In the healthcare setting, real-world data (RWD) could be a useful support to measure the impact of disease-management interventions, in order to create a knowledge base, for the design of effective, efficient and satisfactory healthcare pathways. The present paper aims at investigating the factors affecting patient rehabilitative pathway. Such factors make up the knowledge assets that might influence the design of a patient rehabilitative pathway (in terms of clinical outcomes, patients’ satisfaction and economic resources’ absorption), after the Anterior Cruciate Ligament (ACL) rupture, assuming the hospital wards perspective. For the achievement of the above mentioned objective, a review on the topic is performed for revealing the principal rehabilitative pathway factors, impacting on clinical outcomes, patients’ satisfaction and economic resources’ absorption. An observational study was developed, in two private rehabilitative hospitals in Italy, in order to retrieve RWD with regard to the rehabilitative pathway, thus collecting information from 59 patients, on the factors determined by literature analysis. Patients’ data were analysed considering three methodological approaches. i) Relationships between variables, were investigated to test the existence of correlations among them. ii) A hierarchical sequential linear regression model was implemented to define the predictors of the three dependent variables (clinical outcomes, patients’ satisfaction and economic resources’ absorption). iii) A Qualitative Comparative Analysis – QCA, was implemented, in order to complement previous statistical approaches with a comparative-configurational one. Results of the study would be useful for the optimization of economic resources, as well as for the achievement of an adequate rehabilitative effectiveness, guaranteeing a personalisation of the process, thus becoming more efficient and effective, consistent with cost-containment strategies.

In the present paper we show the potentiality of the Stochastic Multicriteria Acceptability Analysis (SMAA-2) in evaluating 31 general hospital structures across the Kingdom of Saudi Arabia (KSA) in 2017. The method allows for a global evaluation of each hospital beginning with a set of 41 key performance indicators (KPIs) that are computed monthly by the Saudi Ministry of Health (MoH). The paper clearly shows the importance of this multi-criteria technique in supporting decision makers (DM).

This study aims to explore the emergence of an innovation ecosystem as a complex network of entities involved in innovation. After reviewing three ecosystem-based perspectives in the literature, we conduct a participatory and longitudinal action research study based on the analysis of a High Technology District for Cultural Heritage. Our analysis reveals three milestones in the establishment of an innovation ecosystem, which we identify as setting the context, establishing interdependence, and giving continuity. The study contributes to the scholarly debate in that we analyse the dynamics through which an innovation ecosystem emerges as a co-created and co-evolutionary context that shapes actions, interests and rules among a multiplicity of actors and collectively fosters innovation. We further identify different salient tensions between opposing forces that characterize the relationships and interdependencies among actors. The appropriate structures, flexible institutions and negotiation opportunities are necessary for the design and development of the workability and viability of an innovation ecosystem.

Although the innovation phenomenon has been receiving increasing attention in the tourism and hospitality domain, it remain a buzzword extremely fragmented and ignored. Tourism research build on traditional form of innovation emphasizes the key role of information and communication technologies (ICTs) in innovative process. However the technology-driven approach in innovation remains limited neglecting the nature of destination, as a complex system of relationships between diverse public and private actors generating knowledge and innovation. The interpretation of the destination as a continuous process of innovation-based knowledge considers the innovation as a pervasive and holistic results of the interaction between destination public and private actors facilitated by the complementary role of ICT infrastructures and social capital. This paper aims to contribute to the debate on innovation in destination overcoming the isolated technology-driven innovation and introducing the role of social capital and ICT infrastructures in nurturing diverse pervasive and holistic forms of innovations in destination. An initially exploratory multiple-case study was used to investigate six drivers and two forms of innovations, selecting Italian and international destination. The discussion and conclusion design some preliminary theoretical implications and outline some managerial recommendations.

