Institutional Complexity and Individual Responses: Delineating the Boundaries of Partial Autonomy

Martin, Graham; Currie, Graeme; Weaver, Simon; Finn, Rachael; McDonald, Ruth

doi:10.1177/0170840616663241

Cited by 95 publications

(104 citation statements)

References 48 publications

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“…New modes of governing focused on physicians not only as objects but also as actors directly involved in governance (Kuhlmann et al 2013, McDonald et al 2008, Vicarelli and Pavolini 2017. As a result, boundaries between professionalism and managerialism and between professions and organisations are 'blurring' and new forms of more hybrid, integrated or transformative professionalism are emerging (Denis and van Gestel 2016, Kuhlmann and Burau 2015, Martin et al 2017, Noordegraaf 2015, Waring and Currie 2009). The various forms of integration of managerial and professional governance tools may create new and hitherto unknown alliances between NPM and other political agendas like populism.…”

Section: Methodsmentioning

confidence: 99%

New public management, physicians and populism: Turkey's experience with health reforms

Agartan

Kuhlmann

2019

Sociology Health & Illness

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Recent debates on the rise of right‐wing or neoliberal populism globally have prompted public health and health systems researchers to explore its implications in the healthcare systems. This case study of Turkey's recent health reform initiative, the Health Transformation Program, aims to contribute to this debate by examining the nexus among populism, professionalism and the contemporary market and managerial reforms, often described as New Public Management (NPM). Building on document analysis and secondary sources, this article introduces a framework to explore whether and how populist agendas grow up in the shadow of NPM policies. We aim to deepen our understanding of the governance settings that might be used in different ways by right‐wing populist leaders to advance their agendas. Our research reveals that the NPM reforms in Turkey have opened a ‘backdoor’ through which right‐wing populist agendas were supported and the position of the medical profession as an important stakeholder in the institutional settings was weakened. However, what mattered most in the reform process was not the policies themselves but the ways new managerialist policies were implemented. Our analysis makes blind spots of the NPM reforms and healthcare governance research visible and calls for greater attention to implementation processes.

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Section: Methodsmentioning

confidence: 99%

New public management, physicians and populism: Turkey's experience with health reforms

Agartan

Kuhlmann

2019

Sociology Health & Illness

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“…In addition, the logic of managerialism has driven the introduction of market and competition, which, in England, translates into the commissioning of health services (Allen et al, 2017). The commissioning function that some medical professionals are required to assume is thus part of the logic of managerialism (Martin, Currie, Weaver, Finn, & McDonald, 2017).…”

Section: Institutional Logics and It Innovation In Health Carementioning

confidence: 99%

Clinical managers' identity at the crossroad of multiple institutional logics in it innovation: The case study of a health care organization in England

Bernardi

Exworthy

2019

Information Systems Journal

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Clinical managers play a crucial role in securing the implementation and sustainability of information technology (IT) innovation in health care. Yet, not all clinical managers are willing and able to support IT innovation, particularly when the institutional logics of an IT innovation challenge their professional practice. We investigate how clinical managers use their hybrid identities to reconcile differences among competing institutional logics that affect IT innovation. Based on three examples of IT innovation (telehealth for obstructive sleep apnoea, telehealth for heart failure, and electrocardiograms) in a health care organization in England, we identify three roles in IT innovation (innovation advocate, innovation broker, and innovation laggard) that clinical managers enacted in response to three degrees of conflict between institutional logics (no conflict, moderate conflict, and high conflict), respectively. We make the following contributions. First, we demonstrate how clinical managers' perception of their hybrid role in relation to their professional identity influences their response to the conflicting institutional demands of IT innovation. We conclude that clinical managers' fragmented identities can compromise their ability to effectively manage IT innovation in health care. Second, our findings raise implications for understanding the role of professionals' hybrid identities in the implementation of digital transformation at the intersection of multiple institutional logics.

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“…Organizational actors are exposed to these multiple logics through the processes of learning and socialization (Thornton and Ocasio ). As each logic provides “a set of organizing principles for a realm of social life” (Besharov and Smith , 366)—so‐called cognitive or decision frames (Gioia ; Weick , )—organizational actors have alternative ways of making sense of what they experience (Weick ; Ford and Ford ; Martin et al ).…”

Section: Institutional Logics As Frames Of Reference Priming and Inmentioning

confidence: 99%

“…Exceptions that present conceptual and empirical efforts to bring the individual back into institutional theory include the sense‐making literature (Hallett and Ventresca ) and the literature on institutional entrepreneurship (Greenwood and Suddaby ). Much of this literature, however, implicitly assumes a significant degree of autonomy on the part of organizational actors (Martin et al ), with little or no appreciation of the possibility of heteronomy despite compelling research in cognitive and social psychology that suggests nonconscious processes operating alongside conscious thinking and reasoning (Kahneman ; Loersch and Payne ).…”

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confidence: 99%

Different Shades of Gray: A Priming Experimental Study on How Institutional Logics Influence Organizational Actor Judgment

Ngoye

Sierra

Ysa

2018

Public Administration Review

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This article examines whether and how judgments made by individual organizational actors may be influenced by institutional logics-the historical patterns of cultural symbols and material practices, including assumptions, values, and beliefs, by which individuals and organizations provide meaning to their daily activity, organize time and space, and reproduce their lives and experiences. Using an experimental design, the authors prime three institutional logics in three independent groups of managers (n = 98) and assess the influence of the primes on individual-level judgment preferences. The results show that such priming affects participants' judgments in an ambiguous judgmental task, with each prime influencing judgment in a discernibly unique pattern. Consequently, a more nuanced account of larger patterns of behavior can be constructed. The findings highlight the potential of text as priming stimuli within institutionally complex work settings such as those in the public sector, an important yet underexamined issue. Evidence for Practice• Managers should recognize that their perceptions and judgments may be influenced by institutional logics, which, in turn, may be primed by incidental features in their decision environments. • The work environment may perpetuate certain approaches in the public sector based on the type of stimuli that decision makers are (continually) exposed to. These effects, though subtle and nonconscious, may explain the pervasiveness of certain logics. • Text, and how it is used in organizational communication, may by design or otherwise influence organizational actor perception or receptivity to the object of the communication. Tamyko Ysa is full professor in the Department of Strategy and General Management at ESADE, Ramon Llull University, Spain. Her current research interests are the management of partnerships and their impact on the creation of public value; the design, implementation, and evaluation of public policies; and the relationship between companies and governments.English proficiency test scrambled sentence code: 1A. INSTRUCTIONS: Create a sensible phrase using only 4 words (or word pair combinations), as separated by commas, in each of the following 5-word (or word pair combination) sets. For example: cold, so, it, outside, was may be rewritten as it was so cold or it was cold outside. Take as much time as you need but please try not to exceed 10 minutes.

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Institutional Complexity and Individual Responses: Delineating the Boundaries of Partial Autonomy

Cited by 95 publications

References 48 publications

New public management, physicians and populism: Turkey's experience with health reforms

New public management, physicians and populism: Turkey's experience with health reforms

Clinical managers' identity at the crossroad of multiple institutional logics in it innovation: The case study of a health care organization in England

Different Shades of Gray: A Priming Experimental Study on How Institutional Logics Influence Organizational Actor Judgment

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