Background: Recent prospective studies have shown that AI may be integrated in double-reader settings to increase cancer detection. The ScreenTrustCAD study was conducted at the breast radiology department at the Capio S:t Göran Hospital where AI is now implemented in clinical practice. This study reports on how the hospital prepared by exploring risks from an enterprise risk management perspective, i.e., applying a holistic and proactive perspective, and developed risk mitigation actions. Method: The study was conducted as an integral part of the preparations before implementing AI in a breast imaging department. Collaborative ideation sessions were conducted with personnel at the hospital, either directly or indirectly involved with AI, to identify risks. Two external experts with competencies in cybersecurity, machine learning, and the ethical aspects of AI, were interviewed as a complement. The risks identified were analyzed according to an Enterprise Risk Management framework, adopted for healthcare, that assumes risks to be emerging from eight different domains. Finally, appropriate risk mitigation actions were identified and discussed. Findings: Twenty-three risks were identified covering seven of eight risk domains, in turn generating 51 suggested risk mitigation actions. Not only does the study indicate the emergence of patient safety risks, but it also shows that there are operational, strategic, financial, human capital, legal, and technological risks. The risks with most suggested mitigation actions were ‘Radiographers unable to answer difficult questions from patients’, ‘Increased risk that patient-reported symptoms are missed by the single radiologist’, ‘Increased pressure on the single reader knowing they are the only radiologist to catch a mistake by AI’, and ‘The performance of the AI algorithm might deteriorate’. Conclusion: Before a clinical integration of AI, hospitals should expand, identify, and address risks beyond immediate patient safety by applying comprehensive and proactive risk management.

Bottlenecks have recently emerged as one of the key objects of inquiry in research on innovation ecosystems. The broader literature is split into two streams on technological and strategic bottlenecks, relying on the implicit assumption that strategic bottlenecks emerge from technological bottlenecks. In practice, however, many ecosystems get “stuck” in the transition from technological to strategic bottlenecks. This results in the formation of hybrid bottlenecks that combine the features of both technological and strategic bottlenecks. The existing recommendations regarding strategies that can be used to address bottlenecks fail to explain actors' strategic responses in these situations. We address this gap by conducting an exploratory multiple case study of strategies actors apply to address the hybrid bottleneck of public charging infrastructure in the innovation ecosystem of battery electric vehicles. We combine resource dependence theory and resource-based theory to show how actors combine different strategies to address hybrid bottlenecks based on how heavily they depend on the availability of bottleneck resources to create value in the innovation ecosystem, their expectations about the future value of these resources, and the ambiguity and uncertainty of the ecosystem's future evolution.

This paper critically revisits the fundamental, defining notion of “project” in project studies. It examines extant approaches to defining projects and illuminates the ontological fuzziness of the main unit of analysis in project studies. Drawing on the notions of open and essentially contested concepts, the paper emphasizes the importance of studying how the project concept has been applied in empirical research. To advance the debate in this direction, two dimensions are emphasized: (1) the “project” as a realization of an object versus the “project” as an actor’s assignment, and (2) the “project” viewed as an empirical phenomenon versus the “project” used as an analytical lens, resulting in a typology of four distinct research approaches to the project concept. By discussing the approaches’ implications for research inquiries on projects and project management, the paper calls for more prudence when applying the “project” as unit of analysis in future empirical research. Consequently, the paper takes a step towards invigorating the once vivid debate on the core, defining concept within project studies.

This paper critically revisits the fundamental, defining notion of “project” in project studies. It examines extant approaches to defining projects and illuminates the ontological fuzziness of the main unit of analysis in project studies. Drawing on the notions of open and essentially contested concepts, the paper emphasizes the importance of studying how the project concept has been applied in empirical research. To advance the debate in this direction, two dimensions are emphasized: (1) the “project” as a realization of an object versus the “project” as an actor’s assignment, and (2) the “project” viewed as an empirical phenomenon versus the “project” used as an analytical lens, resulting in a typology of four distinct research approaches to the project concept. By discussing the approaches’ implications for research inquiries on projects and project management, the paper calls for more prudence when applying the “project” as unit of analysis in future empirical research. Consequently, the paper takes a step towards invigorating the once vivid debate on the core, defining concept within project studies.

