What makes organizations so similar? We contend that the engine of rationalization and bureaucratization has moved from the competitive marketplace to the state and the professions. Once a set of organizations emerges as a field, a paradox arises: rational actors make their organizations increasingly similar as they try to change them. We describe three isomorphic processes-coercive, mimetic, and normative—leading to this outcome. We then specify hypotheses about the impact of resource centralization and dependency, goal ambiguity and technical uncertainty, and professionalization and structuration on isomorphic change. Finally, we suggest implications for theories of organizations and social change.

The iron cage revisited: Institutional isomorphism and collective rationality in organizational fields (Chinese Translation)

by J. Biggs and C. Tang, Maidenhead, England,
Open University Press, 2007, 360 pp., £29.99, ISBN-13: 978-0-335-22126-4

Teaching for quality learning at university

We extend research on the diffusion of corporate practices by providing a framework for studying practice variation during diffusion processes. Specifically, we theorize about how population-level mechanisms of diffusion link with organization-level mechanisms of implementation that lead to the adaptation of practices. We also identify technical, cultural, and political elements of fit (or misfit) between diffusing practices and adopters and analyze how the process of attaining fit across these elements can trigger different patterns of adaptation.

/pdf/made-to-fit-how-practices-vary-as-they-diffuse-4ow7ru8y9a.pdf

Made to Fit: How Practices Vary As They Diffuse

Editor – I am moved by Professor Allan's elegy to bygone NHS virtues of ‘calm caring and gentle pace of clinical life… and all the time in the world to deliver compassionate care' ( Clin Med October 2009 p 407). One's immediate instinct would be to say ‘Ah, but times have changed' – only

Quality of care.

The editors of this collection declare its mission to be to ‘stimulate thinking on quality-related issues and to facilitate bringing quality into the mainstream of organisational effectiveness’ (p. ix). I understand the first of these goals, but the precise meaning of the second defeats me; in a way, this is emblematic of the volume as a whole. There is some very interesting material here, and some useful guides to prior work—but there is also much to mystify and some disappointments. The book opens with an erudite and lengthy piece by Lengnick-Hall which plays with the idea that existing Total Quality (TQ) thinking and practice is premised on stable and repetitive environments and organisations, and, in these oso-turbulent times, some new thinking is required. After a brief introduction to TQ, there is a lot of discussion on the wild and intriguing world of complex adaptive systems, with allusions to many relevant literatures. This is an important issue, and has much in common with the debates which gently rage in this journal about the prospects for rational intervention in human systems—although the article ignores Beer, Checkland and Mingers and others whose perspectives would be informative. Indeed, Lengnick-Hall’s analysis focuses on the dynamic instability of human systems rather than the subtler philosophical problems about system ontology and epistemology. Nevertheless, it would be churlish to complain about such omissions when there is such a fecund supply of citations from strategy, operations and organisational analysis, and even (curiously) the poppsychology of Michael Scott Peck. The key weakness of the article is that its abstract prognostications are under-illustrated, and careful use of real examples would make the argument more convincing. Strangely, interesting examples are only a few pages away, and the article by Easton and Jarrell on the Japanese concept of Hoshin Kanri (loosely, ‘policy deployment’, a neglected element of Japanese TQ thinking which relates to the generation and cascading of plans for operational improvement) would be an excellent starting point for a discussion of Lengnick-Hall’s themes. Easton and Jarrell compare the experiences of three US organisations who each work with some variant of the technique, and then contrast these implementations with the ‘ideal’ Japanese system—a highly formal process of planning and control which seems to lie in diametric opposition to LengnickHall’s ruminations on managing complexity. Unfortunately, comparisons are drawn against how Hoshin Kanri is supposed to work in Japan rather than against empirical data from Japanese companies: a matched pair comparison would be more interesting. Nevertheless, the chapter contains some useful commentary and some illuminating insights. Elsewhere in the book, several papers give rather cursory coverage of important ideas without offering new data or sufficient depth to really push the debates forward: Greller presents an outline of feedback in TQ systems, and Knouse examines reward and recognition schemes. Both will be useful for teaching, but had the two authors collaborated one would have expected a richer set of ideas to emerge. Harvey, Buckley and Novicevic examine the important question of how TQ ‘culture’ translates across national boundaries in multi-national corporations, but also settle for ruminations and pointers to further work rather than the presentation or discussion of data. Vaughan and Renn present a systematic and informative account of what they term ‘Customer Service Citizenship Behaviour’, and reflect on how employees and customers interact with the notions of ‘organizational justice’ and the degree of support perceived to be available in the organisation in regard to customer service. The article is well-argued and thoughtful, and is worth closer reading by anyone interested in the management of services in which direct customer–employee contact is central. The final chapter, by Handfield, Calantone and Ghosh, is the most disappointing. At last, the reader is offered a chapter with data, but the methods used are suspect and the resulting conclusions are unsupported by the research. Some rather over-ambitious claims do not seem to integrate with the more thoughtful theorisations offered earlier in the book. Incidentally, the authors ignore the controversy regarding the Baldrige award, and the view of WE Deming (whom they cite approvingly) who once wrote that the award ‘transgresses all that I try to teach’. Overall, the volume is a useful addition to the literature, although it does not live up to its potential. One might hope that for subsequent volumes there might be a greater degree of integration between the contributions, and a more obvious contribution from the academic editors. It is also plagued by more typographic errors, misspelled names, and missing references than one would expect in such an expensively produced book from a respectable publisher.

