IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v74y2012i3p356-363.html
   My bibliography  Save this article

The role of institutional entrepreneurs in reforming healthcare

Author

Listed:
  • Lockett, Andy
  • Currie, Graeme
  • Waring, Justin
  • Finn, Rachael
  • Martin, Graham

Abstract

We draw on institutional entrepreneurship theory to analyse the dynamics of institutional change in a healthcare context. The focus of our interest is in the relationship between an institutional entrepreneur’s ‘subject position’, defined in terms of their structural and normative legitimacy within the existing institutional landscape, and the nature of the change enacted. We develop this approach through an examination of the implementation of new pathways for cancer genetic services within the English National Health Service. Employing comparative case analysis we show that those who have limited structural legitimacy under prevailing conditions are most willing to engender change, but also least able; whereas those who have strong structural legitimacy are most able, but often least willing. However, those who are able rhetorically to combine a balance of structural and normative legitimacy are most able to produce change. In doing so, we demonstrate the importance of the concept of institutional entrepreneurship to understand healthcare reform.

Suggested Citation

  • Lockett, Andy & Currie, Graeme & Waring, Justin & Finn, Rachael & Martin, Graham, 2012. "The role of institutional entrepreneurs in reforming healthcare," Social Science & Medicine, Elsevier, vol. 74(3), pages 356-363.
    • Handle: RePEc:eee:socmed:v:74:y:2012:i:3:p:356-363
    DOI: 10.1016/j.socscimed.2011.02.031
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953611001183
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2011.02.031?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Martin, Graham P. & Currie, Graeme & Finn, Rachael, 2009. "Reconfiguring or reproducing intra-professional boundaries? Specialist expertise, generalist knowledge and the 'modernization' of the medical workforce," Social Science & Medicine, Elsevier, vol. 68(7), pages 1191-1198, April.
    2. Julie Battilana & Bernard Leca & Eva Boxenbaum, 2009. "How actors change institutions : Towards a theory of institutional entrepreneurship," Post-Print hal-00576509, HAL.
    3. Sanjay Jain & Gerard George, 2007. "Technology transfer offices as institutional entrepreneurs: the case of Wisconsin Alumni Research Foundation and human embryonic stem cells," Industrial and Corporate Change, Oxford University Press and the Associazione ICC, vol. 16(4), pages 535-567, August.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Marit B Rise & Marit Solbjør & Aslak Steinsbekk, 2014. "Experiences from the implementation of a comprehensive development plan for user involvement in a mental health hospital: A qualitative case study," International Journal of Social Psychiatry, , vol. 60(4), pages 387-395, June.
    2. Lakomaa, Erik & Sanandaji, Tino, 2021. "Exploring collective consumer innovation in health care: Cases and formal modeling," Research Policy, Elsevier, vol. 50(8).
    3. Zec, Dejan & Rüling, Charles-Clemens & Wang, Tao, 2020. "Parliament in action: Drug withdrawals and policy changes in the U.K," Health Policy, Elsevier, vol. 124(9), pages 984-990.
    4. Sheard, Laura & Marsh, Claire & O'Hara, Jane & Armitage, Gerry & Wright, John & Lawton, Rebecca, 2017. "The Patient Feedback Response Framework – Understanding why UK hospital staff find it difficult to make improvements based on patient feedback: A qualitative study," Social Science & Medicine, Elsevier, vol. 178(C), pages 19-27.
    5. Berghout, Mathilde A. & Oldenhof, Lieke & Fabbricotti, Isabelle N. & Hilders, Carina G.J.M., 2018. "Discursively framing physicians as leaders: Institutional work to reconfigure medical professionalism," Social Science & Medicine, Elsevier, vol. 212(C), pages 68-75.
    6. Macfarlane, Fraser & Barton-Sweeney, Cathy & Woodard, Fran & Greenhalgh, Trisha, 2013. "Achieving and sustaining profound institutional change in healthcare: Case study using neo-institutional theory," Social Science & Medicine, Elsevier, vol. 80(C), pages 10-18.
    7. Currie, Graeme & Dingwall, Robert & Kitchener, Martin & Waring, Justin, 2012. "Let’s dance: Organization studies, medical sociology and health policy," Social Science & Medicine, Elsevier, vol. 74(3), pages 273-280.
    8. Welter, Friederike & Smallbone, David, 2015. "Creative forces for entrepreneurship: The role of institutional change agents," Working Papers 01/15, Institut für Mittelstandsforschung (IfM) Bonn.
    9. Baeza, Juan I. & Boaz, Annette & Fraser, Alec, 2016. "The roles of specialisation and evidence-based practice in inter-professional jurisdictions: A qualitative study of stroke services in England, Sweden and Poland," Social Science & Medicine, Elsevier, vol. 155(C), pages 15-23.
    10. Daskalopoulou, Athanasia & Palmer, Mark, 2021. "Persistent institutional breaches: Technology use in healthcare work," Social Science & Medicine, Elsevier, vol. 289(C).
    11. Uddin, Shahzad & Mori, Yuji & Shahadat, Khandakar, 2020. "Private management and governance styles in a Japanese public hospital: A story of west meets east," Social Science & Medicine, Elsevier, vol. 245(C).
