The Interplay of Conflicting and Complementing Institutional Logics in Sustainability Practices.

The impact of institutional environments on sustainability is well documented in the international business literature. However, how multiple and occasionally conflicting institutional logics shape sustainability as it is practiced by individuals across countries remains undertheorized. Our study contributes to this line of research by examining how multiple institutional logics inform the comprehension of sustainability practices in two high-hazard organizations in the Republic of Serbia and Canada. In doing so, our findings explicate three multi-level mechanisms - pulling down (1st level), relating (2nd level), and aligning (2nd level) - through which individuals in these organizations across two countries construct a localized understanding of sustainability. In both countries, individuals pull down elements of the state and organizational logics to construct meso-level logics they use to comprehend sustainability practices, albeit differently. In Serbia, due to the conflict between the current state logic and dominant high-hazard organizational logic, individuals pull down elements of the high-hazard organizational logic and the enduring legacy state logic to construct a community logic and align sustainability practices with it. In Canada, the state logic complements the high-hazard organizational logic, resulting in individuals pulling down elements of both logics to construct the professional logic and aligning their practice with it. In both countries, due to the dominance of the high-hazard organizational logic, individuals relate their practices to the well-being of others. Based on our comparative case analysis, we create a general model and a country-specific model depicting how individuals embed multiple institutional logics into their sustainability practices.

The emergence of a value transformation strategic initiative in the healthcare context.

How do strategic initiatives emerge? Despite rich tradition in the emergent strategy literature-focused on significant organizational change-surprisingly little insight exists on the dynamics of a new initiative's emergence. This is particularly relevant in healthcare because of the increasing pressure to implement value transformation models focused on maximizing value at the point of care. The value transformation model prioritizes the decisions of the frontline providers and thus requires their expertise and commitment for the model's implementation and success. In our case study of a dental organization, "OptiPlex," we trace the emergence of a value transformation strategic initiative from its origination at the point of care to its formalization into the organization's strategic plan. Using qualitative methods, we identify three phases in the emergence of the value transformation strategic initiative, each embodying different championing behaviors necessary for the initiative's emergence. In doing so, we explicate the nature of these behaviors and how they link up across the organizational hierarchy to drive the value transformation strategic initiative's emergence and implementation.

Shared accountability in distributed leadership for improved healthcare access: a study of a US dental institution.

PURPOSE: Accountability within distributed leadership (DL) is critical for DL to drive positive outcomes in health services organizations. Despite this, how accountability emerges in DL is less clear. This study aims to understand how accountability emerges in DL so that distributed leaders can drive improvements in healthcare access - an increasingly important outcome in today's health services environment. DESIGN/METHODOLOGY/APPROACH: The authors use an instrumental case study of a dental institution in the USA, "Environ," as it underwent a strategic change to improve healthcare access to rural populations. The authors focused on DL occurring within the strategic change and collected interview, observation and archival data. FINDINGS: The findings demonstrate accountability in DL emerged as shared accountability and has three elements: personal ownership, agentic actions and a shared belief system. Each of these was necessary for DL to advance the strategic change for improved healthcare access. PRACTICAL IMPLICATIONS: Top managers should be cognizant of the emergence processes driven by DL. This includes enabling pockets of employees to connect, align and link up so that ideas, processes and practices can emerge and allow for shared accountability in DL. ORIGINALITY/VALUE: The overarching contribution of this research is identifying shared accountability in DL and its three elements: personal ownership, agentic actions and a shared belief system. These elements serve as a platform to demonstrate "how DL works" in a healthcare organization.