Toward an institution-based paradigm

As part of the broader intellectual movement throughout the social sciences that is centered on new institutionalism, the institution-based view has emerged as a leading perspective in the strategic management literature. This article (1) traces the emergence of the institution-based view, (2) reviews its growth in the last two decades, and (3) responds to three of its major criticisms. We also identify four promising research directions—deglobalization and sanctions, competitive dynamics, hybrid organizations, and corporate social responsibility. Overall, we demonstrate that the thriving research on institutions has culminated in an institution-based paradigm, which has significant potential for future growth.

Hybrid Organizations in Health Systems: The Corporatization of Malaysia's National Heart Institute

Health system reforms across high- and middle-income countries often involve changes to public hospital governance. Corporatization is one such reform, in which public sector hospitals are granted greater functional independence while remaining publicly owned. In theory, this can improve public hospital efficiency, while retaining a public service ethos. However, the extent to which efficiency gains are realized and public purpose is maintained depends on policy choices about governance and payment systems. We present a case study of Malaysia's National Heart Institute (IJN), which was created in 1992 by corporatization of one department in a large public hospital. The aim of the paper is to examine whether IJN has achieved the goals for which it was created, and if so, whether it provides a potential model for further reforms in Malaysia and other similar health systems. Using a combination of document analysis and key informant interviews, we examine key governance, health financing and payment, and equity issues. For governance, we highlight the choice to have IJN owned by and answerable to a Ministry of Finance (MOF) holding company and MOF-appointed board, rather than the Ministry of Health (MOH). On financing and payment, we analyze the implications of IJN's combined role as fee-for-service provider to MOH as well as provider of care to private patients. For equity, we analyze the targeting of IJN care across publicly-referred and private patients. These issues demonstrate unresolved tensions between IJN's objectives and public service goals. As an institutional innovation that has endured for 28 years and grown dramatically in size and revenue, IJN's trajectory offers critical insights on the relevance of the hybrid public-private models for hospitals in Malaysia as well as in other middle-income countries. While IJN appears to have achieved its goal of establishing itself as a commercially viable, publicly owned center of clinical excellence in Malaysia, the value for money and equity of the services it provides to the Ministry of Health remain unclear. IJN is accountable to a small Ministry of Finance holding company, which means that detailed information required to evaluate these critical questions is not published. The case of IJN highlights that corporatization cannot achieve its stated goals of efficiency, innovation, and equity in isolation; rather it must be supported by broader reforms, including of health financing, payment, governance, and transparency, in order to ensure that autonomous hospitals improve quality and provide efficient care in an equitable way.

Sport for Development and COVID-19: Responding to Change and Participant Needs

As COVID-19 hit in the Spring of 2020, substantial challenges began to emerge for individuals around the world. In this empirical piece we examine the impacts of COVID-19 in the sport for development (SFD) context, as it relates to the individual participant, as well as how those individual needs impact the organization itself. This case study, explores a hybrid SFD organization, Highway of Hope (HOH) in Kenya, and the actions of local leadership in response to emergent participant needs during the onset of the pandemic. Using a case study approach, involving journal responses from program youth participants and local program leadership, along with other field and meeting notes, themes were generated to highlight the most salient challenges and experiences faced by individual participants, as well as the means of addressing those challenges by HOH. Participant journals consisted of both positive and negative thematic findings. Positive experiences included Family Time, Rest, and Practicing Better Hygiene, while negative experiences revolved around Restriction of Activity, and Difficulty at Home. The overall impact on participant lives were expressed in themes such as Socio-emotional, Physical, and Sport-Specific. Further, practical implications for grassroots and hybrid SFD programs during times of unprecedented challenge and notable turning points are highlighted.

Six Recommendations to Build Legitimacy for Translational Research Organizations

Translational research organizations (TROs) face specific challenges to secure resilience and longevity. This perspective article provides the rationale for six hands-on recommendations for the management of legitimacy building in TROs.

Hybrids do it better: Lessons from websites of hybrid organizations in modern health movements

Hybrid organizations in modern health movements adopt multiple organizational logistics, allowing them to more effectively achieve social change. We conducted an analysis of 152 probreastfeeding organization websites categorized as institutionalized organizations, grassroots organizations, or hybrid organizations. Through a series of ANOVA analyses, we found that hybrid's websites provide significantly more useful health care information, better maintained dialogue with members, more efficiently mobilized members, commoditized health care issues less, and created member identity while maintaining institutional ties. Ultimately, hybrids tended to incorporate the positive elements from both grassroots and institutional organizations, while rejecting many of the negative elements.