Recent advances in Information and Communication Technologies (ICT) have exploded the potential for value creation in a variety of innovation ecosystems(Vilhelmson, 2006). The vast increase in potential can be attributed to two distinct underlying factors. First, ICT has extended the reach of more possible actors to the point where nearly any actor can be connected to any other and, as a result, geographic proximity is becoming less and less relevant (Boschma, 2005). Second, the responsiveness of one party in a relationship (to the needs of existing parties or the opportunities from a nearly limitless number of other possible parties) has become almost instantaneous to the point where time has become compress and essentially (a less differentiating factor( Nachira 2002, Boschma 2007). However, despite the vast size of the potential value that, ICT enables, we argue that it is likely that only a tiny fraction of this potential may be realized, unless and until relevant risks are anticipated and effectively managed(Fransman 2010). In this paper, we consider risk at two levels of a prototypical digital ecosystem: First is the level of possible interacting actors. Second is the level of those actors who contribute to the design, organization and maintenance of the ecosystem (Doloreux 2002, Asheim 2002). In each case, extended reach and quicker responsiveness enhances opportunities for greater utilization and better experience of any asset among the parties it also exposes various parties to greater risk. ( Adner 2006, Graca P. and Camarinha-Matos 2017). Accordingly, we apply a value creation-appropriation theoretical framework to consider the managerial challenges that risks pose. We develop a number of scenarios to illustrate how various risk mitigation strategies can influence not only who wins and who loses but also the amount of value that is likely to be created by the digitalized ecosystem(Basole 2015). Some prominent features of the relative dynamics, that our theoretical framework highlights will be illustrated by an agent-based simulation model. This model will comprise multiple agents that can interact according to their level of reach and responsiveness(Leavy and Adner 2012). By manipulating the extent of reach and the degree of responsiveness afforded to agents (a proxy of the level of digitalization) The study seeks to contribute to innovation ecosystems by focusing on the risks that the digitalization of ecosystems (Baldassar 2016) gives rise to (as a direct result of the value potential that it enables) and the inherent managerial challenges that may require a rethinking of the role of eco-system actors and even of non-actors that could be positively or negatively impacted.

This work reports preliminary outcomes from the project LINFA, whose aim is to develop a technological, information and organizational system to support the procurement process of medicines and medical devices within healthcare organizations. Such system integrates simulation and optimization algorithms and forecasting models along with advanced logistic practices and traceability technologies by exploiting the increasing availability of historical information about drugs and patients. Accordingly, the paper presents a real case study within an Italian Hospital where the project team has gone through-out the phases of process discovery, use-cases identification and analysis to devise an integrated tool for supporting logistic operation. Results provide a complete identification and formalization of the drug management process, primary process users and functional requirements of such tool for supporting pharmaceutical last-mile logistic including simulation utilities within a hospital or hospital network setting. Final expected benefits from the project include the minimization of stocks and the effective and efficient management of medicines, with a consequent reduction in healthcare expenditure.

In Italy, the healthcare sector is the one that absorbs the largest economic resources, immediately after Social Security, and, hence, it has been coping with an enduring reforming process. The latest health reform, namely DM 70/2015, suggested the adoption of the Hub & Spoke model for the redesign of regional hospital networks. The aim of this intervention was to have a capillary presence of less specialized disciplines, concentrated at the Spokes, in order to improve users’ accessibility conditions. In this paper, we deal with a particular case study concerning the STEMI (ST-Elevation Myocardial Infarction) network of the province of Naples, in Southern Italy. In particular, we perform a spatial analysis in order to assess the impact on users’ accessibility determined by the occurred reconfiguration. Moreover, we also propose a mathematical programming model aiming at producing alternative reorganization scenarios to improve spatial accessibility. Our results confirm that users effectively benefit from the reorganization process but also that further, and significant improvements, are possible. In particular, our computational experiments reveal that a strategic intervention oriented at redistributing capacities, i.e. the supply of hospital beds, among the existing facilities could lead to averagely better and even more equitable accessibility conditions.

Healthcare is a knowledge driven process (Shahmoradi et al 2017) and the effective exploitation of knowledge in building decision-making tools (Patel et al, 2009) is gaining attention. To this respect, both artificial intelligence and the use of specific algorithms may play a key-role. The present paper aims at discussing the potential use of fuzzy logic algorithm, to be a supportive tool in the clinical decision-making process, in particular with regard to patients with renal impairment. After a literature review, which enable to make allowance for the principal factors involved in a clinical decision-making process led by artificial intelligence, and by fuzzy logic approach specifically, two questionnaires were administered to clinicians, working in an Italian Hospital. Two algorithms were built. Algorithm 1 (ALG 1) was implemented to perform “conservative” decision-making whilst the Algorithm 2 (ALG 2) was thought to simulate a less cautious decision-making process. Inferential analyses were performed: i) the existence of correlations among variables were investigated; ii) a regression model was implemented in order to test the hypotheses and reveal the predictors of the dependent variable (i.e. degree of diagnostic accuracy). Both algorithms showed that only information quality (algorithm 1: β=0.389; p<0.001; algorithm 2: β=0.370; p<0.001) was required to approximate the diagnostic accuracy of a decision-making process supported by artificial intelligence tools (Algorithm 1: Adjusted R2 = 0.346; Algorithm 2: Adjusted R2 = 0.407).

