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The digitalisation of healthcare services has proven to be difficult, with numerous negative effects. We argue that the reason for the problem is not poor project management, but a clash of different institutional logics. The aim of this article is to explore, define and theorise the concept of digitalism, as a term for a new institutional logic in contrast to other, more known logics in organisations, such as managerialism and professionalism, to better understand processes of digitalisation.

We illustrate our arguments with a case study of a process of organizational development before and after the implementation of centralised large-scale IT systems at a large Norwegian hospital. Data was extracted from documents and observations from January 2015 to January 2016 during an organizational audit. In addition, a follow-up study was conducted in 2019 and 2024 by interviewing eight key personnel who were involved in the implementation process.

The implementation of a new digital health record in a Norwegian hospital is a process of social restructuring that involves new actors, logics and control systems. The process of digitalisation shows us how digitalism create tensions, diverges and merges with other institutional logics.

Understanding digitalism as a sensitising concept offers insights into how large-scale technology and organizations are tied together and can help to reduce organizational dysfunctionalities and improve the implementation of IT systems.

This study contributes to a new understanding of digitalisation processes and links an ongoing theoretical debate on the digitalisation of organizations with empirical findings.

This paper aims to investigate how the technical logics of a World Bank-led performance management reform interacted with the social, political and historical logics within a developing country (DC) regulatory organisation. The institutional environment both within and outside the organisation was considered to understand the performance management reform experience.

An interview-based, longitudinal, qualitative case study approach was used to locate accounting in its technical, social and political space. A large regulatory organisation in Bangladesh was investigated as a case study to reveal how traditional organisational practices and public sector norms mediated a performance management reform. Informed by the institutional logics (IL) and economies of worth perspectives, interviews were used to locate IL at macro-level and associated organisational actors’ strategic responses that ultimately shaped the implementation of a performance management system (PMS).

This paper reveals how accounting, as a social and political practice, influences accountability reform within a regulatory organisation. It provides an account of both the processes and resultant practices of an accounting reform initiative. While a consultative and transparent performance management process was intended to enhance accountability, it challenged the traditional organisational authority structure and culture. The new PMS retained, modified and adjusted a number of its characteristics over time. These adjustments reflected an amalgamation of the influence of institutional pressures from powerful constituents and the ability of the local agents (managers) in negotiating and mediating the institutionalisation of a new PMS.

The findings of this paper carry major implications for policy makers, particularly with respect to the design of future reform programs on PMS.

This paper offers a theoretical mapping of IL and its organisation-level interpretations and practices. Thus, the authors locate power and influence at field and firm levels. The findings of this study reflect historical, political and cultural backgrounds of the case study organisation and how these contextual forces were active in shaping the meaning of reform logics. Though the institutional environment and agents were unique to the case study organisation, this research offers a “process generalisation” that reveals how a best practice PMS was translated and transformed by the traditional organisational practices in a DC regulatory context.

Value-based health care (VBHC) argues that health-care needs to re-focus to maximise value creation, defining value as the quota when dividing the outcomes important for the patient, by the cost for health care to deliver such outcomes. This study aims to explore the perception of value among different stakeholders involved in the process of implementing VBHC at a Swedish hospital to support leaders to be more efficient and effective when developing health care.

Participants comprised 19 clinicians and non-clinicians involved in the implementation of VBHC. Semi-structured interviews were conducted and content analysis was performed.

The clinicians described value as a dynamic concept, dependent on the patient and the clinical setting, stating that improving outcomes was more important than containing costs. The value for non-clinicians appeared more driven by the interplay between the outcome and the cost. Non-clinicians related VBHC to a strategic framework for governance or for monitoring different continuous improvement processes, while clinicians appreciated VBHC, as they perceived its introduction as an opportunity to focus more on outcomes for patients and less on cost containment.

There is variation in how clinicians and non-clinicians perceive the key concept of value when implementing VBHC. Clinicians focus on increasing treatment efficacy and improving medical outcomes but have a limited focus on cost and what patients consider most valuable. If the concept of value is defined primarily by clinicians’ own assumptions, there is a clear risk that the foundational premise of VBHC, to understand what outcomes patients value in their specific situation in relation to the cost to produce such outcome, will fail. Health-care leaders need to ensure that patients and the non-clinicians’ perception of value, is integrated with the clinical perception, if VBHC is to deliver on its promise.

