Inside and outside the boardroom: Collaborative practices in the performing arts sector

Collaboration is crucial in the arts sector, where forms of collaborative governance (CG) – the inclusion of private partners in the decision-making process – have been implemented in order to overcome scarcity of resources and to engage with stakeholders. The governance of performing arts organizations today must be based on constant collaboration between public and private entities in order to generate greater value. The purpose of this study is to identify the drivers of CG in performing arts organizations by means of a case study of I Teatri Foundation of Reggio-Emilia, one of the first theatres in Italy to include private partners in governance. The methodology is based on both documentary analysis and interviews. The findings show that CG should be applied at micro and meso levels (inside and outside the boardroom), as both levels contribute to the creation of value for the audience

Inside and outside the boardroom: Collaborative practices in the performing arts sector

Collaboration is crucial in the arts sector, where forms of collaborative governance (CG) – the inclusion of private partners in the decision-making process – have been implemented in order to overcome scarcity of resources and to engage with stakeholders. The governance of performing arts organizations today must be based on constant collaboration between public and private entities in order to generate greater value. The purpose of this study is to identify the drivers of CG in performing arts organizations by means of a case study of I Teatri Foundation of Reggio-Emilia, one of the first theatres in Italy to include private partners in governance. The methodology is based on both documentary analysis and interviews. The findings show that CG should be applied at micro and meso levels (inside and outside the boardroom), as both levels contribute to the creation of value for the audience

Balancing artistic and financial performance: is collaborative governance the answer?

Purpose: Opera houses have been traditionally publicly financed in many western countries. However, today many opera houses are facing serious financial troubles, due to the recent financial crisis. There is thus a widespread public debate on measures to ensure agency efficiency for performing arts organizations. Focusing on the reform implemented recently in Italy, which submitted opera houses that had severe financial difficulties to a recovery plan and encouraged forms of collaborative governance (CG), the purpose of this paper is to investigate the impact of CG on the performance of the arts sector. Design/methodology/approach: Multiple case studies are used, on longitudinal data from multiple sources over a period of up to five years, in order to triangulate the narrative of financial and artistic performance and ensure trustworthiness. The study thus spans the period before the Bray Law came into force (2013) and covers the entire period in which recovery plans were implemented. Findings: The analysis explores how opera houses are building sustainability for themselves and the community in terms of financial and artistic performance through CG. Various forms of CG adopted yielded positive results. Furthermore, more robust forms of CG generated better performance, especially from a financial point of view. Originality/value: This paper adds to the limited knowledge of CG in the non-profit sector by bridging the fields of agency performance and CG. It discusses how the introduction of forms of CG can build up long-term sustainability, solving the dilemma of how to achieve financial equilibrium without compromising artistic quality, focusing on the case of opera houses, which are notably affected by Baumol’s cost disease

Managerial competences in public organisations: The healthcare professionals' perspective

Background: Human resources play a critical role in encouraging efficient performance within organisations, especially for public healthcare organisations, where competences of staff are key aspects of the quality of services provided. In this context, the enhancement of competences are strategic objectives for Human Resources Management (HRM) in order to achieve excellent and lasting results. However, competences of healthcare professionals are both clinical and managerial. This study identifies specific managerial competences perceived as crucial by healthcare professionals in order to improve their performance and develop suitable HRM practices. Methods: The research methodology was divided into three main phases using mixed methods, commencing with literature review to identify the initial framework about managerial competences. Focus groups were then used to discuss evidence from the literature. Feedback from focus groups was used to draft the final questionnaire. Finally, the answers to the questionnaire were analysed through statistical software. Results: The results show that managers and professionals share a view of what specific managerial competences for healthcare organisations should be. Main competences are: Quality evaluation based on outcomes; enhancement of professional competences; programming based on process management; project cost assessment; informal communication style; and participatory leadership. Conclusions: Although the issue of managerial skills in healthcare is widely discussed in literature, findings are often fragmentary. Our work includes a systematic literature review useful for more empirical studies. Furthermore, our results can support public managers who want to set up positive HRM practices for healthcare professionals

Disruptive crisis management: lessons from managing a hospital during the COVID-19 pandemic

