Sub-theme 23: Public Sector Reforms and Organizational Responses: Comparing Universities and Hospitals

Rómulo Pinheiro
University of Agder and Agderforskning, Norway
Francisco O. Ramirez
Stanford University, USA
Karsten Vrangbæk
University of Copenhagen, Denmark

Call for Papers

So far, most research inquiries in the realms of public health (cf. Blomgren & Sahlin-Andersson, 2009; Burau & Vrangbæk, 2008) and higher education (cf. Gornitzka et al., 2005; Vukasović et al., 2012) have tended to look at sector-wide reforms and respective organizational responses in isolation, without necessarily taking into account parallel developments occurring across these two key sectors of society/economy. This, we argue, creates the notion that the above sectors are rather unique in nature, and that their core organizational actors (i.e. public universities and hospitals) are somewhat "special", and therefore can only be understood with reference to the historical trajectories, and the vested interests and strategic agendas of stakeholder groups within each sector. Although this is an important starting point, we contend that it is time to look at developments beyond a given (public) sector of the economy and enable comparative dimensions emanating from cross-sectorial analysis to come to the fore. This, we claim, will contribute not only with new empirical and conceptual insights, but, most importantly, has the potential for reimagining, rethinking and reshaping future scholarship across the above sectors and public sector research as a whole.

In this sub-theme, we are particularly interested in investigating the complex interplay between a set of core dimensions underpinning current reform processes across the publicly-run and funded health care and higher education sectors, namely:

  • Central (state driven) vs. decentralized or bottom-up reform processes (Sabatier, 1986)
  • The complex interplay between change (adaptation) and continuity (inertia) (Ramirez & Christensen, 2012; Streeck & Thelen, 2005)
  • Mechanisms of strategic response (agency); contestation, de-coupling, local translation, symbolic compliance, etc. (Oliver, 1991; Greenwood et al., 2008)
  • Clashes of institutional logics, and the ways in which these co-exist within a given field/sector, organization, and/or inter-organizational arrangements (Greenwood et al., 2011)
  • The role played by internal and external stakeholders, with respect to resource dependencies (Pfeffer & Salancik, 2003) and legitimacy (Deephouse & Suchman, 2008);
  • The importance attributed to similar organizations (nationally and internationally) when it comes to widely adopted organizational archetypes (Greenwood and Hinings 1993) or blueprints for organizing and coordinating activities;
  • The adoption, adaptation, and consequent abandonment of rules, structures, procedures, logics, etc., at the micro, meso and/or macro levels (Colyvas and Powell 2006)
  • The relevance of deeply internalized (taken for granted) norms, values, identities and behaviors, and their consequent effects on change dynamics (Dacin & Dacin, 2008)
  • Governing by measurement, ranking, and/or benchmarking (Dorsch & Yasin, 1998)
  • Stronger (economic) incentives to improve quality and enhance accountability (Stensaker & Harvey, 2011).

We invite papers comparing the two sectors as well as papers dealing with each sector, written by researchers with an interest in developing theoretical contributions of relevance to comparative analysis of the two sectors.



Blomgren, Maria & Kerstin Sahlin-Andersson (2007): 'Quests for Transparency: Signs of a New Institutional Era in the Health Care Field.' In: Tom Christensen & Per Lægreid (eds.): Transcending New Public Management. The Transformation of Public Sector Reform. Aldershot: Ashgate, pp. 155–178.
Burau, Viola & Karsten Vrangbæk (2008): 'Institutions and non-linear change in governance: reforming the governance of medical performance in Europe.' Journal of Health Organization and Management, 22 (4), pp. 350–367.
Colyvas, Jeannette A. & Walter W. Powell (2006): 'Roads to Institutionalization: The Remaking of Boundaries between Public and Private Science.' Research in Organizational Behavior, 27, pp. 305–353.
Dacin, M. Tina & Peter A. Dacin (2008): 'Traditions as institutionalized practices: Implications for Deinstitutionalization.' In: Royston Greenwood, Christine Oliver, Kerstin Sahlin-Andersson & Roy Suddaby (eds.): The SAGE Handbook of Organizational Institutionalism. London: SAGE Publications, pp. 327–351.
Deephouse, David L. & Mark Suchman (2008): 'Legitimacy in Organizational Institutionalism.' In: Royston Greenwood, Christine Oliver, Kerstin Sahlin-Andersson & Roy Suddaby (eds.): The SAGE Handbook of Organizational Institutionalism. London: SAGE Publications, pp. 49–77.
Gornitzka, Åse, Maurice Kogan & Alberto Amaral (2005): Reform and Change in Higher Education: Analysing Policy Implementation. Dordrecht: Springer.
Greenwood, Royston & C.R. Hinings (1993): 'Understanding Strategic Change: the Contribution of Archetypes.' Academy of Management Journal, 36 (5), pp. 1052–1081.
Greenwood, Royston, Christine Oliver, Kerstin Sahlin-Andersson & Roy Suddaby (eds.) (2008): The SAGE Handbook of Organizational Institutionalism. London: SAGE Publications.
Greenwood, Royston, Mia Raynard, Farah Kodeih, Evelyn R. Micelotta & Michael Lounsbury (2011): 'Institutional Complexity and Organizational Responses.' The Academy of Management Annals, 5 (1), pp. 317–337.
Oliver, Christine (1991): 'Strategic responses to institutional processes.' Academy of Management Review, 16 (1), pp. 145–179.
Pfeffer, Jeffrey & Gerald R. Salancik (2003): The External Control of Organizations: A Resource Dependence Perspective. Stanford, CA: Stanford Business Books.
Ramirez, Francisco O. & Tom Christensen (2012): 'The formalization of the university: rules, roots, and routes.' Higher Education, 1-14. doi: 10.1007/s10734-012-9571-y,
Sabatier, Paul A. (1986): 'Top-Down and Bottom-Up Approaches to Implementation Research: a Critical Analysis and Suggested Synthesis.' Journal of Public Policy, 6 (1), pp. 21–48.
Stensaker, Bjørn & Lee Harvey (2011): Accountability in Higher Education: Global Perspectives on Trust and Power. New York: Taylor & Francis.
Streeck, Wolfgang & Kathleen Thelen (2005): Beyond Continuity. Institutional Change in Advanced Political Economies. Oxford: Oxford University Press.
Vukasović, Martina, Peter Maassen, Monika Nerland, Rómulo Pinheiro, Bjørn Stensaker & Agnete Vabø (2012): Effects of Higher Education Reforms: Change Dynamics. Rotterdam: Sense Publishers.


Rómulo Pinheiro is Associate Professor in Public Policy and Administration at the University of Agder, Visiting Professor at the University of Oslo and Senior Research at Agderforskning, Norway. His research interests include the transformation of universities as strategic actors and their societal role, in addition to organizational theory, regional science, and science and innovation studies.
Francisco O. Ramirez is Professor of Education and (by courtesy) Sociology and Associate Dean for Faculty Affairs (Graduate School of Education) at Stanford University, USA. His research interests include: universities as institutions and organizations; education, science and development; globalization, citizenship, and education; and the effects of world society.
Karsten Vrangbæk is Professor in Political Science and Public Health at the University of Copenhagen, Denmark. His research interests encompass different aspects of healthcare reforms and comparison of healthcare systems, values in the public sector, and public sector reforms and management.