Institutionalization, Framing, and Diffusion: The Logic of TQM Adoption and Implementation Decisions among U.S. Hospitals

Abstract

We extend institutional theory's account of diffusion by examining the interplay between economic and social considerations in adoption decisions. Drawing on organizational decision-making research, we argue that both early and late adopters respond to framing and interpreting adoption decision situations as opportunities versus threats. Using data on the diffusion of total quality management (TQM) among U.S. hospitals, we found that motivations to appear legitimate coexist with motivations to realize economic performance improvement, and that issue perception is related to the extent of practice implementation. These findings prompt rethinking of the classic institutional diffusion model.

How Golden Parachutes Unfolded: Diffusion and Variation of a Controversial Practice

“…Perhaps most importantly, contested practices are by their very nature more likely to generate higher levels of variation over the diffusion process, as was also suggested by Ansari et al (2010). Accordingly, we see our findings regarding the role of contestation as complementing prior studies that have focused on the institutionalization of normatively uncontested practices (e.g., Tolbert and Zucker 1983, Westphal et al 1997, Kennedy and Fiss 2009). However, some of the mechanisms of variation we observe-although more prevalent in our setting-may also occur in the absence of contestation (Ansari et al 2010).…”

“…In this regard, factors influencing practice diffusion are likely to reach beyond the mere adoption event to also affect patterns of practice implementation. Developing a cognitively grounded model of how adoption motivations affect the extent of implementation, Kennedy and Fiss (2009) argue that motivations to achieve gains will be associated with more extensive practice implementation, whereas motivations to avoid losses will be associated with less extensive practice implementation. Their arguments suggest that the extensiveness of practice implementation is to a considerable extent affected by whether adopters perceive a diffusing practice as legitimate and aligned with their interest or as imposed by the institutional environment.…”

The strategy of the banking industry in Indonesia: following institutional theory or resource-based view?

“…Early adopters often pioneer templates because they improve efficiency and secure quality (Westphal et al, 1997). Later adopters increasingly stand to gain symbolic benefits as a template itself becomes institutionalized, but this by no means implies that late conformers stop benefiting substantively (Kennedy & Fiss, 2008). Third, isomorphic strategies do allow for competitive differentiation.…”

Practice Transfer in Organizations: The Role of Governance Mode for Internal and External Fit

“…There is a large and growing body of literature examining the diffusion of practices (Fiss et al 2012;Gondo and Amis 2013;Kennedy and Fiss 2009). This literature suggests that misfit between a particular practice and an adopting organization may trigger the response of adapting the practice along various dimensions (Ansari et al 2010).…”