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This paper aims to report “positively deviant” experiences of three public sector networks seeking to enhance organizational and system level capacities. It is the authors' thesis that the knowledge base concerning the true benefits and pitfalls of networks can be captured and interpreted only through intense, ongoing learning effort embedded in practice on the ground, combined with sustained in‐depth observation and collaborative research.

The paper describes through case examples why and how different kinds of networks within different jurisdictional contexts and different organizational cultures are being used to enhance the climate for change towards better health care and improved health. The authors describe the contexts, structures, processes and impacts of three “positively deviant” networks.

The network form can provide opportunity for nurturing changes and innovations within large organizational and complex system environments. This opportunity to create additional and different pathways for improved decision making and service provision comes with challenges that should be recognized.

The authors' experiences indicate that, for networks, a key component of success relates to pulling and pushing at the edges of multiple connections and boundaries in “positively deviant” ways. This pushing and pulling is intrinsically evidence of organizational and intraorganizational learning – in the examples presented – for the improvement of health care and health.

Other networks can learn from the reported experiences and add their own cases to the empirical understanding of how networks can make a difference; this in turn can help the conceptual and theoretical understanding of them.

Efforts of governments to adjust the responsiveness and efficiency of their health care systems are evident across the globe. In the seemingly constant search for solutions providing both better health outcomes and manageable costs, the directions and designs for change are neither consistent nor well studied. Opportunities for shared learning concerning what strategies for transforming health care systems lead to effective and sustainable change are being missed. There is an urgent need to study and understand the processes of change initiated by health policy shifts aimed at controlling health care costs, altering health service delivery and influencing outcomes of health care. In partial response to this need, research was initiated to study health policy transition within the Western Canadian province of Alberta. The primary objective of this research was: to identify, describe, compare and contrast the processes of change adopted and implemented in a variety of health authorities as a result of health policy shift. Change processes initiated by a specific health policy shift (the restructuring of Alberta’s health care system) were explored from the perspective of the change agents (individuals managing the health system reforms) in order to discover indicators of effective change and to identify questions for further consideration and testing in relation to change process related to health policy shift. This qualitative exploratory study coincided with real time alteration to the health system via legislated health policy shift. Findings relate changes in the structure, process and outcome of the health policy transition. Additionally, a number of questions linked to the reported findings are highlighted to encourage additional and continuing efforts to improve understanding of change process related to health policy shift.

In this chapter the authors focus on the role of power associated with microfoundations of organizational hybridity. They develop a framework that illuminates how key sources of power based on Buchanan and Badham (2008) and French and Raven (1959) manifest at the level of everyday work practices. Using this framework, they draw on existing studies concerning hybridity in professional organizations to illustrate how different forms of power come into play when actors guided by different logics engage in day-to-day professional work. Overall, the authors suggest that more attention to how micro-level actors use different forms of power to support, hamper, or alter different mechanisms to manage tensions among competing logics in everyday work is critical to improving our understanding about the microfoundations of institutionalism.

This double volume presents a collection of 23 papers on how institutions matter to socio-economic life. The papers delve deeply into the practical impact an institutional approach enables, as well as how such research has the potential to influence policies relevant to critical institutional changes unfolding in the world today. In Volume 48A, the focus is on the micro foundations of institutional impacts. In Volume 48B, the focus is on the macro consequences of institutional arrangements. Our introduction provides an overview to the two volumes, identifies points of contact between the papers, and briefly summarizes each contribution. We close by noting avenues for future research on how institutions matter. Overall, the volumes provide a cross-section of cutting edge institutional thought and empirical research, highlighting a variety of fruitful directions for knowledge accumulation and development.

This chapter examines existing approaches to conducting qualitative process research (i.e., studies that view phenomena as becoming or evolving over time) by analyzing published process research in six premier organizational journals from 2010 to 2017. We identify four modes of performing process research that we label evolutionary process stories, performative process stories, narrative process stories and toolkit-driven process stories, and explore the particular ways in which they formulate and link empirical and theoretical elements. We also identify some of their specific challenges and suggest directions for the future.

The aim of this paper is to analyse how critical incidents or organisational crises can be used to check and legitimise quality management change efforts in relation to the fundamental principles of quality.

Multiple case studies analyse critical incidents that demonstrate the importance of legitimisation, normative evaluation and conflict constructs in this process. A theoretical framework composed of these constructs is used to guide the analysis.

The cases show that the critical incidents leading to the legitimisation of continuous improvement (CI) were diverse. However all resulted in the need for significant ongoing cost reduction to achieve or retain competitiveness. In addition, attempts at legitimising CI were coupled with attempts at destabilising the existing normative practice. This destabilisation process, in some cases, advocated supplementing the existing approaches and in others replacing them. In all cases, significant conflict arose in these legitimising and normative evaluation processes.

It is suggested that further research could involve a critical analysis of existing quality models, tools and techniques in relation to how they incorporate, and are built upon, fundamental quality management principles. Furthermore, such studies could probe the dangers of quality curriculum becoming divorced from business and market reality and thus creating a parallel existence.

As demonstrated by the case studies, models, tools and techniques are not valued for their intrinsic value but rather for what they will contribute to addressing the business needs. Thus, in addition to being an opportunity for quality management, critical incidents present a challenge to the field. Quality management must be shown to make a contribution in these circumstances.

This paper is of value to both academics and practitioners.