Institutional logics and relational shifts : permeating hierarchies and silos in the healthcare sector

Abstract

Healthcare organizations often confront multiple institutional logics that reinforce professional and departmental hierarchies and silos. Research in the field focuses on how professionals navigate such tensions through everyday practices that maintain, reinterpret or shift specific logics. In this paper, we take a practice perspective to explore the mediating capacity of values-driven practices as a bridge between different logics. Drawing on insights from a leadership programme delivered to 70 public healthcare staff across seven hospitals in South Africa, we argue that articulating values conflicts and shared values shape relational practices, which mitigate the pressures of hierarchy and conflicting logics.