    12. Nigam, Amit, 2013. "How institutional change and individual researchers helped advance clinical guidelines in American health care," Social Science & Medicine, Elsevier, vol. 87(C), pages 16-22.
    13. Mæhle, Per Magnus & Smeland, Sigbjørn, 2021. "Implementing cancer patient pathways in Scandinavia how structuring might affect the acceptance of a politically imposed reform," Health Policy, Elsevier, vol. 125(10), pages 1340-1350.
    14. Niezen, Maartje G.H. & Mathijssen, Jolanda J.P., 2014. "Reframing professional boundaries in healthcare: A systematic review of facilitators and barriers to task reallocation from the domain of medicine to the nursing domain," Health Policy, Elsevier, vol. 117(2), pages 151-169.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Jain, Sanjay, 2020. "Fumbling to the future? Socio-technical regime change in the recorded music industry," Technological Forecasting and Social Change, Elsevier, vol. 158(C).
    2. Welter, Friederike & Smallbone, David, 2015. "Creative forces for entrepreneurship: The role of institutional change agents," Working Papers 01/15, Institut für Mittelstandsforschung (IfM) Bonn.
    3. Jain, Sanjay, 2012. "Pragmatic agency in technology standards setting: The case of Ethernet," Research Policy, Elsevier, vol. 41(9), pages 1643-1654.
    4. Malcolm, Dominic & Scott, Andrea, 2011. "Professional relations in sport healthcare: Workplace responses to organisational change," Social Science & Medicine, Elsevier, vol. 72(4), pages 513-520, February.
    5. Modell, Sven & Yang, ChunLei, 2018. "Financialisation as a strategic action field: An historically informed field study of governance reforms in Chinese state-owned enterprises," CRITICAL PERSPECTIVES ON ACCOUNTING, Elsevier, vol. 54(C), pages 41-59.
    6. Elizabeth J. Altman & Frank Nagle & Michael L. Tushman, 2013. "Innovating Without Information Constraints: Organizations, Communities, and Innovation When Information Costs Approach Zero," Harvard Business School Working Papers 14-043, Harvard Business School, revised Sep 2014.
    7. Pandza, Krsto & Ellwood, Paul, 2013. "Strategic and ethical foundations for responsible innovation," Research Policy, Elsevier, vol. 42(5), pages 1112-1125.
    8. Elert, Niklas & Henrekson, Magnus, 2017. "Entrepreneurship and Institutions: A Bidirectional Relationship," Working Paper Series 1153, Research Institute of Industrial Economics, revised 05 May 2017.
    9. Emil Evenhuis, 2017. "Institutional change in cities and regions: a path dependency approach," Cambridge Journal of Regions, Economy and Society, Cambridge Political Economy Society, vol. 10(3), pages 509-526.
    10. Victoria Johnson & Walter W. Powell, 2015. "Poisedness and Propagation: Organizational Emergence and the Transformation of Civic Order in 19th-Century New York City," NBER Working Papers 21011, National Bureau of Economic Research, Inc.
    11. Kurikka, Heli & Grillitsch, Markus, 2020. "Resilience in the periphery: What an agency perspective can bring to the table," Papers in Innovation Studies 2020/7, Lund University, CIRCLE - Centre for Innovation Research.
    12. Y. Sekou Bermiss & Benjamin L. Hallen & Rory McDonald & Emily C. Pahnke, 2017. "Entrepreneurial beacons: The Yale endowment, run‐ups, and the growth of venture capital," Strategic Management Journal, Wiley Blackwell, vol. 38(3), pages 545-565, March.
    13. Keim, Jan & Müller, Susan & Dey, Pascal, 2024. "Whatever the problem, entrepreneurship is the solution! Confronting the panacea myth of entrepreneurship with structural injustice," Journal of Business Venturing Insights, Elsevier, vol. 21(C).
    14. Hensel, Przemysław G., 2019. "Supporting replication research in management journals: Qualitative analysis of editorials published between 1970 and 2015," European Management Journal, Elsevier, vol. 37(1), pages 45-57.
    15. Slitine, Romain & Chabaud, Didier & Richez-Battesti, Nadine, 2024. "Beyond social enterprise: Bringing the territory at the core," Journal of Business Research, Elsevier, vol. 176(C).
    16. Elbasha, Tamim & Avetisyan, Emma, 2018. "A framework to study strategizing activities at the field level: The example of CSR rating agencies," European Management Journal, Elsevier, vol. 36(1), pages 38-46.
    17. Maxim Voronov & Mary Ann Glynn & Klaus Weber, 2022. "Under the Radar: Institutional Drift and Non‐Strategic Institutional Change," Journal of Management Studies, Wiley Blackwell, vol. 59(3), pages 819-842, May.
    18. Bjorn Remneland Wikhamn & Alexander Styhre, 2019. "Open Innovation Groundwork," International Journal of Innovation Management (ijim), World Scientific Publishing Co. Pte. Ltd., vol. 24(02), pages 1-29, January.
    19. Arshed, Norin, 2017. "The origins of policy ideas: The importance of think tanks in the enterprise policy process in the UK," Journal of Business Research, Elsevier, vol. 71(C), pages 74-83.
    20. Chatterjee, Ira & Cornelissen, Joep & Wincent, Joakim, 2021. "Social entrepreneurship and values work: The role of practices in shaping values and negotiating change," Journal of Business Venturing, Elsevier, vol. 36(1).

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:74:y:2012:i:3:p:356-363. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.