Professional hybrids are situated between managerial and professional groups, potentially enabling them to move between different organizational groups. Extant research assumes that professional hybrids undergo identity transition to overcome the conflicts associated with influencing two distinct organizational realms. However, how these identity conflicts are managed remains unclear. To explore how professional hybrids manage such identity conflicts we consider the experience of nurse hybrids. Drawing on the concept of liminality we argue that influence across multiple groups relies on the construction of a positive liminal space. In contrast, we demonstrate how nurse hybrids occupy a perverse liminal space, perpetuating identity conflict, preventing identity transition, and undermining their effectiveness as hybrids. Our work calls into question the reliance on professional hybrids as an organizational panacea for reform and develops our understanding of individual hybrids.

The ability of individuals to accommodate emotional transition into roles requiring the construction of a leader identity is a poorly explored area. In this paper we consider the experience of 32 individuals moving into middle management positions, exploring how an emotional attachment to their professional group identity may cause identity conflict during the construction of a managerial leader identity. We consider how competing desired identities can result in negative emotional experiences, calling into question existing work, which assumes that desired group identities are congruent with leader identities. We suggest that identity work can mitigate identity conflict at the individual level, enabling middle managers to function in their role, but that emotional distress will continue due to a perceived loss of professional identity and group influence. We suggest it is only by eschewing an emotional attachment to a professional group that middle managers will be able to overcome this negative emotional experience.

BackgroundCrises, such as the COVID-19 pandemic, risk overwhelming health and social care systems. As part of their responses to a critical situation, healthcare professionals necessarily improvise. Some of these local improvisations have the potential to contribute to important innovations for health and social care systems with relevance beyond the particular service area and crisis in which they were developed.FindingsThis paper explores some key drivers of improvised innovation that may arise in response to a crisis. We highlight how services that are not considered immediate priorities may also emerge as especially fertile areas in this respect.ConclusionHealth managers and policymakers should monitor crisis-induced improvisations to counteract the potential deterioration of non-prioritised services and to identify and share useful innovations. This will be crucial as health and social care systems around the world recover from the COVID-19 pandemic and head into another potential crisis: a global economic recession.

Background Over the past decade, Research Translation Centres (RTCs) have been established in many countries. These centres (sometimes referred to as Academic Health Science Centres) are designed to bring universities and healthcare providers together in order to accelerate the generation and translation of new evidence that is responsive to health service and community priorities. This has the potential to effectively ‘flip’ the traditional research and education paradigms because it requires active participation and continuous engagement with stakeholders (especially service users, the community and frontline clinicians). Although investment and expectations of RTCs are high, the literature confirms a need to better understand the processes that RTCs use to mobilise knowledge, build workforce capacity, and co-produce research with patients and the public to ensure population impact and drive healthcare improvement. Methods Semi-structured interviews were conducted with selected leaders and members from select RTCs in England and Australia. Convenience sampling was utilised to identify RTCs, based on their geography, accessibility and availability. Purposive sampling and a snowballing approach were employed to recruit individual participants for interviews, which were conducted face to face or via videoconferencing. Interviews were recorded, transcribed verbatim and analysed using a reflexive and inductive approach. This involved two researchers comparing codes and interrogating themes that were analysed inductively against the study aims and through meetings with the research team. Results A total of 41 participants, 22 from England and 19 from Australia were interviewed. Five major themes emerged, including (1) dissonant metrics, (2) different models of leadership, (3) public and patient involvement and research co-production, (4) workforce development and (5) barriers to collaboration. Conclusions Participants identified the need for performance measures that capture community impact. Better aligned success metrics, enhanced leadership, strategies to partner with patients and the public, enhanced workforce development and strategies to enhance collaboration were all identified as crucial for RTCs to succeed.