Traditional purchasing best practices primarily follow a commercial logic and may not necessarily be applicable for social enterprises (SEs) supplier selection. This study examines how SEs focused on poverty alleviation select suppliers amidst competing institutional logics to achieve both social impact and economic performance.

A grounded theory methodology is applied to guide semi-structured interviews with 18 fair trade verified SEs. Constant comparison methods aided in determining the point of data saturation was reached.

The results of this study indicate that SEs select marginalized suppliers based on implicit criteria that is initially based on social-welfare logic and then through a blend of commercial and social-welfare logic based on company structure.

This study is the first to reveal that SEs addressing social issues do not follow the traditional criteria for supplier selection but have their own unique selection criteria when selecting suppliers.

This paper explores how conflicting institutional logics shape the behaviors of macro- and micro-level actors in their use of a calculative practice. Thereby, this paper explains how quantification can undermine the intended purpose of a governance system based on a single number.

The study draws upon the literature on calculative practices and institutional logics to present the case of how a single number—specifically the conversion factor for Atlantic Cod, established by macro-level actors for the purposes of governance within the Norwegian fishing industry—is interpreted and used by micro-level actors in the industry. The study is based on documents, field observations and interviews with fishers, landing facilities, and control authorities.

The use of the conversion factor, while intended to protect fish stock and govern industry actions, does not always align with the institutional logics of micro-level actors. Especially during the winter season, these actors may seek to serve their interests, leading to potential system gaming. The reliance on a single number that overlooks seasonal nuances can motivate unintended behaviors, undermining the governance system’s intentions.

Integrating the literature on calculative practices with an institutional logics perspective, this study offers novel insights into the challenges of using quantification for the governance of complex industries. In particular, the paper reveals that when the logics of macro- and micro-level actors conflict in a single-number governance system, unintended outcomes arise due to a domination of the macro-level logics.

Managing megaprojects is challenging due to their inherent complexity and uncertainty. Collaborative project delivery models have been introduced as an alternative to traditional project management in public infrastructure megaprojects and are often realized through collaborative contracts. These project organizations act as institutional arenas for logic interaction as actors with differing institutional backgrounds interact within the project. This paper aims to study the delivery phase of three megaprojects through an institutional lens, investigating the institutional interaction and alignment of logics therein.

A multiple case study was employed to reach deep insight into the phenomenon. Sixty-one interviews were conducted over 3 cases with representatives from all levels of the project hierarchy. Respondents were selected through snowball sampling. In two cases, observations of the shared project office were conducted. Data analysis built on first-order codes and second-order themes, collected into a theoretical framework.

The empirical evidence demonstrates the dynamics shaping institutional logics and gives evidence for changing logics in projects with a well-applied collaborative contract. However, there is a risk of resistance and a return to traditional logics since institutional change is slow and an unsuitably applied collaborative contract can lead to adherence to the conventional way of work.

Current research has focused on the regulatory framework and procurement phase of such models, but little attention has been given to the delivery phase and the interaction of conflicting logics. This paper can serve as an exemplar of the different logics found within public infrastructure projects and their interaction and alignment. Contributions include a heightened emphasis on the start of the project as a meeting point for differing institutional logics and the role change necessary when using a collaborative contract.

This chapter focuses on the COVID-19 pandemic’s impact on the recognition through discourses of essentiality, of low-status workers and more specifically of care aides as an occupational group that performs society’s ‘dirty work’. The pandemic appears as a privileged moment to challenge the normative hegemony of how work is valued within society. However, public recognition through political discourse is a necessary but insufficient element in producing social change. Based on the theory of performativity, this chapter empirically probes conditions and mechanisms that enable a transition from discourse of essentiality to substantive recognition of the work performed by care aides in healthcare organizations. The authors rely on three main sources of data: scientific-scholarly works, documents from government, various associations and unions, and popular media reports published between February 2020 and 1 July 2022. While discourse of essentiality at the highest level of politics is associated with rapid policy response to value the work of care aides, it is embedded in a system structure and culture that restrains the establishment of substantive policy that recognizes the nature, complexity, and societal importance of care aide work. The chapter contributes to the literature on performativity by demonstrating the importance of the institutionalization of competing logics in contemporary health and social care systems and how it limits the effectiveness of discourse in promulgating new values and norms and engineering social change.

