Prior research has studied extensively technology mediation in services. Yet, much of this work focuses on the consumer (or customer) viewpoint and there is a scarcity of research that focuses on the service provider perspective. By extension, there is little empirical work on how service providers experience and interpret technology use that is discretionary in nature (i.e., not imposed at an organisational/firm level). This study focuses on the context of healthcare and aims to unpack healthcare service providers discretionary use of mobile applications (apps). The aim of this thesis is to gain new insights on the discretionary use of technology in professional services by investigating its multifaceted nature. In doing so, I bring together the theoretical constructs of legitimacy, institutional work, and institutional logics of neo-institutional theory, role theory, as well as theories of professional identity construction to study healthcare service providers experiences. The emergent findings are structured upon three chapters (articles) and develop specific research questions that address the overarching aims and objectives of the thesis. In essence, this research highlights three core aspects of discretionary technology use; (a) how it is experienced by service providers in regards to the logics and rules of a given institutional context (macro level), (b) how it is approached by service providers based on changes in their roles in the organisation (meso level), and (c) how it is interpreted by service providers in relation to their professional identity (micro level).

The purpose of this study was to analyze how the key staff concept is used in residential care for children and young people and which role the key staff concept plays in the organization. The study was based on semi-structured qualitative interviews with six key staff and two managers from two different residential care facilities for children and young people. The theoretical perspective used was the neo-institutional theory and Hasenfeld´s term Human service organizations. One of the conclusions of the study was that the key staff describe that they have a central role when it comes to the treatment of the children. Another conclusion showed the variety of tasks that the key staff have, like the administrative work that they do. They also have an educational role, similar to the one that parents normally have which means that they are responsible of parenting the children. They also described themselves as a link between the children and their social network. The people interviewed justified the use of the key staff concept as it gives structure for the work, security to the children and serves as a guide on how to create and maintain relationships. The institutional processes shown in the key staff concept are: the coercive, which can be seen by the obligation to follow the treatment plans. The mimetic, since it exists only a few ways to organize the work and the normative which shows that their education and/or the level of education can affect the approach that they have towards the children.

Despite the decline of collective bargaining and trade union membership in the British private sector over the past thirty years, and much academic discussion of 'marketisation' in the public sector, national collective bargaining in English local government has remained remarkably robust - as demonstrated by the Workplace Employment Relations Surveys (Millward et al. 2000). Most academic research on employment relations in the public sector has focused on 'change'. In this study I wish to examine the roots of 'continuity' and a surprising institutional survival. After three decades of reform, national collective bargaining still remains central to the local government employment relations architecture, and contrary to the 'hollowing out' thesis, national agreements are still the bulwark upon which both national and local government (and the related actors: trade unions, management, politicians) rely upon to engage in the process of joint regulation in the workplace. The study has three main objectives: Firstly, to explore why the institutional actors support or do not support the national collective bargining framework in English local government. Secondly, the extent to which national collective bargaining is supported and promoted applying an institutional theory analytical framework. Thirdly, what institutional processes explain the resilience of national collective bargaining in English local government? A sectoral study is used to explore the political dynamics that underlie the survival of national collective bargaining in English local government. This follows a 'firm in sector' methodology (Smith et al., 1990), in which a benchmark authority is compared and contrasted with eight other local authorities. The authorities were chosen by taking account of factors such as size (employing more than 2000 workers); type (metroplitan (7)) and shire (2); geography (north (2), midlands (4), south west (1) and south east (2)); and status (are they part of the national collective bargaining framework or outside of it.) The 'firm in sector' methodology allows for the examination of issues at an organisational level, building on the Workplace Employment Relations Surveys, which have focused more at a macro level. The study will drill down in detail within the benchmark authority; however, the study is nevertheless dependent on understanding the wider sectoral landscape in which the benchmark authority is located and therefore considers how its experiences compare with local authorities who chose to belong or not belong to the national collective bargaining framework. The thesis makes three contibutions. Firstly, it raises the issue of continuity within English local government employment relations and why national collective bargaining has continued to survive and remain relevant. Secondly, it considers what makes English local government different from other parts of the public sector, and what we can learn from this difference. Thirdly, it highlights the value of a new institutional perspective, as a tool for employment relations analysis.

