Contradicting logics in everyday practice

Area of Science:

• Healthcare Management
• Organizational Studies
• Nursing Home Administration

Background:

• Performance management in healthcare challenges traditional professionalism.
• Understanding the practical implementation of these competing logics is crucial for effective healthcare delivery.

Purpose of the Study:

• To investigate how managers and nurses in Norwegian nursing homes interpret and implement performance management and professionalism as contradicting logics.
• To explore the coping strategies employed in everyday practice within this context.

Main Methods:

• Ethnographic study utilizing 18 semistructured interviews and 100 hours of observation.
• Analysis based on the institutional logic perspective, employing qualitative content analysis and NVIVO software.
• Focus on identifying patterns of activities and interactions reflecting coping strategies for handling contradicting logics.

Main Results:

• Three coping strategies were identified: adjusting professionalism to standards, reinforcing professional flexibility, and strategic adoption of documentation.
• Observed patterns indicate the creation of new organizational structures enabling the coexistence of contradicting logics.
• The study highlights the complex dimension of governing processes in nursing homes through managing tensions between logics.

Conclusions:

• Managers and nurses actively reshape internal organizational structures to navigate the complexities of coexisting performance management and professionalism logics.
• The findings offer new insights into the practical adaptation of organizational structures in response to competing professional and managerial demands in nursing homes.