Sub-theme 44: Implementing Innovation in Public Health: Organizational Challenges and Implications on Work

Lorenzo Mercurio
University of Naples Federico II, Italy
Maddalena Illario
University of Naples Federico II, Italy
Regina Roller-Wirnsberger
Medical University of Graz, Austria

Call for Papers

The impulse for change and innovation processes in public health comes from disruptive contextual conditions:

  • An ageing population (Khan, 2019);

  • The persistence of the Covid-19 pandemic;

  • Migration flows;

  • Climate change (Fox et al., 2019).

These elements combine to determine inequalities linked to socio-economic contexts that influence individual and collective resilience, and impact health outcomes by generating new or more complex needs. In addition, these factors exert a very strong pressure on the amount of spending by states, leading to an inevitable revision of investment allocation (Cylus et al., 2019).
The response to these challenges, identified in different areas, is characterized by a strong interdisciplinary nature and requires the contribution of organizations with different scopes and levels. On the other side, international organizations act as a driver for change by developing new solutions and through political leverage that directs the planning of States in a directional manner, facilitates synergies and accelerates the transformation of public health at intermediate and peripheral levels.
These processes of change are not linear, and occur asynchronously, generating an objective difficulty in designing reference models, which are only applicable if they are flexible and modular, so that they can be adapted to specific cases.
The change and innovation required to make public health the driver of a reorganization of the system of services to citizens, in a cooperative and inclusive as well as economic key, requires the use of new organizational approaches (Pearson & Watson, 2018). In a new vision of prevention, the health system needs to redefine the way health services are delivered. Traditionally, the focus of the health system has been on diseases and clinical specialties. This results in a focus on the already sick citizen and places the hospital as the centre of care delivery.
The great challenge, therefore, is to place the person at the centre of the system. This implies a interprofessional and multidimensional approach (McNeil, Mitchell & Parker, 2013) where integration and collaborative practices are essential. People, therefore, and not patients. The impact on the health system is quite large, the citizen is taken care of before he or she becomes frail, and to do this the specialist or purely clinical vision is inadequate.
The impact of this change, as well as on structures and policies, is particularly relevant on the identity of the workers and professionals involved, in particular doctors. These professionals have already been involved for years in a process of redefinition of their role, in the public system, which places management and administrative responsibilities alongside clinical responsibilities (Martin et al., 2020; von Knorrin et al., 2016; Porter & Wilton, 2020). The need for integration with other disciplines, not only clinical but also social, technological, architectural and environmental, leads to a change in the way of working and role. This represents an additional complexity to the change needed and a potential issue of resistance.
At this point in time, the redefinition of the model for approaching public health issues is also being driven by different perspectives without any real integration across the board. This is why the contribution of organization studies to this complex issue is particularly important. The theme of change in the health system can attract organizational scholars who deal with complex organizations in the broad field of health or professionals (doctors, managers, social workers...) involved in public health in particular. From this point of view, organizational studies can bring their perspective to enrich the vision of public health through variables, categories and constructs such as efficiency, conflict, managerialism, power, employment relations, participation, cooperation (Currie et al., 2012; Hasselbladh & Bejerot, 2007).
The long-term objective of this sub-theme is to contribute to establishing organization studies as a prominent discipline in the field of public health. Nevertheless, we are aware that the EGOS Colloquium 203 in Cagliari will be an opportunity to run a sub-theme designed after health crisis and probably the first opportunity to discuss papers on the effect of the pandemic and social and environment implications on work, organization and management in the prospective of good life.


  • Cain, C., Frazer, F., & Kilaberia, T. (2019): “Identity work within attempts to transform healthcare: Invisible team processes.” Human Relations, 72 (2), 370–396.
  • Currie, G., Dingwall, R., Kitchener, M., & Waring, J. (2012): “Let’s dance: Organization studies, medical sociology and health policy.” Social Science & Medicine, 74 (3), 273–280.
  • Cylus, J., Roubal, T., Ong, P., & Barber, S. (2019): Sustainable Health Financing with an Ageing Population. Implications of Different Revenue Raising Mechanisms and Policy Options. Copenhagen: WHO Regional Office for Europe; available at:
  • Hasselblad, H., & Bejerot, E. (2007): “Webs of knowledge and circuits of communication: Constructing rationalized agency in Swedish health care.” Organization, 14 (2), 175–200.
  • Khan, H.T.A. (2019): “Population ageing in a globalized world: Risks and dilemmas?” Journal of Evaluation in Clinical Practice, 25 (5), 754–760.
  • Korica, M., & Molloy, E. (2010): “Making sense of professional identities: Stories of medical professionals and new technologies.” Human Relations, 63, 12, 1879–1901.
  • Martin, G., Bushfield, S., Siebert, S., & Howieson, B. (2020): “Changing Logics in Healthcare and Their Effects on the Identity Motives and Identity Work of Doctors.” Organization Studies, 42 (9), 1477–1499.
  • McNeil, K.A., Mitchell, R.J., & Parker, V. (2013): “Interprofessional practice and professional identity threat.” Health Sociology Review, 22 (3), 291–307.
  • Pearson, C., & Watson, N. (2018): “Implementing health and social care integration in Scotland: Renegotiating new partnerships in changing cultures of care.” Health and Social Care, 26, 396–403.
  • Porter, J., & Wilton A., (2020): “Professional identity of allied health staff associated with a major health network organizational restructuring.” Nursing & Health Sciences, 22 (4), 1103–1110.
  • von Knorring, M., Alexanderson, K., & Eliasson, M.A. (2016): “Healthcare managers’ construction of the manager role in relation to the medical profession.” Journal of Health Organization and Management, 30, 421–440.
Lorenzo Mercurio is Associate Professor in Organization at the Department of Public Health, University Federico II of Naples, Italy. The main topics of his research have been focused on governance, knowledge management, and innovation. The areas of application of these topics were mainly in public organizations and Public Health.
Maddalena Illario is Associate Professor at the Department of Public Health, University Federico II of Naples, Italy. Since 2020, she is WHO expert for the Covid-19 Italy Vulnerabilities Network (CIV-N), and since 2020, Referent for Italy in the COST network “International Interdisciplinary Network on Health and Wellbeing in an Age-friendly Digital World”.
Regina Roller-Wirnsberger is Professor of Geriatric Medicine and Competence-based Curricular Development at Medical University of Graz (MUG), Austria, Department of Internal Medicine where is Head of Research Unit on old age medicine and lifelong health. She is involved in academic research programs in the field of geriatric medicine and public health for older citizens since 2005, and Program Director for curricular development at MUG for clinical education in undergraduate curriculum.