Purpose: Healthcare organizations worldwide were badly hit by the “surprise” of the pandemic. Hospitals in particular are trying hard to manage problems it caused, searching for solutions to protect the health of citizens and reorienting operations. The implementation of resilience solutions in the coping phase and the ability to react promptly and redefine activities is essential. Integrating crisis management and resiliency literature, this paper discusses how health organizations were able to cope with adversity during the crisis. Design/methodology/approach: The research is conducted through a case study of a large Italian hospital, the Gemelli Polyclinic Foundation, which was one of the leading hospitals in the Italian response to the pandemic. Findings: The case reports actions taken in order to continue functioning and to maintain core activities despite severe adversity. The overall response of the Gemelli was the result of the three types of response: behavioral (effective leadership), cognitive (rapid resource reallocation) and the contextual reinforcement (multiagency network response). The authors highlight how an integrative framework of crisis management and resiliency could be applied to healthcare organizations in the coping phase of the pandemic. The experience of the Gemelli can thus be useful for other hospitals and organizations facing external crises and for overall improvement of crisis management and resilience. Responding to crisis brings the opportunity to make innovations introduced during emergencies structural, and embed them moving forward. Research limitations/implications: The paper focuses only on the coping phase of the response to the pandemic, whereas building long-term resilience requires understanding how organizations accumulate knowledge from crises and adapt to the “new normal.” Originality/value: The paper responds to the call for empirical studies to advance knowledge of an integrative framework of crisis management and resiliency theories with reference to complex organizations such as healthcare

Managerial features and outcome in neonatal intensive care units: results from a cluster analysis

Background: Healthcare organisations differ in performance even if they are located in the same country or region. Suitable managerial practices and organisational processes can lead to better health outcomes. As a result, hospitals are constantly looking for managerial arrangements that can improve outcomes and keep costs down. This study aims to identify different managerial models in neonatal intensive care units (NICUs) and their impact on a large number of outcomes. Methods: The research was conducted in Italy, within the SONAR project. SONAR’s aim was to identify the characteristics of NICUs, monitor outcomes and promote best practices. This study includes 51 of the 63 NICUs that took part in the SONAR project. Questionnaires on the activities and managerial features were administered to doctors and nurses working in NICUs. A total of 643 questionnaires were analysed from doctors and a total of 1601 from nurses. A cluster analysis was performed to identify managerial models of NICUs. Results: Three managerial models emerged from cluster analysis: traditional, collaborative and individualistic. In the “traditional” model the doctor is above the nurse in the hierarchy, and the nurse therefore has exclusively operational autonomy. The “collaborative” model has as key elements professional specialisation and functional coordination. The “individualistic” model considers only individual professional skills and does not concern the organisational conditions necessary to generate organisational effectiveness. The results also showed that there is an association between managerial model and neonatal outcomes. The collaborative model shows best results in almost all outcomes considered, and the traditional model has the worst. The individualistic model is in the middle, although its values are very close to those of traditional model. Conclusions: Health management needs to assess NICU strategically in order to develop models to improve outcomes. This study provides insights for management useful for designing managerial characteristics of NICUs in order to achieve better results. NICUs characterised by a collaborative model in fact show better neonatal outcomes

Work environment, volume of activity and staffing in neonatal intensive care units in Italy: results of the SONAR-nurse study

Neonatal units' volume of activity, and other quantitative and qualitative variables, such as staffing, workload, work environment, care organization and geographical location, may influence the outcome of high risk newborns. Data about the distribution of these variables and their relationships among Italian neonatal units are lacking

Natural history, clinicopathologic classification and prognosis of gastric ECL cell tumors.

A series of 50 gastric endocrine tumors classified according to Rindi et al. [1] comprised 12 small cell neuroendocrine carcinomas (NEC) and 38 ECL cell carcinoids, of which 22 associated with type A chronic atrophic gastritis (A-CAG), eight with hypertrophic gastropathy due to combined Multiple Endocrine Neoplasia and Zollinger/Ellison syndrome (MEN/ZES), and eight sporadic. Variables found to predict tumor malignancy were: size > 2 cm, > 2 mitoses and > 130 Ki67 positive cells/10 high power fields (HPF), grade 2 or 3 histology, angioinvasion, p53 protein nuclear accumulation, and the presence of a single tumor. None of these factors increased significantly the predicting ability of tumor classification itself, although grade 2 + 3 shows 100 percent negative predictive value and Ki67 and angioinvasion 100 percent positive predictive value. When the mostly non-malignant A-CAG and MEN-ZES tumors were analysed against the mostly malignant sporadic and NEC tumors, a positive predictive value of 90 percent and a negative predictive value of 93 percent was obtained. Investigation of a larger tumor series is under way with the aim to develop an optimal model for prognostic evaluation of gastric endocrine tumors

Work environment, volume of activity and staffing in neonatal intensive care units in Italy: results of the SONAR-nurse study

Neonatal units' volume of activity, and other quantitative and qualitative variables, such as staffing, workload, work environment, care organization and geographical location, may influence the outcome of high risk newborns. Data about the distribution of these variables and their relationships among Italian neonatal units are lacking