In this paper, we examine how a public sector organization developed a new strategic approach based on the identification and use of an internal dynamic capability (learning through experimenting). In response to the need for continual performance improvement in spite of reduced financial resources, this organization engaged in three overlapping phases as they shifted to this strategic approach. First, managers identified appropriate latent dynamic capabilities. Next, they used their leadership skills and built on established levels of trust to enable the use of these dynamic capabilities. Finally, they managed the tension between unrestricted development of local initiatives and organizational needs for guidance and control. Copyright Blackwell Publishing Ltd 2007.

ABSTRACTe-Health Readiness refers to the preparedness of healthcare institutions or communities for the anticipated change brought by programs related to Information and Communications Technology (ICT). This paper presents e-Health Readiness assessment tools developed for healthcare institutions in developing countries. The objectives of the overall study were to develop e-health readiness assessment tools for public and private healthcare institutions in developing countries, and to test these tools in Pakistan. Tools were developed using participatory action research to capture partners' opinions, reviewing existing tools, and developing a conceptual framework based on available literature on the determinants of access to ehealth. Separate tools were developed for managers and for healthcare providers to assess e-health readiness within their institutions. The tools for managers and healthcare providers contained 54 and 50 items, respectively. Each tool contained four categories of readiness. The items in each category were distributed into sections, which either represented a determinant of access to e-health, or an important aspect of planning. The conceptual framework, and the validity and reliability testing of these tools are presented in separate papers. e-Health readiness assessment tools for healthcare providers and managers have been developed for healthcare institutions in developing countries.

We investigated how professional role identity change can be accomplished in highly institutionalized contexts characterized by resiliency. We show that the collective professional role identity of family physicians was changed through a process of reinterpreting multiple logics and their relationships. Through our inductive analyses, we identified four mechanisms that occurred through social interactions and collectively served to rearrange the constellation of logics guiding physician role identity: (1) revealing the influence of a hidden logic, (2) reinforcing the conflict between logics, (3) reframing the meaning of a dominant logic, and (4) re-embedding the new arrangement of logics. We found that the change in physician professional role identity required significant identity work by a group of actors, but particularly by the managers who had been charged with leading the reform initiative. We contribute to the professional role identity and institutional literatures by showing how others can engage in social interactions with professionals to facilitate the reinterpretation and rearranging of institutional logics that guide collective professional role identity. Key words: Professional role identity; Institutional logics; Social interactions INTRODUCTIONFamily doctors are the last bastion of "I'm going to run my own shop and do it my way" and "I've been expected all along to do everything so that's what I've done and I'm not about to change just because you say some nurse is going to come in here and do some work for me now. (Physician interviewed before change initiative) Yes, absolutely it's different [than before]. Physicians are still the key decision-maker, but involving other healthcare professionals. And I think it's almost like a family. You want to know who's in charge of the family. And make sure that there is one person ultimately that becomes kind of like the person to go to -we are that person. (Physician interviewed at end of our study)The above quotes illustrate how family physicians (called general practitioners or GPs in many countries) viewed themselves at the beginning of our study (T0) compared to the end (T3).It is notable that before the implementation of a Canadian government-designed initiative to reform primary health care and family physicians' role, physicians saw themselves as independent, autonomous professionals who treated patients one-by-one in their offices with little, if any, help from anyone else. The heart of the reform initiative was to create multi-3 disciplinary teams of health professionals that included physicians, thereby improving patient care and reducing health system costs. Initially, there was a small group of 'renegade' physicians who visualized a new role identity; however, the majority of physicians were skeptical or disinterested in change. Over the three years of our study, we heard from interviewees how managers became involved in the change initiative, and facilitated (together with renegade physicians and other professionals) the development ...

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We develop an activity‐focused process model of how new ideas can be transformed into front line practice by reviving attention to the importance of habitualization as a key component of institutionalization. In contrast to established models that explain how ideas diffuse or spread from one organization to another, we employ a micro‐level perspective to study the subsequent intra‐organizational processes through which these ideas are transformed into new workplace practices. We followed efforts to transform the organizationally accepted idea of ‘interdisciplinary teamwork’ into new everyday practices in four cases over a six year time period. We contribute to the literature by focusing on de‐habitualizing and re‐habitualizing behaviours that connect micro‐level actions with organizational level theorizing. Our model illuminates three phases that we propose are essential to creating and sustaining this connection: micro‐level theorizing, encouraging trying the new practices, and facilitating collective meaning‐making.