https://link.springer.com/content/pdf/10.1057%2Fpalgrave.jors.2601260.pdf

Doing Critical Management Research

Background: It is well known that illicit use of methadone and buprenorphine is common among people with an opioid dependence Less notice has been taken of the fact that these substances are also used for extended periods of self-treatment, as a way of handling barriers to OST In this study, motives for self-treatment are investigated, as well as attitudes and perceived barriers to OST among drug users with an opioid dependence in Sweden Method: The study is based on qualitative research interviews with 27 opioid users who have treated themselves with methadone or buprenorphine for a period of at least three months Results: The duration of self-treatment among the interviewees varied from 5 months to 7 years Self-treatment often began as a result of a wish to change their life situation or to cut back on heroin, in conjunction with perceived barriers to OST These barriers consisted of (1) difficulties in gaining access to OST due to strict inclusion criteria, limited access to treatment or a bureaucratic and arduous assessment process, (2) difficulties remaining in treatment, and (3) ambivalence toward or reluctance to seek OST, primarily due to a fear of stigmatization or disciplinary action Self-treatment was described as an attractive alternative to OST, as a stepping stone to OST, and as a way of handling waiting lists, or as a saving resource in case of involuntary discharge Conclusion: Illicit use of methadone and buprenorphine involve risks but may also have important roles to play for users who are unwilling or not given the opportunity to enter OST A restrictive and strict rehabilitation-oriented treatment model may force many to manage their own treatment More generous inclusion criteria, a less complex admission process, fewer involuntary discharges, and less paternalistic treatment may lead to increasing numbers seeking OST Control measures are necessary to prevent diversion and harmful drug use but must be designed in such a way that they impose as few restrictions as possible on the daily life of patients

/pdf/long-term-self-treatment-with-methadone-or-buprenorphine-as-2uqtsggdjy.pdf

Long-term self-treatment with methadone or buprenorphine as a response to barriers to opioid substitution treatment : the case of Sweden

In the policy sciences the study of dissemination phenomena is usually connected to the concept of policy diffusion. In view of what has been produced using this perspective, there is every reason to develop alternative points of view. In this article we present the main features of one such alternative: the constructivist translation perspective. The translation perspective depicts policy diffusion as an imitation process, where meaning is constructed by disembedding policy ideas from their previous context and using them as models for altered political structures in a new context. The translation metaphor draws attention to the importance of a deepened problematisation of the policy concept, the personal character of the translation, and to the fact that translation processes are always tied to local contexts. Policy translation should be seen as an open, continuous process, never independent of the societal distribution of power. In this article the translation perspective is outlined and illustrated by a detailed case study of the Swedish methadone maintenance treatment programme.

The Translation Perspective as an Alternative to the Policy Diffusion Paradigm: The Case of the Swedish Methadone Maintenance Treatment

Diversion of methadone and buprenorphine by patients in opioid substitution treatment in Sweden: Prevalence estimates and risk factors

This thesis discusses an alternative to the conventional policy diffusion approach, i.e. the social constructivist translation perspective. Within the translation perspective, policy diffusion is defined as a process where meaning is constructed by temporally and spatially disembedding policy ideas from their previous context and using them as models for policy change in a new context. This brings attention to the importance of a deepened problematization of the policy concept, the actor-dependent character of translation, and to the fact that translation processes are always tied to a local context. Translation should be seen as open, continuous processes that never take place independently of the societal distribution of power.

In the thesis a distinction is made between political and practical translation. Political translation processes takes place at field level in connection with authoritative decision-making, and are a question of how policy ideas are adapted to the given local political context. This discussion is followed by the creation of an analytical framework for the study of political translation. The framework combines concepts from Kingdon’s version of the garbage-can model with concepts from neo-institutional theories.

The functioning of the political translation framework is empirically illustrated by way of two case studies. The first study traces the Swedish methadone issue, from the introduction of the methadone maintenance treatment in 1966 to the end of 1980s when this form of treatment gained wider acceptance. The second study covers the Swedish family doctor issue, from the launch of the proposal by the Swedish Liberal Party in the election campaign of 1976 to the abolition of the Family Doctor Act in 1995.

http://lup.lub.lu.se/search/ws/files/4711594/1693272.pdf

Policyspridning som översättning. Den politiska översättningen av metadonbehandling och husläkare i Sverige

Opioid substitution treatment (OST) is still controversial, despite positive results. The issue of diversion to the illicit drug market is a cornerstone in the criticism typically voiced against the treatment. Little research is available concerning how professionals who work in OST view the issue of diversion. In this article, we discuss existing ideas and attitudes toward diversion of methadone and buprenorphine among OST staff in Sweden. The article is based on semi-structured interviews with 25 professionals working in eight OST-programs in southern Sweden. Diversion was seen as a deleterious phenomenon by the interviewees. Three problematic aspects were highlighted: medical risks in the form of overdose fatalities and the recruitment of new opiate/opioid users; negative consequences for the legitimacy of OST; and moral objections, since diversion means that the patients remain in a criminal environment. However, positive aspects were also highlighted. Illicit methadone or buprenorphine is perceived as safer than heroin. In this way, diversion can fulfill a positive function; for instance, if there is a shortage of access to regular treatment. Patients who share their medication with opioid-dependent friends are seen as less culpable than those who sell to anyone for money.

Björn Johnson

Papers

Long-term self-treatment with methadone or buprenorphine as a response to barriers to opioid substitution treatment : the case of Sweden

The Translation Perspective as an Alternative to the Policy Diffusion Paradigm: The Case of the Swedish Methadone Maintenance Treatment

Diversion of methadone and buprenorphine by patients in opioid substitution treatment in Sweden: Prevalence estimates and risk factors

Policyspridning som översättning. Den politiska översättningen av metadonbehandling och husläkare i Sverige

Diversion of Methadone and Buprenorphine from Opioid Substitution Treatment: A Staff Perspective