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The research aim of this chapter is to understand how different institutional logics affect the day-to-day activities of healthcare providers and whether the cohabitation of professional logics with business-like logics increases medical providers’ effectiveness and gives chance to constrain healthcare costs. This research is based on longitudinal case study about the restructuring of the Canadian healthcare system in Alberta in 1992–2008, described in two papers (Reay & Hinings, 2005, 2009). We identify the situation after encroachment of a new, business-like logic into a healthcare system as more complex than described in the extant literature. We challenge the findings of the case study authors that there are two cohabitating logics in healthcare: the business-like logic supported by the government and the logic of medical professionalism. From our research it appears that there are two other logics: a managerial logic derived from business-like logic, and a hybrid professional logic that is a modification of the logic of medical professionalism. Across the healthcare field in general, business-like logic has been competing with the logic of medical professionalism, but on the medical providers’ level these logics become uncoupled. Within a medical provider, on the external, symbolic layer, physicians follow their professional logic and managers show conformity with governmental principles. But on the backstage layer, where the day-to-day work is actually performed, these two logics are subject to modification, creating a space for compromise and cooperation, leading to a growth of the number of unnecessary medical services preventing cost containments in healthcare.

The purpose of this paper is to clarify whether UK business schools need to change their strategy, to adopt a more business-like approach, without compromising their role as providers of “quality education”. Business-like activities, as explained by Dart (2004, p. 294) are generally understood to be those characterised by some blend of profit motivation, the use of managerial and organisation design tools developed in for-profit business settings, and broadly framed business thinking to structure and organise activity.

Adopting a mixed methods research design, this study involved the review of quantitative data from questionnaires sent to senior managers within UK business schools, followed by the case-study analysis of five UK-based business schools.

Contemporary evidence suggests business schools have reacted to the current dynamic environment by adapting a more business-like approach, scanning the horizon and identifying new markets and opportunities for growth. However, some business schools remain ardently against a more business-like approach, considering it to work against academic clarity and research excellence, expected of universities.

This paper illustrates the current challenges influencing strategy within five diverse UK business schools. Therefore, the original contribution of the paper lies in the authors’ empirical investigations into the current thinking and practice of existing business school leaders, in light of the changing HE policies and reduced funding arrangements.

There is a longstanding debate over the role of modern business methods in the contemporary non-profit organisation (NPO). Critics of business practices assert that they may undermine the missions of NPOs. The aim of this paper is to contribute to this debate. Many accounting researchers have shifted research focus to concepts such as trust and crises. These are important topics. But they may overshadow practices which are taken for granted as accepted practice which does not merit re-examination.

This qualitative project is based on an initial survey followed by comparative case studies of three NPOs. The researchers have used both interviews and documentary analysis in this study.

The contention that the adoption of business-like practices undermines the fundamental aim of altruism of NPOs is challenged by the findings of this paper. The very concept of altruism is not a single unifying concept in NPOs – it is a contested idea. However, and most importantly, in this research there is no evidence of mission drift by NPOs which adopt business practices. This research highlights the way many NPO CEOs are mission-driven but also pragmatic bricoleurs in their consideration of new business practices. Most importantly, these case studies demonstrate a variation in practices within the participating organisations. This raises challenging questions about a receptive context for the adoption of new business practices which are explored in this paper.

The case studies in this paper are from the UK, and further studies in different operating contexts in other countries would be useful. In particular, the finding that the fundamental ethos of NPOs is not challenged by being business-like merits further research. There is also scope for further research on what constitutes a receptive context for the adoption of new business practices by NPOs.

This study reveals the potential significance of NPO boards, particularly non-executive directors, in the shaping of organisational practices. There is evidence in this study of NPOs recruiting business experts for purposes of legitimation. But this study also shows how business expertise can be mobilised to enhance NPO performance by bricoleurs in NPO who are highly motivated individuals who will adopt useful business practices to hand if they improve charity outcomes.

The NPO organisations are motivated by the desire to make a difference to the lives of people who are vulnerable or disadvantaged. This study has interesting implications for managers and directors of NPOs on their effectiveness.