This dissertation sought to develop a grounded theory explaining how ENGOs assess the environmental performance of firms, select target industries and firms, and influence those targeted industries and firms. A preliminary model based on research in the fields of social movements, neo-institutional theory, stakeholder theory, and corporate social performance was developed. The model contained 21 propositions: seven regarding assessment, nine regarding targeting, and five regarding influencing. Interviews were conducted with 33 representatives of five ENGOs: Natural Resources Defense Council (NRDC), Greenpeace, Environmental Defense (ED), World Resources Institute (WRI), and Union of Concerned Scientists (UCS). NRDC and WRI served as pilot studies. NRDC, Greenpeace, and ED were considered case studies for the purpose of drawing inferences about the propositions. Insufficient interviews were conducted at WRI and UCS to draw inferences from them; however, data from these interviews was included in the dissertation to the extent it provided additional support for the inferences drawn. Qualitative methods were used to analyze the data. Results regarding the propositions were presented, as well as additional findings going beyond the propositions. A grounded theory of how ENGOs assess, target, and influence firms was developed based on the results; a model to accompany the grounded theory was also developed. / Ph. D.

The number of Ombudsman offices in U.S. federal agencies rose dramatically in the 1990s. This study investigates why, despite the efforts of policymakers to force staff reductions across the federal government, Ombudsman offices continued to be established to the point that almost every agency has an Ombudsman. This study uses neo-institutionalist theory to pinpoint indicators that explain what has triggered the proliferation of external facing Ombudsmen in the federal government. The results of this historical retrospective investigation, which uses a mixed methods approach, indicate that the offices were created to ensure procedural justice and as a response to both: stakeholder pressures (since the population became more vocal and active, demanding access to the government, transparency, and accountability) and congressional mandates (such as the Administrative Dispute Resolution Act (ADRA) of 1990 and 1996 the Alternative Dispute Resolution Acts from 1998). This is consistent with neo-institutionalist expectations that organizations change as the result of pressures from forces in the environment combined with the drive for survival. As change accelerates, isomorphism occurs as organizations and agencies adopt strategies that have worked for other similar organizations in their environment. / Ph. D. / This study investigates why, despite the efforts of policymakers to force staff reductions across the federal government, external facing Ombudsman offices continued to be established in the U.S. federal government, to the point that almost every agency has an Ombudsman. This study uses neo-institutionalist theory to pinpoint indicators that explain what has triggered the proliferation of these entities. The results of this historical retrospective investigation indicate that the offices were created to ensure procedural justice and as a response to both: stakeholder pressures (since the population became more vocal and active, demanding access to the government, transparency, and accountability) and congressional mandates (such as the Administrative Dispute Resolution Act (ADRA) of 1990 and 1996 the Alternative Dispute Resolution Acts from 1998).

Yes / We examine the relationships among religious governance, especially Islamic governance quality (IGQ), national governance quality (NGQ), and risk management and disclosure practices (RDPs), and consequently ascertain whether NGQ has a moderating influence on the IGQ–RDPs nexus. Using one of the largest data sets relating to Islamic banks from 10 Middle East and North Africa (MENA) countries from 2006 to 2013, our findings are threefold. First, we find that RDPs are higher in banks with higher IGQ. Second, we find that RDPs are higher in banks from countries with higher NGQ. Finally, we find that NGQ has a moderating effect on the IGQ–RDPs nexus. Our findings are robust to alternative RDP measures and estimation techniques. These results imply that the quality of disclosure depends on the nature of the macro-social-level factors, such as religion that have remained largely unexplored in business and society research, and, therefore, have important implications for policy makers.

The aim of this study was to understand how evaluations are implemented and used in procured nursing homes for elderly. Our methodological approach consisted of a single-case study research. The case in this study was Växjö municipality. Three procured nursing homes for elderly were chosen in the municipality as examples of implementation and use of evaluation. The method for retrieving empirical data and the analyzing of it was based on triangulation. The empirical data was retrieved by semi-structured interviews with representatives from Växjö municipality and the suppliers. Empirical data was also retrieved from documents concerning the procurements and the evaluation process present in this study. The empirical data was analyzed on the basis of the neo-institutional theory and previous research that explain the implementation and use of evaluations. The result shows that evaluations are used as audit to control the suppliers and occur at three different levels in the municipality. The result also shows that the context and legitimacy of an organization affects the implementation and use of the evaluations. The result has made us question the use of evaluation at the overall level in view of the political debate at this level. The source of our doubts lies in that there are ideological differences in how politicians value procurement that may influence the use of evaluation. The ways the municipality implements and uses evaluations appear to be institutionalized.