The transition to a more circular society has been adopted as a guiding principle in several countries’ policies. The present paper reviews the international definitional and theoretical approaches to the circular economy originating in the Anglo-Saxon environment with a view to assessing their applicability in the (post-) transitional context of CEE and identifying the elements of their integrative conceptual core. The main finding is that scientific research of circular economy and circular business thinking takes two relatively independent directions (normative/positive), as it is grounded in two different methodological approaches. The paper shows that it is possible to use a starting point for further research on circularity that would not be based on dichotomous approaches but on integrity (holistic approach).

Remanufacturing plays an important role in the transition towards the circular economy. Since many companies have already begun to implement remanufacturing strategies, consumer’s adoption of already used products (e.g., remanufactured products) are highly essential. Hence, the consumer’s acceptance of the remanufactured product is now receiving more researcher’s attention. The findings of recent studies, however, indicate that consumers have a poor opinion on remanufactured products and thus remain reluctant to buy them. Moreover, these studies focus only on the adult generation and overlook the young generation which will become a new purchase power in the near future. Therefore, the main objective of the presented study is to deeply investigate how product-related knowledge influences the young generation’s purchase intention towards remanufactured white goods. The author uses the theory of planned behaviour as a theoretical framework and for data collection questionnaire survey. Furthermore, the proposed model is empirically tested, using Ordinary least squares (OLS) regression, based on the responses from 234 university students. The results indicate that consumer’s intention to purchase remanufactured products is positively and significantly influenced by consumer attitude, social norm and perceived behavioural control. Moreover, the presented study also demonstrates that consumer’s product-related knowledge is positively associated with both consumer’s attitude and consumers’ intention to purchase remanufactured products. Thus, based on the presented findings, the study not only brings new insight into the purchase behaviour of the young generation towards remanufactured products but also several theoretical and practical implications.

The shifting to a circular economy (CE) demands the understanding of how companies can introduce circularity into their business models, that is, how companies develop and implement circular business models. In this process networks assume a critical role. This paper contributes to the theoretical grounding of the role of network forms of organization for Circular Economy, by providing an analysis on how networks have been integrated into the CE literature. For that, it draws on bibliometrics to map and analyze the evolution of the literature on Circular Economy that mentions networks. Moreover, it conducts a systematic literature review (SLR) considering five analytical dimensions: 1) research method used; 2) level of analysis of the study; 3) type of actors in the analysis/network; 4) purpose of the network; 5) network building strategies and challenges. The results show that the integration of networks in the CE is being accomplished using a diverse set of methodologies, with an underrepresentation of social network analysis and covering several levels of analysis (micro, meso and macro). Studies tend to stress relations inside the value-chain established to manage physical and energy flows. The CE literature also tackles the main challenges in network management, namely coordination, trust and alignment.

In the article, the circular economy is elaborated form the reverse flows perspective, as these flows are the essence of the circular economy. The link between these two areas is straightforward as both focus on transition from liner to circular business environment: To make reverse logistics effective, companies need more than (just) the refinement of reuse/repair/recycle activities, but a more thorough redesign of the production system including product design and the whole business model redefinition is often necessary. In particular, the analysis uncovers managerial characteristics typical for companies that include their first-tier supply chain members in their knowledge ecosystem. The paper utilises the data collected in structured interviews among representatives of companies operating of the Czech market. The interviews covered multiple topics ranging from general management issues to circularity-specific areas such as general business views and motivation, and diverse aspects of management system For this exploratory research aim, the inferential statistics were employed: besides frequencies, the Mann-Whitney tests and bivariate correlations were calculated for scales and dichotomies variables. The analysis revealed managerial attitudes and practices, which are related to the intensity of knowledge sharing with the business partners; with the first-tier supply chain members. In other words, based on the perceived level of knowledge diffusion across a company, its customers, and suppliers, we identified typical features of management systems in companies that put effort into boosting their knowledge ecosystem. First, these companies are more integrated (internally and externally). The multiple indicators suggest that companies boosting the knowledge diffusion in the supply chain also take slightly different actions in tactical and operational level as expressed by planning activities. The ambitions for circularity (as expressed by the motivation for reverse logistics) are not so much solely focussed on marketing motives such as customers loyalty, satisfaction, or image, but their aim is more shifted towards value creation (out of reverse flows) and (environmental) legislation compliance. These companies often believe that reverse flows are useful/necessary to deal with, which is not always the case in companies in general. Finally, the statistic calculations identified that knowledge sharing has no apparent link to company size, manufacturing/service affiliation, but it is more intensive in companies that are closer to end customers, i.e. in downstream supply chain members. The findings of exploratory nature provide insight into relationships and mechanisms in companies that share their circular economy related knowledge with their suppliers and direct customers. Based on perceived company performance, it provides support for the economic rationality of knowledge sharing in the area of reverse flows.

