The 21st century’s rapidly compounding crises – from climate and ecological breakdown to extreme social inequities of power and opportunity – make it irrefutably clear that the global economic system must be transformed if humanity and the rest of life on Earth are to thrive. Doughnut Economics provides an increasingly recognised compass for such a thriving future, and is focused on meeting the needs of all people within the means of the living planet, by creating economies that are regenerative and distributive by design. What are the implications for the role and transformation of business, if it is to be part of this future?This paper explores how the deep design of business – through a company’s Purpose, Networks, Governance, Ownership, and Finance – powerfully shapesits strategic decisions and operational impacts, and ultimately determines whether or not businesses can transform to become part of a regenerative and distributive future. By diving into five layers of deep design, this paper reveals both design blockages that prevent transformative action, and design innovations that can unlock its possibility. In addition, this paper recognises that industry-level and system-wide transformations are crucial for turning the inheritance of a degenerative and divisive economic system into the beginnings of a regenerative and distributive one.
Background and Objective: To develop a health care value framework for physical therapy primary health care organizations including a definition. Method: A scoping review was performed. First, relevant studies were identified in 4 databases (n = 74). Independent reviewers selected eligible studies. Numerical and thematic analyses were performed to draft a preliminary framework including a definition. Next, the feasibility of the framework and definition was explored by physical therapy primary health care organization experts. Results: Numerical and thematic data on health care quality and context-specific performance resulted in a health care value framework for physical therapy primary health care organizations—including a definition of health care value, namely “to continuously attain physical therapy primary health care organization-centered outcomes in coherence with patient- and stakeholder-centered outcomes, leveraged by an organization’s capacity for change.” Conclusion: Prior literature mainly discussed health care quality and context-specific performance for primary health care organizations separately. The current study met the need for a value-based framework, feasible for physical therapy primary health care organizations, which are for a large part micro or small. It also solves the omissions of incoherent literature and existing frameworks on continuous health care quality and context-specific performance. Future research is recommended on longitudinal exploration of the HV (health care value) framework.
