Exploring the Role of Enabling Bureaucracy for the Institutionalization of a Boundary-Spanners in US and UK Healthcare

Co-hosted by Sydney Employment Relations Research

Abstract

This seminar will focus on the role of coercive isomorphism in the institutionalization of a new role in health and social services. Debates on the development and institutionalization of organizational innovations have been bifurcated between scholars who have argued that organizations require autonomy to be creative in adopting innovations while others have argued that rule-setting, either at organizational level or through the state based on coercive isomorphism, is more effective in diffusing organizational innovations. Based on over 285 interviews and other qualitative data comparing the efficacy of developing and institutionalizing a new role intended to span the boundaries of health and social services in the USA and UK, this research argues that the institutionalization of organizational innovations depends on enabling bureaucracy that provides organizations with the knowledge and financial incentives to institutionalize an innovation most successfully. Furthermore, the manifestation of the required enabling bureaucracy depends on the character of the macro-institutional environment: where this environment is inhibitive, meso-level policy programs are required to provide the support of enabling bureaucracy; by contrast, where the macro-institutional environment is enabling, meso-level policy programs are less required and can even become inhibitive. This research advances our understanding of the role of enabling bureaucracy as a specific form of coercive isomorphism that acts at both meso- and macro-levels.

Presenter

Nick Krachler is a Senior Lecturer in Human Resource Management and the Academic Director for Healthcare Leadership at King's Business School, King's College London. He received his PhD and an MSc from Cornell University with specializations in human resource management, comparative employment relations, and work and occupations sociology. He also received an MSc in Political Sociology from the London School of Economics. His research program studies mechanisms of institutional change in the care economy, including workforce innovation through new roles; market-making versus collaboration; and the regulation of work and employment. Nick has comparatively studied such change in the US, the UK and several European countries. Recently, he has also studied the influence of the pandemic on employee wellbeing in UK healthcare.