This article brings together empirical academic research on public sector innovation. Via a systematic literature review, we investigate 181 articles and books on public sector innovation, published between 1990 and 2014. These studies are analysed based on the following themes: (1) the definitions of innovation, (2) innovation types, (3) goals of innovation, (4) antecedents of innovation and (5) outcomes of innovation. Based upon this analysis, we develop an empirically based framework of potentially important antecedents and effects of public sector innovation. We put forward three future research suggestions: (1) more variety in methods: moving from a qualitative dominance to using other methods, such as surveys, experiments and multi-method approaches; (2) emphasize theory development and testing as studies are often theory-poor; and (3) conduct more cross-national and cross-sectoral studies, linking for instance different governance and state traditions to the development and effects of public sector innovation.

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Innovation in the public sector: a systematic review and future research agenda

The aim of the study was to report the results of a systematically conducted literature review of empirical studies about healthcare organizations' ethics and management or leadership issues. Electronic databases MEDLINE and CINAHL yielded 909 citations. After a two stage application of the inclusion and exclusion criteria 56 full-text articles were included in the review. No large research programs were identified. Most of the studies were in acute hospital settings from the 1990s onwards. The studies focused on ethical challenges, dilemmas in practice, employee moral distress and ethical climates or environments. Study samples typically consisted of healthcare practitioners, operational, executive and strategic managers. Data collection was mainly by questionnaires or interviews and most of the studies were descriptive, correlational and cross-sectional. There is need to develop conceptual clarity and a theoretical framework around the subject of organizational ethics and the breadth of the contexts and scope of the research needs to be increased.

Organizational ethics: A literature review

Background This study aimed to provide an understanding of the relationship between the ethical climate at the workplace and job satisfaction among nurses. Methods 210 nurses working in selected wards in the Tehran University of Medical Sciences were asked to fill out questionnaires on their work environment and level of job satisfaction. The data collection tools included a questionnaire to obtain demographic data, the Olson moral climate questionnaire and Minnesota job satisfaction questionnaire. The data were analysed using SPSS software version 14. Results We found a significant positive relationship between the ethical climate and the level of job satisfaction among the nurses. Among the demographic variables, the working shift, income level and type of duties allocated had a significant relationship with job satisfaction. Conclusion Hospital managements should pay attention to the factors influencing job motivation among nurses, including the ethical climate of the work environment.

The relationship between ethical climate at work and job satisfaction among nurses in Tehran.

Changes in Attitudes and Beliefs Concerning Vaccination and Influenza Vaccines between the First and Second COVID-19 Pandemic Waves: A Longitudinal Study.

Corona-regionalism? Differences in regional responses to COVID-19 in Italy.

On 31st January 2020, the Italian cabinet declared a 6-month national emergency after the detection of the first two COVID-19 positive cases in Rome, two Chinese tourists travelling from Wuhan. Between then and the total lockdown introduced on 22nd March 2020 Italy was hit by an unprecedented crisis. In addition to being the first European country to be heavily swept by the COVID-19 pandemic, Italy was the first to introduce stringent lockdown measures. The SARS-CoV-2 outbreak and related COVID-19 pandemic have been the worst public health challenge endured in recent history by Italy. Two months since the beginning of the first wave, the estimated excess deaths in Lombardy, the hardest hit region in the country, reached a peak of more than 23,000 deaths. The extraordinary pressures exerted on the Italian Servizio Sanitario Nazionale (SSN) inevitably leads to questions about its preparedness and the appropriateness and effectiveness of responses implemented at both national and regional levels. The aim of the paper is to critically review the Italian response to the COVID-19 crisis spanning from the first early acute phases of the emergency (March-May 2020) to the relative stability of the epidemiological situation just before the second outbreak in October 2020.

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Response to COVID-19: was Italy (un)prepared?

Purpose – The healthcare sector faces new financial and managerial accountability demands, along with their clinical accountability. Various studies show strong opposition by clinicians to new accountability tools, new structures and new ways of working. Less attention is paid to the innovative roles doctors can play in leading changes that use new managerial tools and techniques. The purpose of this paper is to analyse two original case studies illustrating how general practitioners (GPs) in Germany have led radical change.Design/methodology/approach – The paper draws upon original research in Germany to present two case studies using a qualitative method, which are analysed using Glaser and Strauss' conventions of grounded theory, structured by Wenger's communities of practice framework, supporting a comprehensive literature review.Findings – GPs are found to be able to lead radical change in healthcare delivery models and organisation using entrepreneurial talents developed in their practice businesses...

Innovative doctors in Germany: changes through communities of practice

New public management accountability is increasingly being introduced into health-care systems throughout the world - albeit with mixed success. This paper examines the successful introduction of new management accounting systems among general practitioners (GPs) as an aspect of reform in the Italian health-care system. In particular, the study examines the critical role played by the novel concept of an 'ethical budget' in engaging the willing cooperation of the medical profession in implementing change. Utilizing a qualitative research design, with in-depth interviews with GPs, hospital doctors and managers, along with archival analysis, the present study finds that management accounting can be successfully implemented among medical professionals provided there is alignment between the management imperative and the ethical framework in which doctors practise their profession. The concept of an 'ethical budget' has been shown to be an innovative and effective tool in achieving this alignment.

Iris Bosa

Papers

Response to COVID-19: was Italy (un)prepared?

Corona-regionalism? Differences in regional responses to COVID-19 in Italy.

Innovative doctors in Germany: changes through communities of practice

Ethical budgets: a critical success factor in implementing new public management accountability in health care:

The business of philanthropy: Challenges in measuring the value of cultural giving