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How healthcare organisations can act as institutional entrepreneurs in a context of change

How healthcare organisations can act as institutional entrepreneurs in a context of change Purpose – The aim of this paper is to illustrate and discuss how healthcare organisations can act as institutional entrepreneurs in a context of change. Design/methodology/approach – The authors conducted an in‐depth longitudinal case study (2005‐2008) of a healthcare organisation in the province of Quebec, Canada. Data collection consisted of real‐time observations of senior managers ( n =87), interviews ( n =24) with decision‐makers and secondary data analysis of documents. Findings – The paper reports on the extent to which entrepreneurial healthcare organisations can be a driving force in the creation of a new practice. The authors analyse the development of a diabetes reference centre by a healthcare organisation acting as an institutional entrepreneur that illustrates the conceptualisation of an innovation and the mobilisation of resources to implement it and to influence other actors in the field. The authors discuss the case in reference to three stages of change: emergence, implementation and diffusion. The results illustrate the different strategies used by managers to advance their proposed projects. Research limitations/implications – This study helps to better understand the dynamics of mandated change in a mature field such as healthcare and the roles played by organisations in this process. By adopting a proactive strategy, a healthcare organisation can play an active role and strongly influence the evolution of its field. Originality/value – This paper is one of only a few to analyse strategies used by healthcare organisations in the context of mandated change. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Health Organisation and Management Emerald Publishing

How healthcare organisations can act as institutional entrepreneurs in a context of change

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Publisher
Emerald Publishing
Copyright
Copyright © 2014 Emerald Group Publishing Limited. All rights reserved.
ISSN
1477-7266
DOI
10.1108/JHOM-07-2011-0072
pmid
24783667
Publisher site
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Abstract

Purpose – The aim of this paper is to illustrate and discuss how healthcare organisations can act as institutional entrepreneurs in a context of change. Design/methodology/approach – The authors conducted an in‐depth longitudinal case study (2005‐2008) of a healthcare organisation in the province of Quebec, Canada. Data collection consisted of real‐time observations of senior managers ( n =87), interviews ( n =24) with decision‐makers and secondary data analysis of documents. Findings – The paper reports on the extent to which entrepreneurial healthcare organisations can be a driving force in the creation of a new practice. The authors analyse the development of a diabetes reference centre by a healthcare organisation acting as an institutional entrepreneur that illustrates the conceptualisation of an innovation and the mobilisation of resources to implement it and to influence other actors in the field. The authors discuss the case in reference to three stages of change: emergence, implementation and diffusion. The results illustrate the different strategies used by managers to advance their proposed projects. Research limitations/implications – This study helps to better understand the dynamics of mandated change in a mature field such as healthcare and the roles played by organisations in this process. By adopting a proactive strategy, a healthcare organisation can play an active role and strongly influence the evolution of its field. Originality/value – This paper is one of only a few to analyse strategies used by healthcare organisations in the context of mandated change.

Journal

Journal of Health Organisation and Management – Emerald Publishing

Published: Mar 11, 2014

Keywords: Canada; Healthcare; Management strategy; Organisational theory; Leaders; Change process

