Logic fluidity: How frontline professionals use institutional logics in their day-to-day work

Abstract

<jats:title>Abstract</jats:title> <jats:p>This article aims to gain a better understanding on micro processes of how frontline professionals use institutional logics in their day-to-day work. It contributes to the growing literature on the dynamics between institutions and the professional frontline. To further develop this field of study, a conceptual framework is presented that integrates institutional logics, vocabularies of practice, and narratives as central concepts. By adopting a composite narrative approach and identifying vocabularies of practice, the article interprets how frontline professionals make use of different logics to make sense of a new principle introduced in their professional field. Findings are based on a case study of professional patient collaboration in healthcare. The article composes five narratives that act as vehicles through which healthcare professionals use five logics: a medical professional logic, managerial logic, commercial logic, consultation logic, and patient-centeredness logic. It argues that frontline professionals use vocabularies of practice to assemble narratives that help them to navigate between a plurality of logics. It further shows that professionals move fluently from one narrative to another, critiquing the ideas of adherence to a dominant logic and conflict solving. The article finalizes with a discussion that advocates for a process studies perspective and a stronger focus on micro processes in research on professional performance in the context of institutional plurality.</jats:p>

Organizing professional work and services through institutional complexity – how institutional logics and differences in organizational roles matter

“…Andersson and Liff, 2018; Bévort and Suddaby, 2016; McPherson and Sauder, 2013; Reay et al, 2017; Smets and Jarzabkowski, 2013; Smets et al, 2015; Voronov et al, 2013). Recent studies have disclosed how professionals employ multiple logics pragmatically and creatively at the operational level; for instance, to give meaning to patient collaboration in their professional everyday work (ten Dam and Waardenburg, 2020), in co-opting others’ logics to facilitate vertical collaboration within professional organizations (Andersson and Liff, 2018), in manoeuvring positionally within an organizational hierarchy (Currie and Spyridonidis, 2016), in using multiple logics flexibly to frame performance in different ways in accordance with various contextual expectations (Smets et al, 2015; Voronov et al, 2013) or in negotiations with other professional groups for reaching decisions in courtrooms (McPherson and Sauder, 2013). As such, multiple logics are not challenges to be managed but resources or tools that reflexive, knowledgeable individual actors can use for strategic and tactical purposes in their performance of professional work.…”

Bureaucratie de guichet et hybridité au ministère des Affaires municipales et de l'Habitation

“…(2018) ont étudié l'impact de la position structurelle des acteurs sur la réponse fournie quant à l'hybridité. Pour leur part, Ten Dam et Waardenburg (2020) se sont intéressés aux professionnels en première ligne. Ils ont trouvé que ces derniers concevaient la collaboration avec le patient de cinq façons distinctes et que celles‐ci permettaient de donner du sens à leur travail.…”

Patient Flow or the Patient’s Journey? Exploring Health Care Providers’ Experiences and Understandings of Implementing a Care Pathway to Improve the Quality of Transitional Care for Older People

“…We did not, however, perform formal member checking, which could have potentially further increased credibility (Birt et al, 2016). Participant observation required the researcher to balance closeness and distance to the field (Spradley, 1980). The researcher's presence at the quality collaborative meetings may also have influenced individuals because of social desirability bias (Maxwell, 2013).…”