This study challenges the critical view that becoming more business-like undermines the fundamental ethos of altruism in NPOs. This is an important finding, but this study also reveals the recruitment of business expertise by NPOs purely for purposes of legitimation. However, these legitimating practices differ from the well-established view of isomorphism in the field of NPOs and suggests that, on the contrary, there is a variation in practice within the NPO field which has important implications for donors, regulators, directors and managers of NPOs.

The purpose of this paper is to make intelligible the rationalities and mechanisms through which markets have been proffered as alternatives or complements to traditional welfare‐based provision and the effect of this development on the subjectivity of workers.

The research involved collection of archival data, personal encounters and in‐depth interviews with managers, staff and elected representatives at a local authority in New Zealand. Michel Foucault's concept of governmentality is mobilised to interpret these data.

The paper finds that the mandatory changes required by legislation are associated with efforts to constitute local authority workers as business‐like subjects through disciplinary mechanisms and technologies of the self. While markets have permeated this local authority, with some managers and staff claiming to work in a business‐like manner and transact with each other as customers, these discourses have not vanquished the traditional concern of working for one organisation to serve the community.

While the results of this study are not generalisable to other contexts, they show how the introduction of New Public Management in a specific context is associated with a contest between the traditional discourses of community and public service, and the more recent ones of enterprise and customer. The paper illuminates the pathologies associated with these new technologies and how their implementation is often divergent from the rationalities in the name of which they are promoted.

The paper will contribute to ongoing debate on how best to deliver public goods and services and especially, the limits and potential of markets.

The paper's mobilisation of Foucault's governmentality framework in the study of a local authority case study in a contemporary setting is relatively unusual.

Health care organizations are increasingly demanded to balance the institutional logic of “medical professionalism” and “business-like health care,” that is, to both recognize physicians’ professional expertise while locating it in a wider social, economic, and political organizational setting. The purpose of this paper is to examine the implications from this shift in terms of leadership work in health care organizations.

Case study methodology including interviews with 15 residents in Swedish health care organizations.

A study of the willingness of residents to take on leadership positions show that leadership roles are treated as what is potentially hindering the acquisition of the know-how, skills, and expertise demanded to excel in the clinical work. Consequently, taking on leadership positions in the future was relatively unattractive for the residents. In order to overcome such perceived conflict between professional skill development and leadership roles, top management of health care organizations must help residents overcome such beliefs, or other professional groups may increasingly populate leadership positions, a scenario not fully endorsed by the community of physicians.

The paper demonstrates how complementary or completing institutional logics are influencing debates and identities on the “shop floors” of organizations.

The NHS began life in 1948 with the noble intention of providing free health care for all from cradle to grave. Today the NHS is the largest employer in Europe employing in excess of one million people and it has commonly been held that, since the NHS is an organisation committed to treating and providing care to patients, those working for the NHS are generally perceived to hold, in the main, altruistic values. Over the last two decades NHS managers have been given the responsibility for the implementation of the various NHS reforms which have been aimed at making the NHS more efficient, effective, accountable and business like. This paper explores the extent to which the managers in this role as change agents believe that they hold core values that are in line with the altruistic service ethos of the NHS and as a result the extent to which they believe they are seen to be performing and behaving in a socially responsible manner. Furthermore this study also provides an insight into understanding the managers' perceptions of their public image and assesses the extent to which this has an impact on the managers’ psyche, performance and commitment to the NHS ethos. Twenty eight managers from two Acute Care and one Community Care NHS Trusts in London were interviewed, after completing questionnaires, with a view to understanding their perceptions of their managerial culture and their public image. It appeared that managers generally believed that all NHS workers, themselves included, share altruistic values and demonstrated a collective commitment to the altruistic service ethos of the NHS. This therefore demonstrates the managers' commitment to behaving and performing in a socially responsible manner. As far as the managers’ perceived public image is concerned the research revealed that the majority of the managers, despite holding values that were altruistic in nature and similar to those held by clinicians, appeared to be convinced that the general public believed that doctors and nurses are the only professionals in the NHS who are motivated by a desire to serve/provide care to society and that these groups alone have an altruistic ethos. The managers indicated that they felt the public viewed them in a generally poor light and did not confer upon them the service driven values that were ascribed to clinicians. It is in the context of being the main change agents within the NHS that NHS managers appear to have become unpopular with the general public who tend to hold the view that “a service which managers are trying to make ever more efficient, rational and controlled cannot at the same time be caring and people centred” [Learmonth, 1997, pg. 219]. Whilst the NHS managers were aware of this negative view held by the public, they felt certain that this public perception was misguided and driven by several unfair and politically motivated agendas. They do not appear to have allowed this perceived negative public opinion to affect how they view their own role and in fact offered various reasons to explain why this public opinion was misguided and misinformed. This paper considers the implications of these views as regards the managers' role and commitment to the NHS.