Les récentes réformes inspirées de la nouvelle gestion publique font de la comptabilité analytique hospitalière une pièce maîtresse du financement et de la gouvernance des établissements de soins français. Les coûts unitaires par séjour alimentent en effet à la fois le processus d'élaboration des tarifs et les nouveaux instruments de gestion supposés améliorer l'efficience hospitalière. Ce travail confronte la comptabilité analytique en vigueur à une méthode basée sur les activités pour calculer les coûts unitaires d'un échantillon de 2130 interventions chirurgicales réalisées consécutivement au CHU de Montpellier en 2009. Il montre que les deux méthodes sont discordantes et que, en outre, la méthode actuelle reflète mal la complexité réelle de la prise en charge des patients au bloc opératoire. La théorie néoinstitutionnelle suggère que le développement de la comptabilité analytique hospitalière, structure organisationnelle formelle, est un processus isomorphique par lequel les établissements de santé internalisent le mythe rationalisé du calcul des coûts des séjours. Pour pouvoir répondre aux contraintes et à la complexité du réel, un certain degré de découplage entre cette comptabilité et l'activité réelle apparaît. La comptabilité analytique ne serait donc plus seulement un instrument au service de l'efficience des hôpitaux mais aussi un facteur de légitimation au sein d'un environnement fortement institutionnalisé. Dès lors se pose la question de la pertinence des tarifs et des outils de gestion alimentés par ces coûts unitaires au regard des objectifs poursuivis. / Consequently to the recent implementation of NPM-inspired reforms, cost accounting plays a key role in financing and governance of French hospitals. Calculating unit costs per hospital stay is indeed the first step in the elaboration of case-based tariffs. Moreover, unit costs are used to develop new management tools aimed at improving hospital efficiency. This study compared the current cost accounting method to an innovative activity-based one for the calculation of the unit costs of 2130 surgical procedures performed consecutively at the University Hospital of Montpellier in 2009. The results show a poor agreement between both methods. In addition, the current method fails to accurately reflect the real complexity of the management of patients in the operating room. New institutionalism suggests that the development of hospital cost accounting (a formal organizational structure) results from an isomorphic process by which health care institutions internalize the rationalized myth of unit cost calculation. In order to address the constraints and the complexity of reality, a certain degree of decoupling between the accounting and real activity occurs. Hence, cost accounting would not only be an efficiency improvement tool, but also a legitimating factor within a highly institutionalized environment. This raises the issue of the relevance of the tariffs and the management tools based on these unit costs.

