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)

This paper analyzes, from a cross-national perspective, publicized incidents of alleged wrongdoing on the part of nongovernmental organizations (NGOs). Data were derived from daily, weekly, or monthly newspapers and special nonprofit newsletters accessible through websites. Analysis of media reports of “scandals” involving NGOs was conducted to identify issues and trends in governance and management problems associated with this sector. The paper focuses on NGOs involved in the financing or delivery of health and human services. After highlighting some of the precedent-setting cases of NGO improprieties in the United States during the 1990s, prominent global cases of wrongdoing during the period 1998–2000 are reviewed. The underlying problems that allowed these cases to occur and their implications regarding NGO credibility and public trust are identified, and strategic options for enhancing accountability presented.

Very Public Scandals: Nongovernmental Organizations in Trouble

Background: The voluntary sector has long been recognised as making an important contribution to individual and community health. In the UK, however, the links between primary health care services and the voluntary and community sector are often underdeveloped. Social prescribing is an innovative approach, which aims to promote the use of the voluntary sector within primary health care. Social prescribing involves the creation of referral pathways that allow primary health care patients with non-clinical needs to be directed to local voluntary services and community groups. Such schemes typically use community development workers with local knowledge who are linked to primary health care settings. Social prescribing therefore has the potential to assist individual patients presenting with social needs to access health resources and social support outside of the National Health Service. Aim: The aim of this paper is to explore the concept of social prescribing and discuss its value as a public health initiative embedded within general practice. Methods: The rationale for social prescribing and existing evidence are briefly reviewed. The paper draws on a case study of a pilot social prescribing scheme based in general practice. Data collected during the development, implementation and evaluation of the scheme are used to illustrate the opportunities and limitations for development in UK primary health care. Findings: The potential for social prescribing to provide a mediating mechanism between different sectors and address social need is discussed. The paper argues that social prescribing can successfully extend the boundaries of traditional general practice through bridging the gap between primary health care and the voluntary sector. The potential for wider health gain is critically examined. The paper concludes that social prescribing not only provides a means to alternative support but also acts as a mechanism to strengthen community–professional partnerships. More research is needed on the benefits to patients and professionals.

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Can social prescribing provide the missing link

There are increasing and multiple pressures on nonprofit organizations to demonstrate excellence in performance. Although there is a growing literature on the various approaches to performance improvement taken by nonprofits, little is known about the processes involved in the adoption and implementation of specific approaches. This article is about the adoption and use of one approach to performance improvement, quality systems, in the U.K. nonprofit sector. We report findings about factors that encourage nonprofits to adopt quality systems. We also analyze the distinctive challenges of implementing quality approaches in a nonprofit sector context and suggest critical success factors. The article concludes with a discussion of the organizational and policy implications of applying the management concepts of quality and performance to the nonprofit sector.

Improving performance? The adoption and implementation of quality systems in U.K. nonprofits

User Involvement in Change Management: A Review of the Literature

The implementation of the NHS and Community Care Act, the greatly increased use of voluntary sector providers and the switch from grants to contracts form the background to this study. The article brings together two main themes in current social policy debate in the personal social services: regulation and quality assurance. Contracts are seen as increasingly significant forms of input, process and output regulation, although their impact depends upon their type and specificity and upon the capacity of purchasers to monitor contract compliance, and the sanctions available to them. Clarification of the conceptual framework is followed by the report of an empirical study of the position in a single large county. The results from this study are then discussed in the context of evidence from other parts of Britain and the United States. The main issues identified in this discussion are competition, consumer choice, user involvement, the dangers of excessive and inappropriate regulation, the importance of trust and risk, and the relationship of resources to quality.

Regulating for Quality in the Voluntary Sector

The research on which this paper is based is part of a wider study of quality assurance and the voluntary sector. The focus of this paper is on complaints procedures, as part of quality assurance mechanisms, where voluntary agencies are the contracted service providers. The authors argue that, with the introduction of contracting and particularly with its further development, the way in which complaints mechanisms currently operate will need to be revised if they are to be an effective part of the quality assurance process.

Complaining Our Way to Quality: Complaints, Contracts and the Voluntary Sector

Privatisation in four European countries: Comparative studies in government-third sector relationships

Lester M. Salamon and Helmut K. Anheier (eds.), Defining the Nonprofit Sector: A Cross-national Analysis , Manchester University Press, Manchester, 1997, xiii + 536 pp., £50.00 hard, £16.99 paper.

Norman Johnson

Papers

Regulating for Quality in the Voluntary Sector

Complaining Our Way to Quality: Complaints, Contracts and the Voluntary Sector

Privatisation in four European countries: Comparative studies in government-third sector relationships

Lester M. Salamon and Helmut K. Anheier (eds.), Defining the Nonprofit Sector: A Cross-national Analysis , Manchester University Press, Manchester, 1997, xiii + 536 pp., £50.00 hard, £16.99 paper.