Elizabeth Goodrick

We studied the discursive institutional work written by pharmacy leaders as part of a larger institutional project to preserve the institution of pharmacy. Our analysis of monthly editorials printed in theJournal of the American Pharmacists Associationfrom 1960 to 2003 shows how different discrete emotions were systematically incorporated in specific rhetorical argument structures over the course of an institutional project. In contrast to previous research, we show how discursive institutional work that is directed to members of the same specific social group (e.g., a profession) can vary over time in response to significant events and changes in practices of the target audience. Our longitudinal study shows that the relative frequency of argument types, the incorporation of emotion, and the content of rhetorical argumentation changed over time. We contribute to theory about the role of emotions in discursive institutional work by unpacking the role of discrete emotions and showing how such discourse evolves over time in concert with field conditions.

We employ aspects of institutional theory to explore how Accountable Care Organizations (ACOs) can effectively manage the multiplicity of ideas and pressures within which they are embedded and consequently better serve patients and their communities. More specifically, we draw on the concept of institutional logics to highlight the importance of understanding the conflicting principles upon which ACOs were founded. Based on previous research conducted both inside and outside health care settings, we argue that ACOs can combine attention to these principles (or institutional logics) in different ways; the options fall on a continuum from (a) segregating the effects of multiple logics from each other by compartmentalizing responses to multiple logics to (b) fully hybridizing the different logics. We suggest that the most productive path for ACOs is to situate their approach between the two extremes of “segregating” and “fully hybridizing.” This strategic approach allows ACOs to develop effective responses that combine logics without fully integrating them. We identify three ways that ACOs can embrace institutional complexity short of fully hybridizing disparate logics: (1) reinterpreting practices to make them compatible with other logics; (2) engaging in strategies that take advantage of existing synergy between conflicting logics; (3) creating opportunities for people at frontline to develop innovative ways of working that combine multiple logics.

Drawing on the professions and institutional literature, we develop theory about how professional work can reflect multiple institutional logics by analyzing changes in the work of pharmacists over time. Through a historical case study of U.S. pharmacists from 1852 to the present, we propose a new conceptualization of professionals and professional work as guided by a constellation of logics derived from broader society. We show that both competitive (segmenting) and cooperative (facilitative or additive) relationships among coexisting logics allow for the simultaneous influence of multiple logics on professionals and their work.

We examined the discursive processes through which a new professional role identity for registered nurses was legitimized by analysing introductory textbooks over time. We theorize five ways of rhetorically legitimizing a new professional role identity: naturalizing the past, normalizing new meanings, altering identity referents, connecting with the institutional environment, and referencing authority. In contrast to previous research focused on legitimizing new practices, we contribute to the institutional literature by showing that legitimizing a professional role identity requires the incremental development of new arguments where the past is not delegitimized. Our findings also indicate that instead of a progression from moral and pragmatic legitimacy to cognitive legitimacy, legitimizing a new role identity may focus only on moral legitimacy. Finally, our study highlights the importance of interactions between the professional task environment and the wider institutional environment as part of the process of legitimizing a professional role identity.

Using an institutional perspective, I analyze the historic circumstances surrounding the shift from a management as a vocation model to one that is scientifically based. I argue that prior to World War II, the management education field was fragmented but dominated by a vocational model in which specific trade practices and skills were taught. I trace how the institutional field shifted to embrace a model of management education that was tightly linked to empirical research. Using the Academy of Management Journal articles as a marker for this paradigm shift, I test hypotheses about the diffusion pattern of science-based concepts of management education.