La recherche en contrôle a montré que le champ hospitalier français a subi de profonds changements, notamment à travers l’introduction de l’accountability. La conformité aux pressions institutionnelles pousse les organisations à s’orienter vers de nouveaux outils et principes pour renfoncer leur légitimité externe (Power, 2003). Cette même littérature a montré que l’accountability s’infiltre dans la sphère médicale et démontre des phénomènes d’hybridation de rôle chez les médecins hospitaliers, qui sont ainsi sensibilisés aux contraintes financières (Kurunmäki, 1999). La sphère administrative ne fait pas exception et subit également des pressions coercitives. L’objectif de notre thèse est de contribuer à cette littérature en analysant les effets et les rôles de l’accountability dans le secteur hospitalier public français sur la sphère médicale. Pour analyser ces effets, nous nous ciblons sur les dispositifs d’accountability tels que le reporting d’informations (audit financier, pratique budgétaire). Pour répondre à cette problématique, notre terrain s’est focalisé sur des entretiens semi-directifs et une approche ethnographique dans un CHU de grande taille. Premièrement, à travers une étude exploratoire qualitative menée auprès de 19 directeurs administratifs financiers (représentant 19 CHU/CH), nous montrons que l’accountability au travers de l’exemple de l’audit financier amène à des changements organisationnels et sert également à « rendre des comptes » aux parties prenantes externes (Agence Régionale de Santé, banques) mais aussi internes des organisations hospitalières. Nos résultats soulignent notamment que l’audit financier renforce la légitimité de la sphère administrative vis-à-vis de la sphère médicale. Deuxièmement, nous identifions à partir d’une approche ethnographique (observation non-participante et entretiens) menée dans un CHU des acteurs administratifs spécifiques, servant de vecteurs pour l’infiltration de l’accountability dans la sphère médicale : les Techniciens d’Information Médicale. Ces acteurs administratifs ont un rôle essentiel dans l’hybridation des médecins aux compétences gestionnaires, et les sensibilisent aux logiques financières. A travers le reporting de leur activité médicale, nos résultats mettent en lumière une atténuation du clivage traditionnel observé dans la littérature entre acteurs administratifs et corps médical. Nous montrons également que l’infiltration de l’accountability par d’autres agents administratifs spécialisés, tend à sensibiliser les médecins à la réduction de surplus, de slack présent dans la prise en charge des patients. Il s’avère que cette organisation hospitalière privilégie des dispositifs d’accompagnements afin de solliciter les médecins à intégrer de nouvelles responsabilités dans l’efficience de leur rôle. Notre étude montre que les médecins tentent désormais de trouver un équilibre afin d’articuler « logique patient » et logique gestionnaire. Pour cela, nos résultats soulignent une modification des protocoles de soins, du raisonnement ainsi que des valeurs des professionnels de santé qui concilient et promeuvent désormais le médico-économique. / How are accountability measures used by actors in the administrative field? Consequently, which are the associated effects on workers in the health sector?Research in control has shown that the French hospital has undergone profound changes, notably through the introduction of accountability. Compliance with institutional pressure drives organizations to move towards new tools and principles that reinforce their external legitimacy (Power, 2003). The same literature has shown that accountability infiltrates the medical sphere and that a new phenomenon occurs: doctors adopt hybridization role in hospital. This hybridization creates doctors who are aware of financial constraints (Kurunmäki, 1999). The administrative sphere is no exception and is also subject to coercive pressure.The aim of our thesis is to contribute to this literature by analyzing the intra-organizational effects and roles of accountability on the medical logic in the French public hospital sector. To analyze these effects, we focus on accountability mechanisms such as information reporting (i.e. financial audit, budget practice). To answer this problematic, we use semi-structured interviews into French hospitals and we adopt an ethnographic approach of one large university hospital.Firstly, from a series of exploratory interviews with 19 financial administrative directors (in 19 public hospitals), we show that accountability through financial audit leads to organizational changes and also use to “give account” not only to external stakeholders (Regional Health Agency, banks) but also internal hospital organizations. Our results show that the financial audit reinforces the legitimacy of the administrative sphere towards the medical sphere.Secondly, we identify with an ethnographic approach (non-participant observation and interviews) in a UHC of specific administrative actors called “Medical coders” (i.e. actors serving as vectors for the infiltration of accountability in the medical sphere). These administrative members have a key role in hybridization of health professionals to management skills, and sensitize them to financial logics.Through the reporting of their medical activity, our results highlight an attenuation of the traditional cleavage observed in the literature between administrative members and the medical profession.Moreover, we show that the infiltration of accountability by others specialized administrative agents tends to sensitize doctors to the reduction of surplus, and the slack in the care of patients. It turns out that, the hospital organization favors support systems to make physicians integrate efficiency in their health role.Our result show that physicians are now trying to find a balance in order to articulate medical logic and managerial logic. For this, our study highlights a modification of care protocols as well as the reasoning and values of health professionals who reconcile and promote medico-economic logic.This thesis argues that the introduction of accountability within the French public hospital sector has intra-organizational effects on both the administrative and medical spheres and emphasizes that on the basis of the reduction of the organizational slack, the conflicts between medical and managerial logic are lessened.

<p>This study investigates forces and organizational structures that facilitate or hinder sustainabledevelopment to be introduced and integrated in the core activities of public institutions.Specifically, the way global national sustainable development goals find their way into thelocal curriculum and overall-encompassing strategy of a few Swedish high-schools isidentified.To facilitate the search, the study is assisted by actor-network theory to find human and nonhuman―power-brokers‖ that can ensure the adoption and continuous application of newconcepts in a school. A pre-study of several schools, consisting of explorative interviews,located and classified factors and processes of potential importance for the implementation ofactivities related to sustainable development. At the same time, the large variety ofdefinitions of sustainable development encountered was recorded.The main study expanded on the findings from the pre-study and provided a more detailedanalysis of one senior high-school (upper secondary school). Several examples oforganizational structures and other factors– macro-actors in the theoretical model - werelocated with the potential to influence the furthering of the cause of sustainable developmentin that particular school. The possibility is discussed that the school would profit fromdeveloping a common mode of communication based on exploring experiences from applyingthe many issues that can be related to sustainable development. Such an endeavor could resultin organizational change typical of a learning organization. In that case, the resilience andcapacity of the organization to handle abrupt changes in national policy would be increased aswell as the preparedness of its students – our future – to handle rapidly changing situations intomorrow‗s society.The study further suggest that a similar ―tool-box‖ of theoretical models could be applied tothe local implementation of other national issues in an institutional setting.</p>