Elizabeth Goodrick

Constellations of Institutional Logics Changes in the Professional Work of Pharmacists

Drawing on the professions and institutional literature, we develop theory about how professional work can reflect multiple institutional logics by analyzing changes in the work of pharmacists over time. Through a historical case study of U.S. pharmacists from 1852 to the present, we propose a new conceptualization of professionals and professional work as guided by a constellation of logics derived from broader society. We show that both competitive (segmenting) and cooperative (facilitative or additive) relationships among coexisting logics allow for the simultaneous influence of multiple logics on professionals and their work.

Florence Nightingale Endures: Legitimizing a New Professional Role Identity

We examined the discursive processes through which a new professional role identity for registered nurses was legitimized by analysing introductory textbooks over time. We theorize five ways of rhetorically legitimizing a new professional role identity: naturalizing the past, normalizing new meanings, altering identity referents, connecting with the institutional environment, and referencing authority. In contrast to previous research focused on legitimizing new practices, we contribute to the institutional literature by showing that legitimizing a professional role identity requires the incremental development of new arguments where the past is not delegitimized. Our findings also indicate that instead of a progression from moral and pragmatic legitimacy to cognitive legitimacy, legitimizing a new role identity may focus only on moral legitimacy. Finally, our study highlights the importance of interactions between the professional task environment and the wider institutional environment as part of the process of legitimizing a professional role identity.

Transforming New Ideas into Practice: An Activity Based Perspective on the Institutionalization of Practices

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.

From Management as a Vocation to Management as a Scientific Activity: An Institutional Account of a Paradigm Shift:

Using an institutional perspective, I analyze the historic circumstances surrounding the shift from a management as a vocation model to one that is scientifically based. I argue that prior to World War II, the management education field was fragmented but dominated by a vocational model in which specific trade practices and skills were taught. I trace how the institutional field shifted to embrace a model of management education that was tightly linked to empirical research. Using the Academy of Management Journal articles as a marker for this paradigm shift, I test hypotheses about the diffusion pattern of science-based concepts of management education.

A Tale of Two Countries: How Different Constellations of Logics Impact Action

We build on the concept of “constellations of logics” (Goodrick & Reay, 2011) to further our understanding of the relationship between institutional logics and action. We do so through a comparative case study of similar primary health care initiatives in Denmark and Canada. We draw on micro- and macro-level data to show how both the arrangement and relationship among logics impacted the design and accomplishment of the initiatives in each country. Based on our data, we theorize five different mechanisms through which logics can simultaneously constrain and enable action.

Legitimizing new practices in primary health care.

Background: Finding ways to reinvent primary health care is imperative. One way is to change practices from a physician-focused model to an interdisciplinary team approach where other health professionals (nurses, nurse practitioners, dieticians, rehabilitation therapists, and other qualified primary care providers) collectively take on much stronger roles—often providing services instead of the physician. Health care policy makers and professionals agree that these new practices are a good idea, and yet they have not been widely adopted. Purpose: Our goal was to understand how new interdisciplinary practices became legitimized as the new accepted working standards. Methodology: We conducted a qualitative, longitudinal comparative case study of 8 primary health care innovation sites established to provide services through interdisciplinary teams. We followed changes in practices over a 3-year period by conducting 150 interviews with professionals and managers across the 8 sites. Findings: At the end of 3 years, new practices were adopted in 5 of the sites, but in 3 sites, they were not. We explain the differences by identifying a series of strategies used by managers in the successful sites and compare them with those used in the other 3 sites. Strategies used in the successful sites were (a) gaining full engagement, (b) enticing people to try new practices, (c) encouraging structured disagreement, and (d) staying focused on overall goals. Practice Implications: Managers of health care change initiatives must gain buy-in from professionals, but that is not enough. They must also facilitate trying the new practices as soon as possible. Open disagreement should be carefully encouraged, but any concerns must also be successfully addressed. Finally, managers must keep professionals focused on the overall goals of change rather than allowing paralysis in response to external events.

Look What's Back! Institutional Complexity, Reversibility and the Knotting of Logics

Through a comparative historical study of community pharmacy in the UK, Italy, Sweden and the USA, the authors examine what happens to institutional arrangements designed to resolve ongoing conflicts between institutional logics over extended periods of time. It is found that institutional arrangements can reflect the heterogeneity of multiple logics without resulting in hybridization or dominance. Because logics remain active, similar conflicts can reappear multiple times. It is found that the durability of the configurations of competing logics reflects the characteristics of the polities in which fields are embedded. The dominance of any societal institutional order leads to more stable field-level arrangements. The authors suggest that the metaphor of institutional knots and the related image of institutional knotting are useful to capture aspects of this dynamic and to foreground the discursive and material work that allows multiple logics to coexist in local arrangements with variable durability.

Looking Away: Denial and Emotions in Institutional Stability and Change

Abstract While there has been increased attention to emotions and institutions, the role of denial and repression of emotions has been overlooked. We argue that not only the expression and the feeling of emotions, but also their control through denial contribute to stabilize institutional orders. The role denial plays is that of avoiding the emergence of disruptive emotions that might motivate a challenge to the status quo. Reflecting on the example of the livestock industry, we propose a theoretical model that identifies seeds for change in denied emotional contradictions in an integration of the cultural-relational and issue-based conceptions of organizational fields.

An Institutional Perspective on Accountable Care Organizations.

We employ aspects of institutional theory to explore how Accountable Care Organizations (ACOs) can effectively manage the multiplicity of ideas and pressures within which they are embedded and consequently better serve patients and their communities. More specifically, we draw on the concept of institutional logics to highlight the importance of understanding the conflicting principles upon which ACOs were founded. Based on previous research conducted both inside and outside health care settings, we argue that ACOs can combine attention to these principles (or institutional logics) in different ways; the options fall on a continuum from (a) segregating the effects of multiple logics from each other by compartmentalizing responses to multiple logics to (b) fully hybridizing the different logics. We suggest that the most productive path for ACOs is to situate their approach between the two extremes of “segregating” and “fully hybridizing.” This strategic approach allows ACOs to develop effective responses that combine logics without fully integrating them. We identify three ways that ACOs can embrace institutional complexity short of fully hybridizing disparate logics: (1) reinterpreting practices to make them compatible with other logics; (2) engaging in strategies that take advantage of existing synergy between conflicting logics; (3) creating opportunities for people at frontline to develop innovative ways of working that combine multiple logics.

Addressing Grand Challenges with Institutional Research: The Critical Role of Power

This symposium focuses on how grand challenges can be addressed by taking an institutional theory perspective, and it puts particular emphasis on the role of power in this regard. Taking an institu...