Processing Institutional Change in Public Service Provision

With the proliferation of New Public Management (NPM) worldwide, public service providing agencies are increasingly expected to operate in a business-like manner and exposed to ‘competing institutional logics’. Exploring the German hospital sector, this article shows that this is processed within two areas of collective action simultaneously: at enterprise-level and at the regulatory infrastructure of the organizational field. In both places, ‘institutional work’ takes place, albeit differently. With emerging tensions, trial-and-error strategies (deployed by individual hospitals) and mitigating (regulatory) measures engender a nervous cohabitation of the two logics, endangering potentially the sector’s public mission in the long term. Copyright Springer Science+Business Media New York 2013