This article analyzes how firms can enable their innovation strategies through projects under various conditions. Previous research has identified an array of project-related means, such as explorative projects, project lineages, and ambidextrous programs, by which firms aim to realize their long-term innovation goals. These approaches, although powerful, are primarily focal firm-centered; address product-, platform-, and business-model levels; and tend to draw heavily on the firm’s resources and coordination efforts. However, systemic transitions are characterized by complex and unforeseen redefinitions of organizational and industrial boundaries, which require mobilization of resources by multiple actors, prompting firms to engage in time-limited experimental networks. This article introduces this concept to project studies and juxtaposes it with the key extant project-based concepts for enabling innovation by scrutinizing their definitions, intended scope of innovation, locus of attention, and coordination principles. Consequently, it draws attention to the importance of interorganizational aspects when facing a systemic transition and contributes to an emerging debate on the linkages among project studies, innovation management, and sociotechnical transitions.

The concepts “circular business models” and “transitions towards a circular economy” have become modern-day buzzwords. Yet, an understanding of the interplay between these two concepts remains unclear. This paper proposes a conceptual framework that illustrates the innovation mechanisms enhancing circular business models emerging within the context of transitions towards a circular economy. The paper follows a two-step methodology. First, a theoretical framing is proposed by adopting insights from transitions studies. Second, a systematic literature review is employed. The review synthesizes the selected literature tracing the proposed framing in the previously published research. Finally, a transitions framework for circular business models is proposed. This framework suggests future lines of research to support its plausibility. Moreover, it offers prescriptive help to managers, entrepreneurs, policymakers, and other social actors enabling them to make informed decisions about and take innovative actions for circular business models in specific contexts.

The paper analyzes how incumbents can enable their innovation strategy through projects under various conditions. Previous research has identified an array of project-related means, such as explorative projects, project lineages, and ambidextrous programs, by which firms aim to achieve their long-term innovation goals. These approaches, although powerful, are primarily firm-centered, address product-, platform- and business model-level, and emphasize intra-organizational resources and coordination mechanisms. However, systemic transitions are characterized by complex and unforeseen redefinitions of organizational and industrial boundaries, which require mobilization of resources from multiple actors, prompting firms to engage in time-limited experimental networks. The paper takes stock of the approaches by scrutinizing their rationale, locus, mechanisms, and consequences. Consequently, it draws attention to the importance of inter-organizational aspects when facing a systemic transition and contributes to the emerging debate on the linkages between project studies, innovation management and socio-technical transitions.

Decaying water infrastructure is a growing challenge in high-income countries while at the same time being under pressure from other socioeconomic and environmental issues. This paper analyses why addressing these challenges is so challenging, despite the critical role of water service for society. The paper is based on a study of the Swedish water sector and reveals how the utilities are influenced by several factors that constrain their agency. Most importantly, the utilities operate in a ‘societal shadowland’ where the public and politicians take their services for granted, lowering the sense of urgency and impeding their ability to take action.

This study establishes the relationship between surgical volume and cost and quality outcomes, using patient-level clinical data from a national quality registry for bariatric surgery in Sweden. Data include patient characteristics with comorbidities, surgical and follow-up data for patients that underwent gastric bypass or gastric sleeve operations between 2007 and 2016 (52,703 patients in 51 hospitals). The relationships between surgical volume (annual number of bariatric procedures) and several patient-level outcomes were assessed using multilevel, mixed-effect regression models, controlling for patient characteristics and comorbidities. We found that hospitals with higher volumes had lower risk of intraoperative complications as well as complications within 30 days post-surgery (odds ratios per 100 procedures are 0.78 and 0.87, respectively, p<0.01). In addition, higher-volume hospitals had substantially shorter procedure time (17 min per 100 procedures, p<0.01) and length of stay (0.88 incidence-rate ratio per 100 procedures p<0.01). Our results support the claim that increased surgical volume significantly improves quality. Further, the results strongly suggest that increased volume leads to lower cost per surgery, by reducing cost drivers such as procedure time and length of stay. 

To navigate sustainability transitions, firms are often prompted to take an active role in business model innovation. Previous research has shown, however, that when attempting to change business models, incumbent firms frequently face challenges concerning the ambiguity of transition pathways. This paper is an inquiry into this intersection between business model innovation and sustainability transitions. Anchored in three case studies of sustainability-driven, pre-commercial projects of emerging technologies, it reveals how groups of organizations collaborate in time-limited, cross-industry networks, to explore potential business models for anticipated, profound, changes in socio-technical systems. Drawing on these findings, the paper introduces the concept of experimental networks and illustrates how experimental networks can facilitate business model innovation in relation to systemic change. By outlining the constituents of the experimental network concept, the paper contributes to theory by uncovering the interplay of interorganizational collaboration and network level business model innovation. In addition, it reveals how experimental networks constitute one way for incumbents to claim agency with respect to emerging sustainability transitions.