Mads Solberg, Ralf Kirchhoff, Jannike Dyb Oksavik and Lauri Wessel
Norway, like other welfare states, seeks to leverage data to transform its pressured public healthcare system. While managers will be central to doing so, we lack knowledge about…
Abstract
Purpose
Norway, like other welfare states, seeks to leverage data to transform its pressured public healthcare system. While managers will be central to doing so, we lack knowledge about how specifically they would do so and what constraints and expectations they operate under. Public sources, like the Norwegian policy documents investigated here, provide important backdrops against which such managerial work emerges. This article therefore aims to analyze how key Norwegian policy documents construe data use in health management.
Design/methodology/approach
We analyzed five notable policy documents using a “practice-oriented” framework, considering these as arenas for “organizing visions” (OVs) about managerial use of data in healthcare organizations. This framework considers documents as not just texts that comment on a topic but as discursive tools that formulate, negotiate and shape issues of national importance, such as expectations about data use in health management.
Findings
The OVs we identify anticipate a bold future for health management, where data use is supported through interconnected information systems that provide relevant information on demand. These OVs are similar to discourse on “evidence-based management,” but differ in important ways. Managers are consistently framed as key stakeholders that can benefit from using secondary data, but this requires better data integration across the health system. Despite forward-looking OVs, we find considerable ambiguity regarding the practical, social and epistemic dimensions of data use in health management. Our analysis calls for a reframing, by moving away from the hype of “data-driven” health management toward an empirically-oriented, “data-centric” approach that recognizes the situated and relational nature of managerial work on secondary data.
Originality/value
By exploring OVs in the Norwegian health policy landscape, this study adds to our growing understanding of expectations towards healthcare managers' use of data. Given Norway's highly digitized health system, our analysis has relevance for health services in other countries.
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Anne Berghöfer, Denes G. Göckler, Jörg Sydow, Carolin Auschra, Lauri Wessel and Martin Gersch
Many health systems face challenges such as rising costs and lacking quality, both of which can be addressed by improving the integration of different health care sectors and…
Abstract
Purpose
Many health systems face challenges such as rising costs and lacking quality, both of which can be addressed by improving the integration of different health care sectors and professions. The purpose of this viewpoint is to present the German health care Innovation Fund (IF) initiated by the Federal Government to support the development and diffusion of integrated health care.
Design/methodology/approach
This article describes the design and rationale of the IF in detail and provides first insights into its limitations, acceptance and implementation by relevant stakeholders.
Findings
In its first period, the IF offered € 1.2 billion as start-up funding for model implementation and evaluation over a period of four years (2016–2019). This period was recently extended to a second round until 2024, offering € 200 million a year as from 2020. The IF is triggering the support of relevant insurers for the development of new integrated care models. In addition, strict evaluation requirements have led to a large number of health service research projects which assess structural and process improvements and thus enable evidence-based policy decisions.
Originality/value
This article is the first of its kind to present the German IF to the international readership. The IF is a political initiative through which to foster innovations and promote integrated health care.
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Patrick Haack, Jost Sieweke and Lauri Wessel
This double volume presents the state of the art in research on the microfoundations of institutions. In this introductory chapter, we develop an overview of where the emerging…
Abstract
This double volume presents the state of the art in research on the microfoundations of institutions. In this introductory chapter, we develop an overview of where the emerging microfoundational agenda in institutional theory stands and in which direction it is moving. We discuss the questions of what microfoundations of institutions are, what the “micro” in microfoundations represents, why we use the plural form (microfoundations vs microfoundation), why microfoundations of institutions are needed, and how microfoundations can be studied. Specifically, we highlight that there are several traditions of microfoundational research, and we outline a cognitive, a communicative and a behavioral perspective. In addition, we explain that scholars tend to think of microfoundations in terms of an agency, levels, or mechanisms argument. We delineate key challenges and opportunities for future research and explain why we believe that the debate on microfoundations will become a defining element in the further development of institutional theory.
The authors discuss the microfoundations of institutional theory, specifically as microfoundations are manifested in this volume of Research in the Sociology of Organizations. The…
Abstract
The authors discuss the microfoundations of institutional theory, specifically as microfoundations are manifested in this volume of Research in the Sociology of Organizations. The authors argue that the main interest seems to be in better understanding macrofoundations: top-down forces from institutions to actors. Furthermore, throughout the volume institutions themselves are definitionally layered – in problematic ways – with a large array of other macroconstructs, including fields, logics, practices, habitus, situations, routines, and so forth. The authors argue that there is an opportunity to more carefully delineate microfoundations for institutional theory, by focusing on lower-level heterogeneity, agency, as well as the aggregate and emergent social processes that animate microfoundational explanation.
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Tim Hallett and Amelia Hawbaker
The “micro” turn in institutional research is a welcome development in a field that has commonly adopted a macro approach to the study of institutions. Nevertheless, research in…
Abstract
The “micro” turn in institutional research is a welcome development in a field that has commonly adopted a macro approach to the study of institutions. Nevertheless, research in the emergent “microinstitutional” tradition often ignores a fundamental social form: social interaction. The goal of this chapter is to bring this form of society back into institutional analysis, as a key mesocomponent of an “inhabited institutional” approach. The authors argue that social interactions are vital to the understandings of institutions, how they operate, and their impact on society. The authors advance inhabited institutionalism as a mesosociological approach that is consistent with key premises of institutional theory.
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Mary Ann Glynn and Benjamin D. Innis
The authors theorize the role that identity, and especially collective identity, plays in the creation of new institutions. The authors begin by reviewing the literature on social…
Abstract
The authors theorize the role that identity, and especially collective identity, plays in the creation of new institutions. The authors begin by reviewing the literature on social movements, focusing on identity movements; from this, the authors extract and explore the role of identity in collective action and institutional formation. The authors propose that identity and lifestyle movements create institutions that furnish the necessary cultural tools to support and enact a given identity. As an example of this process, the authors examine Martha Stewart’s cultivation of a lifestyle-driven brand. The authors discuss the implications of their work on social movement theory and institutional theory.
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Yanfei Hu and Claus Rerup
This study examines how highly disruptive issues cause profound dissonance in societal members that are cognitively and emotionally invested in existing institutions. The authors…
Abstract
This study examines how highly disruptive issues cause profound dissonance in societal members that are cognitively and emotionally invested in existing institutions. The authors use PETA’s (People for the Ethical Treatment of Animals) entrepreneurial advocacy for animal rights to show how this highly disruptive issue interrupted and violated taken-for-granted interpretations of institutions and institutional life. The authors compare 30 YouTube videos of PETA’s advocacy to explore pathways to effective sensegiving and sensemaking of highly disruptive issues. The findings augment the analytical synergy that exists between sensemaking and institutional analysis by unpacking the micro-level dynamics that may facilitate transformational institutional change.