Background: Research on maternity care often focuses on factors that prevent good communication and collaboration and rarely includes important stakeholders – parents – as co-researchers. To understand how professionals and parents in Dutch maternity care accomplish constructive communication and collaboration, we examined their interactions in the clinic, looking for “good practice”. Methods: We used the video-reflexive ethnographic method in 9 midwifery practices and 2 obstetric units. Findings: We conducted 16 meetings where participants reflected on video recordings of their clinical interactions. We found that informal strategies facilitate communication and collaboration: “talk work” – small talk and humour – and “work beyond words” – familiarity, use of sight, touch, sound, and non-verbal gestures. When using these strategies, participants noted that it is important to be sensitive to context, to the values and feelings of others, and to the timing of care. Our analysis of their ways of being sensitive shows that good communication and collaboration involves “paradoxical care”, e.g., concurrent acts of “regulated spontaneity” and “informal formalities”. Discussion: Acknowledging and reinforcing paradoxical care skills will help caregivers develop the competencies needed to address the changing demands of health care. The video-reflexive ethnographic method offers an innovative approach to studying everyday work, focusing on informal and implicit aspects of practice and providing a bottom up approach, integrating researchers, professionals and parents. Conclusion: Good communication and collaboration in maternity care involves “paradoxical care” requiring social sensitivity and self-reflection, skills that should be included as part of professional training.
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We aim to understand how actors respond to field logic plurality and maintain legitimacy through business model innovation. Drawing on a longitudinal field study in the fashion industry, we traced how de novo and incumbent firms incorporate circular logics in business models (for sustainability) and uncover how the intersection between issue and exchange fields creates institutional complexity and experimental spaces for business model innovation. Our findings showed a shift in the discourse on circular logic that diverted attention and resources from materials innovation (e.g., recycling) to business model innovation (e.g., circular business models). By juxtaposing institutional complexity and external pressure to maintain legitimacy, we derived four strategic business model innovation responses—preserve, detach, integrate and extend—that illuminate how actors leverage shifting logics and innovate extant business models (for sustainability). We make novel contributions to the literature on organizational fields, business models for sustainability, and business model innovation.
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We examine the demise of a multi-stakeholder network that was launched to promote an inclusive dairy market in Ethiopia to better understand why nongovernmental organizations (NGOs) may develop interventions in contexts of poverty that fail to endure after they exit. We identify organizational reflexivity – the capacity to recognize and understand the recursive interplay between an intervention and the local environment – as a key explanatory mechanism for this intervention outcome. Limited reflexivity not only prevented the NGO we studied from properly aligning the intervention with the context (design failures), but also prevented the organization from adjusting its intervention when negative feedback emerged (orchestration failures), which eventually evolved into the demise of the network (maintenance failure). While our study confirms the theoretical premise that NGOs need to contextualize their interventions, we expand current knowledge by highlighting the role of organizational reflexivity in this process. Moreover, by showing how reflexivity deficits can trigger a cascade of failure, especially when intervening in voids where incumbent firms have interests in maintaining the void, our study calls attention to the politicized nature of institutional voids.
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