The main objective of the paper is to gain understanding and overview of how knowledge management practices are understood and approached in the current academic research of circular economy with the focus on business life. A systematic literature review was conducted to identify knowledge management concepts, implemented knowledge management methods, tools or models as well as the areas of knowledge management theory applications and the contexts of applications in the existing academic papers. The aim of the paper behind the main objective is not only to summarize existing evidence but also to draw attention of business practice to the role of knowledge management and complex knowledge ecosystems for meeting the circular economy challenges and overcoming the circular economy barriers. For this paper peer-reviewed journals articles included in the Web of Science and SCOPUS databases were analysed within the systematic literature review. The main findings show that most of the current body of knowledge management theory is ignored in circular economy and circular business literature and the interest is focused mainly on knowledge sharing, knowledge acquisition and lack of knowledge while other important themes are not elaborated at all or only marginally.

The aim of this paper is to investigate the role of boundaries management when firms should implement open innovation. The paper is based on: the review of relevant literature on strategic management, firm’s boundaries and open innovation fields; a survey of a sample of Italian listed firms. Findings show, from a side, that open innovation and many modern paths growth are connected to the firm’s boundaries and, on the other side, that boundaries management play a key role for the implementation of open innovation. Indeed, we provide implications for practitioners by shedding light on the advantages and the risks that can jeopardize the successful outcome of opening up the innovation processes without the effective management of boundaries.

The Italian banking system has profoundly changed during the last 20 years both due to the privatization of the major State banks and out of the greater use of market financing taken place on the stock exchange. Thanks to the M&A process, nowadays, banks are larger and more complex than in the past but, M&A is a dangerous process if it is not appropriately dealt. The major risks are related to the numerous different items that must be well managed during the transition period such as, e.g., employees and information systems. Concurrently, banks’ managers are being asked to incorporate the new features and changes deriving from the recent years’ digitization. These important changes, unavoidably, lead to the need to close branches reducing the number of employees which has repercussions on the relations that the bank has with the territory and this could compromise the economic local grow. The present work revolves around the idea of understanding which actions the managers could undertake to ensure that the relationship with the territory is not lost while facing exponential growth in size, caused by the M&A process, and the challenges brought about by digitalisation. The methodology used in the present paper is an ethnographic exploratory single case study where the information will be collected using semi-structured interviews. In this first part of a wider project, in addition to a literature review, the process required to elaborate the schemes of the semi-structured interviews is explained. The value of the work is interesting for scholars as well as for practitioners; in fact, from the analysis of the answers provided by managers it will be possible to learn a lesson regarding the actions that were carried out, but also about the activities that have not led to the desired results and therefore should be avoided. At the same time, this study could contribute to the academic debate as it allows us to add literature on management while selecting which prior author’s position to endorse, regarding the influence of managers’ behaviours on obtaining profitability in banking institutions.

Knowledge Management (KM) is vital factor to successfully undertake projects. The temporary nature of projects necessitates employing useful KM practices for tackling issues such as knowledge leakiness and rework. The existing Project Management Maturity Models (PMMMs) have focused on discussing Project Management practices, however, the management of project knowledge is yet to be addressed, at various levels of maturity. This research project was undertaken to investigate the mentioned gap for addressing KM practices at the existing PMMMs investigating how the knowledge being captured, managed, redistributed, shared and stored in the interviewed companies and the identification of the tools used to ensure that this occurs correctly and properly timed, to pursue continuous improvement and the success of the projects with the aim of sharing and promoting the development of the Project Management culture and Knowledge Management starting from the academic sphere, encouraging company’s growth and effectiveness thanks to: Improved business decisions thanks to facilitated access to expertise and to leading practices. Increased efficiency, productivity and work smarter by reducing cases of “reinventing the wheel”. Improved Innovation through wider and borderless collaboration. Reduced loss of know-how by capturing explicit and tacit knowledge. Speeded-up productivity with on-board trainings and timely access to knowledge. Increased client satisfaction by delivering value insights. Enhanced quality and ability to collaborate by standardizing ways of working and enabling discussions with leading experts. Due to the exploratory and inductive nature of this research, statistical methods were chosen as the research methodology. The web and free tool has been chosen to distribute the survey across the selected list of participants.

