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One of the latest trends within public administration and healthcare organizations (HCOs) is process orientation, often in the shape of Lean management. The purpose of this study is to expand our understanding of process orientation of HCOs and the more specific aim is to investigate what measures are taken to re-frame the HCOs to include the process dimension.

This empirical study is based on 67 interviews and 20 meeting observations.

The main observation in this study is that introducing process-oriented management solutions is about disconnecting and cutting-off existing links. The authors see how attempts are made to cut-off links to the logic of functional specialization, the autonomy of the professional worker, equal treatment of patients and other objectives.

This study adds to and expands previous studies that have problematized the use of Lean-inspired ways of organizing in the public sector.

The problematization indicates the need for enhancing the understanding of hybrid settings as potentially dynamic, changing and fragile. The purpose of this paper is to generate the knowledge through a conceptualization of the relationship between hybrid organizing and object, helping us understand how and why hybridization takes place or de-hybridizing occurs.

The study is based on a longitudinal qualitative case study of an attempt to introduce cost-benefit calculations as a management initiative in the social sector. In total, 18 observations of meetings and 48 interviews were done.

The main contribution is the empirically detailed description of how hybridizing must be understood in connection to a complex task at hand. A core observation is how complexity is escaped by either an intensive framing or compartmentalization – the former either leading to a disciplined hybrid allowing efficient action or to a hot and contested situation characterized by inertia. The latter, compartmentalization, presupposes less complexity with the potential of full de-hybridization into single-purpose organizing, failing to deal with the complex task at hand.

A limitation is the one case approach and further research could focus on other settings.

The paper provides concepts useful for analysis of specific cooperative arrangements.

The authors believe that the findings can bring useful insights to professionals, policy makers and others who are engaging in and addressing complex societal issues, not least within the public sector, a matter all too often overlooked by the accounting research community.

The originality of the paper is the focus on the organization and control in relation to the task at hand.

This essay focuses on an argument that challenges the notion of market reform as a desirable idea. It examines how market requirements, accounting practices, political intervention and organizational conditions interact and create conflicts in the implementation of market reform. In our case study, we aim to elucidate the detrimental effects of expanding pricing mechanisms into areas typically untouched.

The essay adopts a critical perspective toward the marketization in the public sector organizations based on the authors' previous studies and observations of the reforms in Swedish schools over the last 30 years. The case is conceptualized within Callon’s framework of the sociology of worth.

The paper provides an example of market dynamics introduced without the presence of pricing and qualification mechanisms, resulting in a trial-and-error situation. In this context, we document and problematize a trend toward marketization that has had negative consequences for Swedish schools. In doing so, the paper shows how market requirements, accounting practices, political interventions and organizational conditions interact and create conflicts during the implementation of market reforms. The case shows the emergence of a new economic entity and its underlying rationale, the quantification/pricing mechanism, with a special emphasis on the role of accounting and the repercussions on subjectivities as values shift.

This paper follows up on the New Public Financial Management (NPFM) global warning debate on the emergence of pricing/charging mechanisms in public services. It provides a critical overview of the diffusion and relevance of accounting evaluation processes to sustain continuous reforms, despite claimed criticisms, limitations and (un)intended consequences. The paper also provides some reflections on new avenues for further research and some possible ways out for accounting studies.

The authors argue that the mainstream scholarly discourse on hybridity and accounting is thus far primarily interested in the use and effects of accounting “in” hybrid organizations. Consequently, the literature has to a lesser extent explored how accounting mediates hybrid settings (while also being mediated), and the role of disentanglements in such processes. In hybrid settings, objects are difficult to define, and measures and tools difficult to agree upon. However, the literature on hybrid accounting is inconclusive and indicates that accounting can potentially both stabilize and de-stabilize relations in a hybrid setting. The authors address the research question of how accounting emerges and manifests itself in a process of entangling and disentangling in a heterogeneous emerging hybrid setting.

The paper is based on a longitudinal qualitative case study of the implementation of social investments, a public sector calculative framework based on the logic of measuring long term and social and economic impact of prevention. Methodologically, the study was guided by actor-network theory. In total, 18 observations and 48 interviews were conducted.

The observation the authors make in their case study is that much effort was spent on both keeping things apart and tying elements together. What the authors add to the literature is an illumination of how the interplay between entanglements and disentanglements facilitated the design idea of social investments to be enacted as multiple semi-integrated and purified hybridizations. The authors describe different translation points, each representing a specific hybridization where elements were added, recombined and disentangled. Still, the translation points were not completely compartmentalized, but rather semi-integrated where associations were facilitated through active mediation, likeness and productiveness for each other.

