In data in standard form on seventy manufacturing organizations in three countries, consistent relationships are found between variables of organization context or `task environment' (size, dependence, technology) and measures of structure (Formalization, Specialization, Autonomy). These support the hypothesis that relationships will be stable across societies. Even though culturally shaped variations may occur in some features of organizations, contextual constraints or pressures will persist. Simply stated, if Indian organizations were found to be less formalized than American ones, bigger Indian units would still be more formalized than smaller Indian units.

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Hospital average length of stay varies considerably between countries. However, there is limited patient-level research identifying or discounting possible reasons for these differences. This study compares the length of stay of patients in Japan, where it is the longest in the OECD, and Canada, where length of stay is closer to the OECD mean. Administrative patient-level data, including age, gender, co-morbidities, intervention, discharge plan, outcome and length of stay were collected from two Japanese and two Ontario, Canada hospitals for two diagnoses: colorectal cancer surgery and acute myocardial infarction. Analyses examined linkages between patient characteristics, hospitals and countries and length of stay. When controlling for patient demographic characteristics, the incidence of co-morbidities and discharge plan practices, Japanese length of stay tended to be significantly longer than that in Canada for both diagnoses. Mortality rates were not significantly different; however, the readmission rate (28 days or less) for acute myocardial infarction was higher in the Canadian hospitals. The findings indicate that non-clinical factors contribute to sustained international differences in length of stay. These factors may include professional or cultural norms, differing payment schemes and access to long-term care facilities. The study also introduces a protocol that can be used for international patient-level comparisons that can enable effective policy and management learning.

Purpose – The purpose of this paper is to critique the existing decision-making models of organizational theory and the ability of strategic managers to address unconventional problems using these models. Strategic management models presume reasonable stability in the task environment and the organizational design features. However, complex problems, or wicked problems, are prolific in a global world. They change profoundly the nature of strategic management, where management faces a deep paradox – an environment of unprecedented interdependence, yet unpredictable forces of chaos and volatility, a landscape of wicked problems. In this paper, the authors address wicked problems within the context of strategic management. Design/methodology/approach – The authors review and critique the organizational theory literature, namely, microeconomics, bounded rationality, organizational failure and the theory of creative destruction within the context of wicked problems. Findings – The authors find that the contemporary models of strategic management are incapable of assisting managers in addressing the reality of wicked problems. They argue that organizational pathologies rest in executive action: pursuit of goals and objectives with a false sense of causation, feedback filters that exaggerate good news and restrict bad news and actions that give only token measures to correct faulty design decisions and faulty decision processes, including more emphasis on vertical channels than horizontal task interdependencies. Originality/value – The authors conclude that wicked problem-solving is by temperament and time horizon, a multilayered, multitasked, organizational challenge, and requires fundamentally different mindsets for design and performance systems for senior executives. The study of wicked problems requires a new corporate mindset, new collaborative models to address them and new corporate processes and executive training tools who increasingly have to address them. This research is a first step toward extending our understanding of how to address the world of wicked problems.

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