The study intends to examine employee relations with a changing workforce resulting from the business-like transformation in the charity sector. The authors investigated sector-specific employment practices that can alleviate job stress (as a given and which has been made worse by the transformation). Developed from the intrinsic and extrinsic motivation framework, the findings can inform human resource management practices in its new efficiency-seeking business model.

The authors collected both quantitative (through a staff survey and administrative records of sick leave in the previous 12 months) and qualitative data (through interviews and focus groups) from one branch of an internationally well-established and UK-based religious charity between 2017 and 2018.

The quantitative results support a strong mediating effect of job satisfaction between job stress and staff sick leave. The negative correlation shown between job stress and job satisfaction is subject to paid staff perception of meaningful work and their level of involvement in decision-making, with the latter having a stronger moderating effect. The qualitative data provides further contextualized evidence on the findings.

It is important for charities to uphold and reflect their charitable mission towards beneficiaries and paid staff during the shift to an efficiency-seeking business model. Charities should involve their new professional workforce in strategic decision-making to better shape a context-based operational model.

The study examined employee relations in the non-profit charity sector with a changing workforce during the transition to a more business-oriented model. In particular, the authors revealed sector-specific factors that can moderate the association between job stress and absenteeism, and thereby contribute to the understanding of human resource management practices in the sector.

The purpose of this paper is to add to the emerging literatures on organizational learning and strategic management by developing a practice perspective on strategic organizational learning (SOL). While the literature on SOL has been growing, much of it has targeted exclusively practitioners and has not yet elaborated the mechanics and the micro‐dynamics of SOL. This paper is an initial attempt at exploring two important aspects of SOL: deep‐structure politics, and sensegiving.

The paper reports a qualitative case study of a major construction project undertaken by a mid‐size urban university as a part of its strategic change initiative.

Several ways in which deep‐structure politics shaped SOL at the research site are highlighted. The findings suggest that deep‐structure politics and sensegiving can shape identity processes in the context of SOL in important ways, such as dramatically altering the identity of the project team and symbolically separating it from the host institution.

The paper enriches the predominantly practitioner literature on SOL with empirical examination of the practices of SOL.

This chapter explores archetypal change in the context of professional service firms. To understand recent and ongoing changes in professional service firms, we briefly show how the professional archetype has evolved since the 1960s. We then present four theoretical models to describe processes by which institutionalized archetypes can change, and possibly coexist in the same field. Three professional archetypes are described, each in the context of historical development and the change model described earlier. At the one extreme is the traditional professional partnership; at the other the larger, multidisciplinary, corporate, global professional network, or GPN; in between is the “Star” form – relatively specialized, flatter structure, resisting significant growth, with fixations on excellence, and being the leader in a professional niche.

In the past decades, Dutch public sector organizations (PSOs) have been encouraged to become more “business-like” in their internal control and accountability processes, following a more general trend toward New Public Management (NPM) in Western societies. However, in the Netherlands, this trend has met with increasing resistance and discontent among public sector professionals. In this chapter, a framework is developed that enables these public sector professionals themselves to discuss and reflect on their internal control and accountability processes, and possibly to effect changes in it.

The chapter contains a critical analysis of existing research on management control, accountability, and learning in PSOs and describes a reflection and discussion session with a group of senior staff employees at a Dutch university, employing the framework developed in this chapter.

It is argued that, generally speaking, the “business-like” approach of NPM does not appear appropriate for most public sector activities and may even negatively affect accountability and learning in PSOs.

The chapter critically assesses the impact of NPM on PSOs and provides an alternative to NPM in the form of experimentalist governance, with possible positive implications for the effectiveness of public sector activities.

This chapter is among the first to adapt a framework, developed for scientific and descriptive use, for more practical and prescriptive purposes, that is, as an instrument for public sector professionals to discuss and reflect on their internal control and accountability processes.