Unlocking medical leadership’s potential:a multilevel virtuous circle?

Background and aim: Medical leadership (ML) has been introduced in many countries, promising to support healthcare services improvement and help further system reform through effective leadership behaviours. Despite some evidence of its success, such lofty promises remain unfulfilled. Method: Couched in extant international literature, this paper provides a conceptual framework to analyse ML's potential in the context of healthcare's complex, multifaceted setting. Results: We identify four interrelated levels of analysis, or domains, that influence ML's potential to transform healthcare delivery. These are the healthcare ecosystem domain, the professional domain, the organisational domain and the individual doctor domain. We discuss the tensions between the various actors working in and across these domains and argue that greater multilevel and multistakeholder collaborative working in healthcare is necessary to reprofessionalise and transform healthcare ecosystems

Conceptualising sustainability in UK urban Regeneration: a discursive Formation

Despite the wide usage and popular appeal of the concept of sustainability in UK policy, it does not appear to have challenged the status quo in urban regeneration because policy is not leading in its conceptualisation and therefore implementation. This paper investigates how sustainability has been conceptualised in a case-based research study of the regeneration of Eastside in Birmingham, UK, through policy and other documents, and finds that conceptualisations of sustainability are fundamentally limited. The conceptualisation of sustainability operating within urban regeneration schemes should powerfully shape how they make manifest (or do not) the principles of sustainable development. Documents guide, but people implement regeneration—and the disparate conceptualisations of stakeholders demonstrate even less coherence than policy. The actions towards achieving sustainability have become a policy ‘fix’ in Eastside: a necessary feature of urban policy discourse that is limited to solutions within market-based constraints

A New Institutional Analysis of IFRS Adoption in Egypt: A Case Study of Loosely Coupled Rules and Routines

This paper examines the symbolic use of International Financial Reporting Standards (IFRS) in an Egyptian state-owned company (AQF Co.) that is partially privatised by drawing on new institutional sociology and its extensions. It explains how the ceremonial use of IFRS is shaped by the interplay between institutionalised accounting practices, conflicting institutions, power relations and the use of IT to institutionalizing accounting rules and routines. The research methodology is based on using an intensive case study. Data were collected from multiple sources, including unstructured and semi-structured interviews, direct and participative observations, discussions and documentary analysis. The findings revealed that the company faced conflicting institutional demands from outside. The Central Agency for Accountancy required the company to use the Uniform Accounting System (as a state-owned enterprise) and The Egyptian Capital Market Authority required the company to use IFRS (as a partially private sector company registered in the stock exchange). To meet these conflicting institutional demands, the company adopted loosely coupled accounting rules and routines and IT was used to institutionalizing existing Uniform Accounting System and preserving the status quo