One limitation is the single case approach. A second limitation arises from the ANT approach to hybridity.

A practical implication of this paper is that in hybrid settings, the semi-integrated character may be interpreted as a strength because it allows the mobilization of heterogenous actors. However, this may also come at the cost of governability and raises further questions of managerial practices in hybrid settings.

The paper suggests the potentially productive role of disentanglements in allowing multiple hybridizations to evolve in hybrid accounting settings.

The paper suggests the potentially productive role of disentanglements in allowing multiple stabilized hybridizations to evolve in hybrid accounting settings.

Within the strategy as practice field several studies have recently paid attention to organizational arenas like meetings, workshops and away‐days. There has, however, been a tendency to focus on what happens “inside” separated organizational arenas. The aim of the paper is to contribute to the understanding of the relationship between the separated organizational arenas and other organizational activities in the strategizing process.

The paper is conceptual. The framework rests on Niklas Luhmann's social systems theory and draws on recent empirical studies.

The main contribution of the article is the presentation of a theoretically well‐founded framework that further specifies and problematizes the relationships of separated organizational arenas. By focusing and conceptualizing the conditions for separation and reconnection, a foundation for analyzing the interconnectedness between different arenas is provided.

The paper contributes to our understanding of phenomena like meetings and work‐shops in the strategic process.

The framework is in line with, and expands the theorizing that Hendry and Seidl (2003) initiated about strategic episodes and the theorizing about first and second order observations in strategic processes initiated by Schreyögg and Kliesch‐Eberl (2007).

In the last decade, greater attention has been paid to the role of management accounting and control (MAC) in making professional organizations more horizontal. The authors argue that earlier research has not shown how the interrelatedness between professional identities and MAC influences attempts to make organizations more horizontal. In this paper the authors respond to the call for more research on the relationship between horizontalization and accounting and control. The purpose of this paper is to contribute to the emerging literature on the relationship between accountability arrangements and professional identities.

Theoretically the authors have an actor-network theory (ANT) approach. Empirically, the authors followed two episodes where actors at top management levels in two Swedish health care organizations introduced horizontalization.

The two episodes support the view that the role of MAC when making professional organizations more horizontal is limited. Professionals dominate what happens at the operational level and they do not act on MAC rules and performance targets in opposition of their professional identity. However, in alliance with other interessement devices MAC may have a role in creating overflows, that is, pointing out imperfections in the existing frame. The authors noticed no signs that professionals developed hybrid identities as in previous research.

The authors apply ANT to move beyond the commonly used contingency and new institutional sociology perspectives.

In order to improve cooperation and collaboration between units, clinics and departments, many health care organizations (HCOs) have introduced process orientation. Several studies indicate problems in realizing these ambitions. The purpose of this paper is to explain and understand the success and failure of process orientation in HCOs.

The authors conducted three case studies and applied Actor-Network Theory as an analytic lens.

The realization of process orientation is hindered by neglect or resistance from physicians, who find the process targets to be of low medical priority. However, the authors also see that medical priorities are no stable entities but are susceptible to negotiations. Over time, process organization, process mapping, process measurement activities and the acting of enroled actors may have impact on medical priorities.

Contrary to previous research, the findings indicate that New Public Management may not be the main obstacle against processes, that accounting figures may not be hard to disregard and that the role of leadership is not paramount.

The purpose of this paper is to synthesize insights from previous accounting, performance measurement (PM) and accountability research into the rapidly emerging field of knowledge-intensive public organizations (KIPOs). In so doing, it draws upon insights from previous literature and other papers included in this special issue of Accounting, Auditing and Accountability Journal.

The paper reviews academic analysis and insights provided in the academic literature on accounting, PM and accountability changes in KIPOs, such as universities and healthcare organizations, and paves the way for future research in this area.

The literature review shows that a growing number of studies are focusing on the hybridization of different KIPOs, not only in terms of accounting tools (e.g. performance indicators, budgeting and reporting) but also in relation to individual actors (e.g. professionals and managers) that may have divergent values and thus act according to multiple logics. It highlights many areas in which further robust academic research is needed to guide developments of hybrid organizations in policy and practice.

This paper provides academics, regulators and decision makers with relevant insights into issues and aspects of accounting, PM and accountability in hybrid organizations that need further theoretical development and empirical evidence to help inform improvements in policy and practice.

The paper provides the growing number of academic researchers in this emerging area with a literature review and agenda upon which they can build their research.