In this paper we develop a framework for comparing changes in the management of public hospitals across different national health systems, drawing on insights from institutional theory. Using a range of secondary sources we show how one particular form of hospital management, pioneered originally at the Johns Hopkins Hospital in Baltimore, has been translated differently in four health systems: England, Denmark, Italy and France. This analysis builds on the notion of editing rules, which derive from the institutional context, and illustrates how these rules broaden our understanding of variable translations of global templates for hospital management. The paper concludes by highlighting wider implications for theory and policy.

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A central motif of health reforms around the world has been the drive to persuade doctors and other clinical professionals to become more actively engaged in the management of services. Examples include moves to extend the commissioning role of primary care doctors (such as general practitioners in the UK) and the introduction of ‘clinical directorates’ in secondary care. This strategy has been seen as a means of controlling professionals, turning ‘poachers into game keepers’, especially with regard to resource allocation. However, there is also a mounting body of evidence pointing to how clinical leadership may play a role in stimulating quality improvement and new innovations inservice design, with positive consequences for patient safety and satisfaction (1). Focusing on the top 100 hospitals in the US Goodall (2) finds a strong positive association between the ranked quality of hospitals and whether the chief executive officer was a clinician. A survey of 1200 hospitals across seven countries (UK, US, Germany, France, Italy,Canada and Sweden) conducted by McKinsey and LSE also finds that clinically qualified managers improve both the effectiveness of management decisions and clinical performance of hospitals overall (3).

Managing resources and tensions at the front line is crucial for organizational success. To advance our understanding of how frontline employees turn assets into useful resources under tensions, we draw on research on resourcing and practices of responding to paradoxical tensions. Our ethnographic study of employees in a multinational retail fashion company finds three resourcing practices – situational reframing, organizational preframing and institutional deframing – that enable frontline employees to balance tensions. We contribute to both the resourcing perspective and to research on individuals’ responses to paradoxical tensions, first, by identifying the varying scopes of meaning (situational, organizational or institutional) that employees infuse potential resources with; second, by extending the notion of framing to understand how resourcing is accomplished interactively in tension-laden situations; and third, by explaining how employees’ construction of tensions is related to their dynamic moves between resourcing practices.

Entrepreneurship has become an important issue in contemporary management practice and research. While there is much debate about the benefits of entrepreneurial behavior, its obvious pervasion in many areas of life remains largely unexplored. It is this persuasive power that inspired us to conceptualize entrepreneurship as a dominant institution in modern Western societies. In contrast to most institutional approaches which draw on entrepreneurial behavior for studying institutional change, our approach focuses on the societal preconditions for the dominance of entrepreneurship. We outline how entrepreneurship is manifested in ideals of modern Western societies, discourse and techniques of control and how individuals who are socialized into an entrepreneurial society, contribute to legitimize entrepreneurship and further its pervasiveness. Our analysis provides a framework for research on differences in the valuation of entrepreneurial behavior across societal settings, as well as for the study of mechanisms for the deepening of taken for-grantedness of entrepreneurship.

Herding cats-Future professionals' expectations of attractive employers ** Professionals, like business consultants, have been described as crucial for modern knowledge-intensive organizations, but they are not always thought to be easy to manage or to attract. This might be due to a need for autonomy and commitment that is aimed more at the profession than at their employer. For their recruitment it is thus important for modern organizations like professional service firms (PSFs) to know what expectations applicants who are future professionals have regarding human resource (HR) principles and programmes. We refer to the institutional logics perspective to gain insights whether, in the context of PSFs, applicants' expectations are associated with the logic of the profession, the corporation or the family. This article describes a discrete choice experiment conducted to analyse the influence of HR attributes in job advertisements used by PSFs to attract business management students. We use a hierarchical Bayesian analysis to carry out the conjoint analysis, as it enabled us to measure the relative importance of attributes on an individual level. The results show that first required job-related attitudes and then company and job description are the most important features of a job advertisement. Our study also indicates that future professionals simultaneously draw on different institutional logics when deciding which employer is attractive.

Purpose The purpose of this paper is to study the antecedents of the adjustment of expatriate children to foreign destinations. This process of adjustment is partly explained by the transformation of their identities while abroad. Design/methodology/approach This research used a mixed method approach. First, to identify the factors that affect expatriate children’s adjustment, 36 interviews were conducted. An ad hoc survey was then developed, distributed and analyzed, in order to determine the factors that really help or inhibit the adjustment of expatriate children. Findings Expatriate children adapt quite well, and they are mostly interested in fitting in with other children, whether locals or other internationals. Some relevant factors found to relate to adjustment were children’s social skills, their academic self-efficacy, the academic level of the school in the host country and the support received from their families. Practical implications Companies could use the results of this study in their cross-cultural training of expatriates traveling with families. Originality/value This is the first study to examine a rather comprehensive set of factors that affect the adjustment of expatriate children, using a mixed methods approach.

The question how individuals experience and respond to competing logics has recently received intensified attention, but current theories remain incoherent, and research is restricted to situations with stable constellations of logics. To elaborate on these issues, we use insights from identity control theory, and develop a model for individuals’ considerations during interactions characterized by institutional complexity. We argue that individuals engage with several logics, unless these logics are related to conflicting identities that become salient simultaneously. Conflicting identities encourage individuals to choose the logic that is linked to the identity higher up in their “self.” In situations where the conflict is not clear from the beginning, individuals may distance themselves from the logic that is related to a lower level identity, to maintain self-esteem. This article contributes to research by clarifying the competing perspectives on individual considerations when there are multiple institutional logics and extends research to dynamically evolving situations.