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The role of institutional entrepreneurs in reforming healthcare
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Lockett, Andy, Currie, Graeme, Waring, Justin, Finn, Rachael and Martin, Graham P.. (2012) The role of institutional entrepreneurs in reforming healthcare. Social Science & Medicine, Vol.74 (No.3). pp. 356-363. ISSN 0277-9536
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Official URL: http://dx.doi.org/10.1016/j.socscimed.2011.02.031
Abstract
We draw on institutional entrepreneurship theory to analyse the dynamics of institutional change in a healthcare context. The focus of our interest is in the relationship between an institutional entrepreneur’s ‘subject position’, defined in terms of their structural and normative legitimacy within the existing institutional landscape, and the nature of the change enacted. We develop this approach through an examination of the implementation of new pathways for cancer genetic services within the English National Health Service. Employing comparative case analysis we show that those who have limited structural legitimacy under prevailing conditions are most willing to engender change, but also least able; whereas those who have strong structural legitimacy are most able, but often least willing. However, those who are able rhetorically to combine a balance of structural and normative legitimacy are most able to produce change. In doing so, we demonstrate the importance of the concept of institutional entrepreneurship to understand healthcare reform.
| Item Type: | Journal Article | ||||
|---|---|---|---|---|---|
| Subjects: | H Social Sciences > H Social Sciences (General) | ||||
| Divisions: | Faculty of Social Sciences > Warwick Business School > Centre for Small & Medium-Sized Enterprises Faculty of Social Sciences > Warwick Business School > Entrepreneurship, Innovation & Management Faculty of Science > Centre for Scientific Computing Faculty of Social Sciences > Warwick Business School |
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| Journal or Publication Title: | Social Science & Medicine | ||||
| Publisher: | Elsevier | ||||
| ISSN: | 0277-9536 | ||||
| Official Date: | February 2012 | ||||
| Dates: |
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| Volume: | Vol.74 | ||||
| Number: | No.3 | ||||
| Number of Pages: | 8 | ||||
| Page Range: | pp. 356-363 | ||||
| Identification Number: | 10.1016/j.socscimed.2011.02.031 | ||||
| Status: | Peer Reviewed | ||||
| Publication Status: | Published | ||||
| Access rights to Published version: | Restricted or Subscription Access | ||||
| URI: | http://wrap.warwick.ac.uk/id/eprint/43964 |
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