References

  • Institutionalization and structuration: studying the links between action and institution
    Barley, R.; Tolbert, P.S.
  • How actors change institutions: towards a theory of institutional entrepreneurship
    Battilana, J.; Leca, B.; Boxenbaum, E.
  • Agency, entrepreneurs, and institutional change. The role of strategic choice and institutionalized practices in organizations
    Beckert, J.
  • Incorporating public health more closely into local governance of health care delivery: lessons from the Québec experience
    Breton, M.; Denis, J.; Lamothe, L.
  • Nobody in charge: distributed change agency in healthcare
    Buchanan, D.A.; Addicott, R.; Whitley, R.; Lutz, W.J.; Wieder, B.L.; Jones, A.M.; McHugo, G.J.
  • The decline and fall of the conglomerate firm in the 1980s: the desinstitutionalization of an organizational form
    Davis, G.F.; Diekmann, K.A.; Tinsley, C.
  • Managing in transition: a case study of institutional management and organizational change
    De Holan, P.M.; Phillips, N.
  • The reciprocal dynamics of organizing and sense‐making in the implementation of major public‐sector reforms
    Denis, J.; Lamothe, L.; Langley, A.; Breton, M.; Gervais, J.; Trottier, L.; Contandriopoulos, D.; Dubois, C.‐A.
  • Interest and agency in institutional theory
    DiMaggio, P.
  • The iron cage revisited: institutional isomorphism and collective rationality in organizational fields
    DiMaggio, P.J.; Powell, W.W.
  • Institutional entrepreneurship, partaking, and convening
    Dorado, S.
  • Social skill and institutional theory
    Fligstein, N.
  • Institutional entrepreneurship as embedded agency: an introduction to the special issue
    Garud, R.; Hardy, C.; Maguire, S.
  • Institutional entrepreneurship in the sponsorship of common technological standards: the case of Sun Microsystems and Java
    Garud, R.; Jain, S.; Kumaraswamy, A.
  • Institutional entrepreneurship in mature fields: the big five accounting firms
    Greenwood, R.; Suddaby, R.
  • Theorizing change: the role of professional associations in the transformation of institutionalized fields
    Greenwood, R.; Hinings, C.R.; Suddaby, R.
  • The Sage Handbook of Organizational Institutionalism
    Greenwood, R.; Oliver, O.; Suddaby, R.; Sahlin‐Andersson, K. (Eds)
  • Ecologist and institutionalist: friends or foes?
    Haveman, H.A.; David, R.J.
  • Dynamics of change in organizational fields
    Hinings, C.R.; Greenwood, R.; Reay, T.; Suddaby, R.
  • Le role des professionnels dans la structuration des réseaux: une source d'innovation
    Lamothe, L.
  • Strategies for theorizing from process data
    Langley, A.
  • Institutional change and the transformation of interorganizational fields: an organizational history of the US radio broadcasting industry
    Leblebic, H.; Salancik, G.R.; Copay, A.; King, T.
  • Grounded Theory in Management Research
    Locke, K.
  • Process transformation: limitations to radical organizational change within public service organizations
    McNulty, T.; Ferlie, E.
  • Institutional entrepreneurship in emerging fields: HIV/AIDS treatment advocacy in Canada
    Maguire, S.; Hardy, C.; Lawrence, T.B.
  • Understanding the implementation of complex interventions in health care: the normalization process model
    May, C.; Finch, T.; Mair, F.; Ballini, L.; Dowrick, C.; Eccles, M.
  • Institutionalized organizations: formal structure as myth and ceremony
    Meyer, J.W.; Rowan, B.
  • Qualitative Data Analysis: An Expanded Sourcebook
    Miles, M.B.; Huberman, A.M.
  • Business planning as pedagogy: language and control in a changing institutional field
    Oakes, L.S.; Townley, B.; Cooper, D.J.
  • Strategic responses to institutional processes
    Oliver, C.
  • Qualitative Research & Evaluation Methods
    Patton, M.Q.
  • ‘Healing the scars of history’: projects, skills and field strategies in institutional entrepreneurship
    Perkmann, M.; Spicer, A.
  • Evaluation of the implementation of an integrated primary care network for prevention and management of cardiometabolic risk in Montréal
    Provost, S.; Pineault, R.; Tousignant, P.; Hamel, M.; Borgès Da Silva, R.
  • Legitimizing a new role: small wins and microprocesses of change
    Reay, T.; Golden‐Biddle, K.; Germann, K.
  • Portrait de la population du Sud‐Ouest Verdun
    Regional Health and Social Services Agency, Montreal
  • Institutional Change and Healthcare Organizations: From Professional Dominance to Managed Care
    Scott, W.R.
  • Institutional contradictions, praxis, and institutional change: a dialectical perspective
    Seo, M.; Creed, W.E.D.
  • Sensemaking: a driving force behind the integration of professional practices
    Sylvain, C.; Lamothe, L.
  • Institutional sources of change in the formal structure of organizations: the diffusion of civil service reform, 1880‐1935
    Tolbert, P.S.; Zucker, L.G.
  • Case Study Research: Design and Methods
    Yin, R.K.