SDMP) literature taking into consideration information management while taking important strategic decisions. Here, the ability of decision importance to predict decision effectiveness as an outcome of SDMPs in higher education institutions (HEIs) is examined in the context of Bahrain.

A conceptual model is developed relating decision importance to decision effectiveness indirectly via the SDMP characteristics intuition, rationality and decentralization. Data from a cross-sectional questionnaire completed by leaders of HEIs and academics involved in strategic decision-making in Bahrain are used to test the model and hypotheses via correlation analysis. The paper also considers a literature review of the use of information management while taking a strategic decision.

Decision importance is shown to positively influence decision effectiveness in Bahraini HEIs mediated by rationality and by decentralization in decision-making, although negative effects of decentralization are also demonstrated. However, decision importance does not influence decision effectiveness mediated by intuition.

Due to the small sample size, the results cannot be generalized to contexts beyond HEIs in Bahrain. Additional SDMP characteristics of significance in the context of HEIs could be future investigated, for instance, political behaviour and lateral communication, are not included in the model. Future research exploring the latter two aspects could provide deeper insight into the findings.

The findings of this paper could be considered by HEIs senior management and members of the governing body while strategic decision-making, which could be at different levels, including strategic planning or assessing a strategic decision in terms of effectiveness. This paper will also provide insight one the use of information while considering strategic decision-making.

A model leading for effective strategic decision-making could be used by leaders of HEIs and regulators including licensing bodies and QA agencies to set standards for HEIs for sustainable performance and quality education in line with United Nations Sustainable Development Goals and Initiative. Strategic decision-making will have an impact on the overall performance of HEIs and serve all relevant stakeholder’s including parents, students, employers and industry.

Little research conducted in relation to strategic decision-making in the Gulf Cooperation Council therefore, this research will add original findings and the outcome of this study will lead to future research related to SDMP and the use of information management in the overall strategic decision-making.