The organizational decision-making perspective (ODM) has a legacy regarding its concern for budgeting as an essential organizational routine in decision-making. Budgeting has also become a direct concern to organizational institutional theory (OIT) because of its prominent role in institution building, where budgeting can build trust in inter-organizational relationships. This paper builds on these two perspectives to explore organizational budget processes' formation, disruption, and re-creation over time.

We conducted a comprehensive review and critical analysis of the ODM and OIT perspectives, focusing on a fundamental paradox between ODM's emphasis on stability through organizational routines and OIT's focus on organizational legitimacy through the decoupled expression of organizational values. We then expanded on these paradoxical concerns in the context of budgeting, formalizing them into specific research propositions for future studies.

Tensions around the stability, decay, and re-creation of budgets as organizational routines emerge as a pressing issue requiring further empirical investigation from the ODM perspective. A critical issue in the OIT perspective is the potential for organizational budgets to provide an opportunity to decouple from practice through routinized expressions of rationality and to facilitate loose coupling in practice. These findings offer a fresh perspective and open up new avenues for future research in this area.

This paper contributes to the accounting and organizational research literature by shedding light on how organizations respond to the potential decay of budget routines and the manifestation of organizational values in decoupling processes by further re-creating and elaborating budget processes.

Forced labour is one of the most exploitative practices in supply chains, generating serious human right abuses. The authors seek to understand how relationships for reducing forced labour are influenced by institutional logics. The emerging supply chain efforts of social enterprises offer particularly intriguing approaches, as their social mission can spur creative new approaches and reshape widely adopted management practices.

The authors study supplier relationships in the smartphone industry and compare the evolving practices of two cases: the first, a growing novel social enterprise; and the second, a high-profile commercial firm that has adopted a progressive role in combating forced labour.

The underlying institutional logic influenced each firm's willingness to act beyond its direct suppliers and to collaborate in flexible ways that create systematic change. Moreover, while both focal firms had clear, well-documented procedures related to forced labour, the integration, rather than decoupling, of forced labour and general supply chain policies provided a more effective way to reduce the risks of forced labour in social enterprises.

As authors’ comparative case study approach may lack generalizability, future research is needed to broadly test their propositions.

The paper identifies preconditions in terms of institutional logics to successfully reduce the risk of forced labour in supply chains.

This paper discusses how social enterprises can provide a learning laboratory that enables commercial firms to identify options for supplier relationship improvement.

This study explores a novel conception of corporate social responsibility (CSR) hybridity and investigates its effect on returns following CSR announcements and the moderating role of aspirational CSR talk.

Based on an event study of 136 Chinese companies’ CSR announcements, this study empirically insights into an overall tension between the short-term firm performance (FP) loss and medium-term FP success of CSR hybridity.

First, CSR hybridity has a negative impact on short-term FP. Second, although there is positive effect on medium-term FP, this influence is not permanent. Third, aspirational CSR talk has a moderating role on the positive relationship between CSR hybridity and FP. These results point to the unique features of hybridity that require time to diffuse the impacts.

First, by adopting new concept of CSR hybridity, this study contributes to the literature by considering better solutions to integrate strategic CSR. Second, by investigating the complexity of the CSR hybridity–FP dialogue, the results provide insights into the questions of why and when organizations could be incentivized to adopt hybrid CSR approaches. Third, this study contributes to the CSR–FP and stakeholder literature by demonstrating that aspirational talk is key in CSR’s medium-term success. The implication of this is a growing pressure on companies’ CSR communications with investors through managerial talk that depicts organizational ambitions for CSR engagement.