If the “early modernity” contemplated the antagonism between high and low complexity, the transition to the new paradigm of so called global and digitized capitalism modifies this relationship in the direction of complementarity. Complexity, far from representing an entity to be compressed and simplified, becomes a source of value for the variety of products and processes and for the management of network interconnections. The notion of enterprise as a cognitive system, which uses knowledge as a source of sustainable competitive advantage and which continuously creates new knowledge from existing capacities provides researchers with a significant reading key to redirect itself into complexity and to give representation to the new organizations: from the model of the castle to the model of the network, of the widespread enterprise, in whose knots represent subsystems connected in a continuous dynamic of relationships, of knowledge and economic exchanges. In the context outlined, organizations face complex challenges in terms of changing business models and reconfiguring the value chain. In particular, new alternative paradigms emerge with respect to the concept of innovation in the traditional sense, such as that of open innovation. Unlike traditional innovation, based on the vertical integration of the innovative process and on defence, open innovation is based on the idea that the company can create value through a strategic path to open up to the competitive environment. The level of analysis is twofold. First, an exploratory comparative analysis was conducted with reference to companies that have embraced the “open” approach in their innovation processes, shedding light on the interconnections existing between the various organizational systems, whose complexity determines the spread of the network. A framework that we called SKIN was applied. Second, through the analysis of Enel Open Power case, attention will be paid to the role of the strategy in the management of the process of transition to a “network” type of business model with a special emphasis to the ecosystem concept where actors, technologies, and institutions co-evolve through their interactions and shared purpose.

This paper proposes a theoretical framework that aims to support firms to adopt the processes of open innovation for implementing successful environmental strategies. The aim of this paper is to investigate the open innovation processes when firms should implement environmental strategies. Through a theoretical analysis, the study highlights the links between environmental strategy and open innovation practices focusing on specific theme of open sustainability innovation model. Drawing on and extending prior studies and practice oriented approaches to environmental strategies, this study identifies some relevant open innovation tools which may provide insights for more effective models of green management. Specifically, the theoretical framework suggests implications for practitioners by shedding light on the sources and methods to translate the transferred/shared knowledge into effective environmental ideas and therefore in goals and actions, to support the strategic decision-making.

This paper aims to provide an explanatory representation of the concept of ecosystem by mean of a systemic review of a selected sample of research papers hinged on the study of ecosystems in the field of management and business. Reviewed papers were selected according to a multistep process and the following criteria: 1) coverage of a comprehensive range of business and management-related peer-reviewed journals chosen from Scopus database; 2) timeframe of the investigated topic restricted to the period 1993-2019; 3) papers mainly focused on providing a general framework on ecosystems drawn from research. This paper represents an attempt to give a systemic representation of the existing research on the definition of ecosystem. This study has implications not only for researchers, but also for business practitioners. By means of this literature review it is possible to properly interpret, according to the criteria selected, the concept of ecosystem as depicted in the field of management and business.

The present study explores organizing knowledge co-creation for radical innovation within knowledge ecosystem. Building on research on knowledge creation, innovation, and organizing, the study at hand understands knowledge co-creation as central basis for organizing and source of interdependence. Study sheds light on temporary and emergent organizing of knowledge co-creation within knowledge ecosystem. The findings of the study reveal that process of knowledge co-creation is cyclic in which each cycle builds on previous one. In addition, knowledge co-creation considers multidimensional orientation between technology, business and regulation throughout the process. Hence, beyond formal project organization, organizing knowledge co-creation is temporary, dynamic, informal, and follows cyclic and generative process. Specifically, organizing comprises activities of shared problem identification, shared goal setting, making experiments (testing), open demonstrations, and seeking internal and feedback and knowledge synthesis. Such an organizing enables contextual, situational, and flexible involvement of critical knowledge for the development of innovation, building novel business, and changing regulation. The paper discusses the findings and implications more detailed.