Managers constantly struggle with where to allocate their resources and efforts in managing the complex service delivery system called a hospital. In the broadest sense, their decisions and actions focus on two important aspects of health care-clinical or technical medical care that emphasizes "what" the patient receives and process performance that emphasizes "how" health care services are delivered to patients. Here, we investigate the role of leadership, clinical quality, and process quality on patient satisfaction. A causal model is hypothesized and evaluated using structural equation modeling for a sample of 202 U.S. hospitals. Statistical results support the idea that leadership is a good exogenous construct and that clinical and process quality are good intermediate outcomes in determining patient satisfaction. Statistical results also suggest that hospital leadership has more influence on process quality than on clinical quality, which is predominantly the doctors' domain. Other results are discussed, such as that hospital managers must be mindful of the fact that process quality is at least as important as clinical quality in predicting patient satisfaction. The article concludes by proposing areas for future research.

Purpose – Existing supply chain literature provides examples of countermeasures that firms can adopt to mitigate abnormal or catastrophic supply chain disruptions. However, none address reducing interactive complexity prior to adopting countermeasures to mitigate everyday or normal supply chain disruptions. Most mitigation strategies focus on adding capabilities or resources to protect an organization. Here, the authors aim to consider an alternative strategy of examining current processes to determine whether processes can be simplified by using the normal accident theory and its constructs of interactive complexity and coupling as a theoretical basis. Design/methodology/approach – The authors develop a model based on the normal accident theory and use logistic regression to test their propositions in the context of a steel processing plant and its customers. Findings – The findings show the importance of reducing interactive complexity to mitigate supply chain disruptions. However, high inventory is not considered a significant countermeasure, and high inventory levels may increase the likelihood of causing a disruption downstream. These findings support the lean management approach of operating under low inventory levels while eliminating complexity to make problems more visible, causing fewer disruptions. Originality/value – While others have examined the impact of mitigation strategies conceptually, no study has captured information from actual supply chain disruptions to assess how interactive complexity and inventory levels affect disruption potential at downstream customers' facilities. Capturing information from supply chain disruptions enables managers to assess the situation as the disruption is occurring. The authors suggest a strategy in which countermeasures that increase slack in the system should be considered only after the system is sufficiently simplified to mitigate disruptions.

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This research draws on the stakeholder salience framework to explore more deeply the web of business–stakeholder relationships that characterize the Fortune Global 100’s corporate social responsibility and sustainability reports. By better understanding stakeholder salience, defined as the power, legitimacy, and urgency attributed to stakeholders in these corporate reports, this research enables business leaders and scholars to further their recognition and comprehension of the characteristics of the critical stakeholder relationships that link business’s social and sustainability performance with its economic performance—the triple bottom line. Despite the predictions of this research, nationality was not found to be a differentiating factor of stakeholder salience, whereas industry membership, in one of two instances, was found to differentiate stakeholder salience in the corporate reports. Implications of these findings are discussed.

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