Purpose: – To investigate implementation of benchmarking (BM) in three hospital trusts by adapting receptive context of change model according to BM principles of EFQM business model. Design/methodology/approach: – Perceptions of managers, clinicians and finance personnel towards implementation of BM are compared. Both qualitative and quantitative data are collected in three hospitals and results are cross compared to analyse both organisational and professional perceptions. Findings: – The paper concludes that there are limits to the rapid or broad implementation of BM principles in health services. It argues that the patients and their expectations are not referred in BM. It also suggests that local implementation programmes should be used for BM health services. Research limitations/implications: – Future research could use data from other hospitals and apply same/similar framework in order to create knowledge representing the general attitude in hospitals and between professionals towards BM in health services. Practical implications: – Both academics and professionals working in the field of health services management might find the paper useful especially in managing different professional groups' attitude in managing change in large organisations. Originality/value: – The originality of the paper is the fact that it attempts to report on both professional and organisational approaches in implementation of BM. It also attempts to report on not only organisational factors but also individual and external factors of change for BM

Purpose The purpose of this paper is to investigate institutions of accountability in Zambia in order to understand how social networks may influence such institutions not to discharge their mandates as expected from time to time. The study equally seeks to explore how social networks may perpetuate corrupt activities and compromise the functioning of institutions of accountability. Design/methodology/approach The conceptual framework adopted in this study draws on insights from social network theory (SNT) and Bourdieu’s ideas of capital to devise a critical lens for investigating network activity and its influence on the functioning of institutions of accountability. Qualitative data were collected through semi-structured interviews with respondents drawn from different institutions of accountability. Social network analysis was conducted through content analysis. Findings Research findings highlight the presence of networks of a corrupt nature operating within government structures and some institutions of accountability. Manifested in the form of systemic and familial archetypes, these networks appear to be championed and propelled by senior government officials like controlling officers and other actors of a political nature including ministers and presidents. Most of these corrupt activities are organised through brokerage mechanisms that interface internal and external networks. Research limitations/implications Due to the clandestine nature of corruption activities, however, the study was unable to determine measures of centrality and density since these details were not forthcoming during interviews. Such information could only become available if willing individuals involved in corruption could be identified so that they explain who they conduct their corruption with together with the number of connections involved and the most influential individuals in those networks. Social implications This study helps us to understand that activities of a corrupt nature are often undertaken through well-connected groups and networks that make it difficult for institutions of accountability to detect and untangle such activity. The study also suggests that accountants and other accountability actors may have forgotten that accounting is not just a technical discourse for enhancing one’s economic status but is an ethical profession as well. There is a great need to put institutions in place which should hold everyone, including the president and ministers, accountable to the Zambian people in the light of wrongdoing. Dismantling the corrupt network activities inferred from the data entails a complete top-down change in systems of politics, governance, wealth distribution and social values. Originality/value This study contributes towards filling the gap of undertaking accounting research of a critical nature focussed on African contexts (Rahaman, 2010). The paper is equally an attempt at providing empirical flesh to Laughlin’s (1991) framework on organisational transformations through complementing that framework with SNT. The study is also among the first to draw on the experiences and insights of actors working within institutions of accountability to highlight accountability challenges within an African context.

This paper reports the findings from a case study research about in-depth analysis of ‘decoupling point’ as a reference model to address a particular management dilemma. Managers from a health service organisation contacted the researchers to investigate possible causes of a managerial dilemma where managers and clinical professionals were not able to agree on a satisfactory decision. Researchers designed a decoupling point reference model where decision-making was taking place to decide which particular process would be chosen for treatment. Clinical professionals were favouring a particular process because of health benefits to patients, whereas managers were more inclined to support a different process, which seemed to bring better outcomes for the organisation. The decoupling point implied applying a hybrid strategy where lean and agile paradigms coexisted so that particular operational views of these different groups of professionals could be taken into account simultaneously. The current performance management system indicated some limitations in the sense that it did not include relevant knowledge of the processes that the reference model suggested. The paper concluded that reference models have potential to offer benefits if considered as tools of process-driven analysis for service organisations. They could serve to find out about potential conflict between different professional groups, as well as indicating the limitations or weaknesses of other critical aspects of management such as measuring of performance and allocations of resources so that better integration across all facets of the service could be achieved

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