Purpose – The purpose of this paper is to report on an action research project carried out in an Italian university hospital that was facing a strategic challenge. The role of intellectual capital (IC) for university hospital strategic management is discussed after developing and applying an IC framework to enhance the visualisation of strategic IC elements. Design/methodology/approach – An action research process has been applied in the studied setting based on Susman and Evered’s (1978) definition of the engaged research cycle. Findings – The action research process allowed a gap between theory and practice to be bridged; the strategic control process resulted supported by new measures; a different approach to strategy management was launched, and other organisations perceived the relevance of the IC representation and wished to import it. Research limitations/implications – Research limitations are related to those recognised for the interventionist research approach. Practical implications – The paper contributes to the improvement of managerial and accounting technologies for practitioners managing university hospitals and discusses a university hospital’s strategic goals. Originality/value – The paper represents a methodological contribution related to the interventionist research stream of literature, and enriches the limited studies focused on IC in health care organisations. Furthermore, the paper enables appreciation of the role of academics in the convergence of theory and practice.

Purpose Exploring how to enhance innovative work behaviour (IWB) has been the main concern of top managers and researchers, particularly in knowledge-intensive and public organizations. Yet, studies investigating factors that shape innovative behaviour at work are scarce. Focussing on the healthcare setting, the purpose of this paper is to hypothesize a direct relationship between individuals’ perceived creative self-efficacy (CSE), creative collective efficacy (CCE) and IWB. Design/methodology/approach The research used survey data from 446 clinical managers working in public healthcare organizations in six different Italian regions and a set of previously validated questionnaires to measure the study variables. Findings Findings suggest that clinical managers’ perceptions of their CSE and their perceived CCE significantly influence their self-reported IWB. Research limitations/implications Findings highlight the importance of constructing and developing clinical managers’ efficacy in creativity at both an individual and team level in order to incentivize the emergence of innovation behaviour. Further research is needed to assess the existence of mediating and/or moderating mechanisms underlying the relationships emerging from this study in order to support decision makers in diffusing innovation and creativity in healthcare organizations. Originality/value The research adds to the debate on improving IWB by introducing perceived individual and team creative efficacy as determinants of IWB in healthcare organizations. The research is among the first attempts to contribute to healthcare organizations’ management through exploring clinical managers’ characteristics that influence their IWB.

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This paper provides a review of the literature concerning clinicians’ approach to accounting information systems (AISs) in healthcare organizations. The paper examines highly rated accounting and management literature since 1980. Articles are categorized according to their research topics, settings, and methodologies, then findings are analyzed. Results show that clinicians’ resistance to accounting is the consequence of the inadequacy of AISs, which are designed according to reforms inspired by a managerial orientation. This suggests that future research should focus on AISs design, investigating patterns of implementation of AISs that can increase clinicians’ commitment to and use of accounting for decision making.

Purpose This paper aims to investigate the consequences of the coercive regulations for performance measurement and comparability that strengthened regional health authority’s control over organizations’ activities on management accountants’ relationship with clinician managers, who are the recipients of accounting information for decisional processes in health-care organizations. To achieve this aim, the research focuses on management accountants’ perception of their role and whether they perceive role conflict and role ambiguity. Design/methodology/approach A case study was undertaken in a public university hospital in the Emilia-Romagna region, Italy; 9 management accountants and 11 clinician managers were interviewed and secondary data analyzed. Findings Management accountants show low capabilities to support clinician managers’ decisional processes. Following the enactment of regulations, management accountants perform their role with a primary focus on functional responsibility. The focus on the provision of information to address regulations influenced management accountants’ capability to act as business partners in the organization. Because of the conflicting information needs from regulations and clinician managers, management accountants experience role conflict and ambiguity. Research limitations/implications The paper has implications for policymakers, underlining the consequences of strict regulations on management accountants’ role. It also emphasizes the importance of revising accounting techniques to satisfy both regional requirements and clinician managers’ needs for decision-making. Originality/value The article contributes to knowledge related to the role of management accountants in health care. It explores, in particular, the consequences of coercive regulations in health-care organizations, adding knowledge to a field that remains quite unexplored.