Trust and Formal Control in interorganizational Relationships

There is a tendency to see trust and control by formal agreements as substitutes. According to transaction cost economics trust is unreliable, and some form of control is needed to reduce hazards of opportunism. According to others, high trust allows for a limited extent of formal control. Formal control signals distrust and thereby evokes reciprocal distrust and formal control. This paper studies all combinations of high/low trust and high/low formal control in four longitudinal case studies. We find that trust and formal control are at least as much complements as they are substitutes. We find that like trust contracts can be both the basis and the outcome of relations.governance;inter-organizational relations;trust;contract

Contractual Alliance Governance: Impact of Different Contract Functions on Alliance Performance

Recent research on alliance governance has emphasized that contracts can have both a control and coordination function. In this paper, we test the impact of these different contract functions on alliance performance. Conducting structural equation analyses on a sample of 270 Dutch technology alliances, we disentangle the relationship between different contract functions, partner cooperation and alliance success. Our data show that different contract roles have a different impact on partner cooperation within the alliance. In addition, we find strong indications that the presence/absence of prior trustful collaboration and the number of alliance partners moderate the relationship between contract functions and partner cooperation. Finally, our data provide evidence that contract functions indirectly influence alliance success via partner cooperation

The National Systems of Innovation Approach and Innovation by SMEs

The National Systems of Innovation (NSI) approach is a young but successful approach to help to understand how innovation and interactive learning evolve in national economies and how they propel economic prosperity and international competitiveness. The NSI approach has been embraced by policy makers all around the world, because this approach offers them the potential to derive more appropriate leads for innovation policy. In the Netherlands too, the drafting of innovation policy is increasingly based on the NSI concept. The main aim of this study is to add to the understanding of the NSI approach. The research questions addressed in this study include: What are the main concepts, value added and shortcom-ings of the approach? And: How does the NSI approach offer policy makers the potential to derive more appropriate leads for innovation policy towards SMEs?

The effects of trust on performance of high-tech business relationships

We investigate the effects of trust propensity, cognition based trust and affect based trust on relationship performance in terms of openness, conflicts and success. Data from a field study of 391 Dutch firms in high tech industries support the research model. Trust that derives from affection is key and outweighs cognition based trust and trust propensity. Openness increases success that in turn fosters the development of affect based trust. The results provide preliminary but convincing evidence for the value of relational capital in durable business relationships that strive for the development of new technological knowledge.

Learning towards system innovation.Evaluating a systemic instrument.

In this paper we develop an analytical framework for studying learning processes in the context of efforts to bring about system innovation by building new networks of actors who are willing to work on a change towards sustainable development. We then use it to evaluate two specific intervention programmes carried out by a self-proclaimed ‘system instrument’. The framework integrates elements from the Innovation Systems approach with a social learning perspective. The integrated model proposes essentially that these kinds of systemic instruments can serve to enhance conditions for social learning and that such processes may result in learning effects that contribute to system innovation by combatting system imperfections. The empirical findings confirm the assumption that differences in learning can be explained by the existence or absence of conditions for learning. Similarly, the existence or creation of conducive conditions could be linked to the nature and quality of the interventions of the systemic instrument. We conclude that the investigated part of the hypothesised model has not been refuted and seems to have explanatory power. At the same time we propose that further research is needed among others on the relation between learning, challenging system imperfections and system innovation.social learning, system innovation, systemic instruments, system imperfections, innovation systems

Trust and Formal Control in interorganizational Relationships

There is a tendency to see trust and control by formal agreements as substitutes. According to transaction cost economics trust is unreliable, and some form of control is needed to reduce hazards of opportunism. According to others, high trust allows for a limited extent of formal control. Formal control signals distrust and thereby evokes reciprocal distrust and formal control. This paper studies all combinations of high/low trust and high/low formal control in four longitudinal case studies. We find that trust and formal control are at least as much complements as they are substitutes. We find that like trust contracts can be both the basis and the outcome of relations

Training specialists to write appropriate reply letters to general practitioners about patients with medically unexplained physical symptoms; A cluster-randomized trial.

Objective: To evaluate effects of a communication training for specialists on the quality of their reply letters to general practitioners (GPs) about patients with medically unexplained physical symptoms (MUPS). Methods: Before randomization, specialists included ≤3 MUPS patients in a multi-center cluster-randomized trial. In 14 h of MUPS-specific communication training, 2.5 h focused on reply letters. Letters were discussed with regard to reporting and answering GPs' referral questions and patients' questions, and to reporting findings, explaining MUPS with perpetuating factors and giving advice. After the training, all doctors again included ≤3 MUPS patients. Reply letters to GPs were assessed for quality and blindly rated on a digital scale. Results: We recruited 478 MUPS patients and 123 specialists; 80% of the doctors wrote ≥1 reply letters, 285 letters were assessed. Trained doctors reported (61% versus 37%, OR=2.55, F(1281)=6.60, pgroup*time=.01) and answered (63% versus 33%, OR=3.31, F(1281)=5.36, pgroup*time=.02) patients' questions more frequently than untrained doctors. Conclusion: Training improves reply letters with regard to patients' questions, but not with regard to the following: GPs' referral questions, somatic findings, additional testing, explaining, and advice. Practice implications: Training specialists to write appropriate reply letters needs more focus on explanation and advice

The organisation and delivery of health improvement in general practice and primary care: a scoping study

Background This project examines the organisation and delivery of health improvement activities by and within general practice and the primary health-care team. The project was designed to examine who delivers these interventions, where they are located, what approaches are developed in practices, how individual practices and the primary health-care team organise such public health activities, and how these contribute to health improvement. Our focus was on health promotion and ill-health prevention activities. Aims The aim of this scoping exercise was to identify the current extent of knowledge about the health improvement activities in general practice and the wider primary health-care team. The key objectives were to provide an overview of the range and type of health improvement activities, identify gaps in knowledge and areas for further empirical research. Our specific research objectives were to map the range and type of health improvement activity undertaken by general practice staff and the primary health-care team based within general practice; to scope the literature on health improvement in general practice or undertaken by health-care staff based in general practice and identify gaps in the evidence base; to synthesise the literature and identify effective approaches to the delivery and organisation of health improvement interventions in a general practice setting; and to identify the priority areas for research as defined by those working in general practice. Methods We undertook a comprehensive search of the literature. We followed a staged selection process involving reviews of titles and abstracts. This resulted in the identification of 1140 papers for data extraction, with 658 of these papers selected for inclusion in the review, of which 347 were included in the evidence synthesis. We also undertook 45 individual and two group interviews with primary health-care staff. Findings Many of the research studies reviewed had some details about the type, process or location, or who provided the intervention. Generally, however, little attention is paid in the literature to examining the impact of the organisational context on the way services are delivered or how this affects the effectiveness of health improvement interventions in general practice. We found that the focus of attention is mainly on individual prevention approaches, with practices engaging in both primary and secondary prevention. The range of activities suggests that general practitioners do not take a population approach but focus on individual patients. However, it is clear that many general practitioners see health promotion as an integral part of practice, whether as individual approaches to primary or secondary health improvement or as a practice-based approach to improving the health of their patients. Our key conclusion is that there is currently insufficient good evidence to support many of the health improvement interventions undertaken in general practice and primary care more widely. Future Research Future research on health improvement in general practice and by the primary health-care team needs to move beyond clinical research to include delivery systems and be conducted in a primary care setting. More research needs to examine areas where there are chronic disease burdens – cancer, dementia and other disabilities of old age. Reviews should be commissioned that examine the whole prevention pathway for health problems that are managed within primary care drawing together research from general practice, pharmacy, community engagement, etc