The Creation of a Hybrid and Innovative Model of Occupational Health Delivery through the Lens of Institutional Work

• DOI: http://doi.org/10.1111/emre.12182
• Published date: 01 December 2019
• Author: Neil Anderson,Maria Balta,Raffaella Valsecchi,John Harrison
• Date: 01 December 2019

The Creation of a Hybrid and Innovative

Model of Occupational Health Delivery

through the Lens of Institutional Work

RAFFAELLA VALSECCHI,

1

NEIL ANDERSON,

1

MARIA BALTA

2

and JOHN HARRISON

1

1

Brunel Business School, CBASS, Brunel University London, Uxbridge, UK

2

Kent Business School,University of Kent, Canterbury, UK

By applying the lenses of institutional work, this study presents an empirical analysis on how agents create and

manage a hybrid virtual organization to provide an innovative solution to the problem of the lack of occupational

health (OH) services among small businesses. We specifically focus on how these actors exploit and balance the

prescriptions of different logics within this hybrid organization. Our qualitative study showed that the funders

manage this virtual social enterprise through two main strategies: ‘commitment to the social mission’and ‘support

for the social mission’. The first strategy shows how the social mission helped a diverse group of funders and

employees to work together as a team. The secondstrategy assists these actors to grant the maintenance and justify

the existence of this novel organization, which provides immense societal benefits but could not support itself

financially.This article shows how a hybrid organizations’capacity for innovation and societaladvantages depends

on the ability to rely on multiple logics and simultaneously to shift the attention on the social mission as a catalytic

force for its survival.

Introduction

Hybrid organizational forms are increasingly gaining

prevalence as they generate innovative solutions to

complex and crucial problems faced by organizations in

different sectors (Kratz and Block, 2008; Jay, 2013).

Examples of hybrid organizations can be found in the

healthcare setting (Reay and Hinings, 2005, 2009), social

enterprises (Battilana and Lee, 2014), public service

partnerships (Jay, 2013), universities (Murray, 2010),

and financial institutions (Smets et al., 2014).

Over the last three decades, the boundaries between

public sector organizations, private businesses, and

charitableorganizations have becomeincreasingly blurred

(Weisbrod, 2004; Mahoney et al., 2009; Billis, 2010;

Battilana et al., 2012; Kivleniece and Quelin, 2012). As

a consequence,observation of the socialworld reveals that

hybrid organizations are more commonthan organizations

which are closer to ‘ideal types’(Brandsen et al.,2005).

Although initial studies have considered hybrid

organizations to be challenging, such as in the

managerialization of health care systems (Reay and

Hinings, 2005), recent studies state that hybrid

organizations are bringing many benefits, as they can

address important social issues in an innovative manner

(Battilana and Dorado, 2010; Tracey et al., 2011; Jay,

2013). For instance, social enterprises are very common

example, as they rely on both market and community

logics. These organizations are spreading rapidly in our

society due to their ability to address innovatively and

rapidly important social issues (Kratz and Block, 2008).

Social enterprises are intended to be easy to set up, with

all the flexibility and certainty of the company form, but

with some special features to ensure that they are working

for the benefitof the community (Shaw and Carter,2007).

Moreover,they operate in a rapidly changingenvironment

against high compe tition, thus increasing thei r needs in the

target communities and creating a tighter funding

environment (Mort et al., 2003). Such enterprises are

becoming increasingly common because of their ability

to play a subordinate role to state agencies, complement

and supplement their services, pioneer new methods of

meeting needs, and act as an advocate for marginalized

groups (Kendall and Knapp, 1996).

Social enterprises, through their hybrid nature are

accountable for both social mission and market profit

Correspondence: Raffaella Valsecchi, Brunel Business School, CBASS,

Eastern Gateway, Brunel University London,Uxbridge UB8 3PH, UK.

E-mail: raffaella.valsecchi@brunel.ac.uk

DOI: 10.1111/emre.12182

©2018 The Authors European Management Review published by John Wiley & Sons Ltd on behalf of European

Academy of Management (EURAM)

This is an open access article under the terms of the Creative Commons Attribution License, which permits use,

distribution and reproduction in any medium, provided the original work is properly cited.

European Management Review, Vol. 16 , 97 –, (2019)

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(Ebrahim et al. 2014). However, a number of social

enterprises havebeen criticized for prioritizing the market

logics at the expenses of their social missions (Fowler,

2000; Weisbrod, 2004). In contrast, other studies have

emphasized the social mission over the financial profits

and defended the organizational survival although

financial profits were not met (Jay, 2013). This

importance of the social mission emerged as one of the

findings of our paper.

By drawing on a new OH on-line service, our paper

aims to answer the following question: how do different

actors balance and exploit the prescriptions of different

logics within a hybrid organization?

To answer this question, the paper uses a case of an

innovative occupational service, the Health for Work

Adviceline (OHA), a community of interest company

(CIC), to explore how the senior managers/executive

funders of this servicemanage and benefit from its hybrid

form. The OHA is a new telephone and online

occupational health (OH) service, recently introduced in

England to provide help and advice to medium-sized

enterprises (SMEs). As many organizations which have

been created to solve innovatively crucial problems, it

has a hybrid form. It embodies the logic of social goals

and collective c hoice typical of the non-profit

sector/public sector and the logic of efficiency of private

sector organizations. Although this company provides

immense societal benefits, it could not self-sustain,

therefore the managers/funders had to find elaborate new

strategies to effectuate its survival. As the paper will

emphasize the social mission of this organization plays a

major role for managing its hybrid elements and for

justifying its survival.

By exploring the unique case of the OHA, we aim to

contribute to the existent academic literature on

institutional work and hybrid organizations. Particularly

we aim to providefurther contributions to previousstudies

which explored how multiple institutional logics can

coexist in organizations and increase their effectiveness

(e.g., Battilana and Dorado, 2010; Tracey et al.,2011;

Jay, 2013; Pache and Santos, 2013; Battilana and Lee,

2014; Smets et al. 2014; Gümüsay et al.,2018).

Specifically, through our case study, we explore how

actors, through their institutional work, exploit and

balance theprescriptions of different logics.By generating

the two theoretical concepts ‘commitment to the social

mission’and, ‘support to the social mission’, we offer a

theoretical contribution to the literature of institutional

work and hybrid organizations. These two strategies give

a meaning to the different forms of institutional workand

their associatedphases. Moreover, theyrepresent the main

reference point for actors in order to make multiple logics

coexist.

Moreover,we demonstrate to practitioners,new models

of partnershipsand networking between public-and third-

sector organizations and private companies to provide

broader benefits for society. Finally, through an analysis

of a unique empirical case study, we offer contributions

in the field of OH and we show how this service created

changes in this s pecific institu tional field.

The paper first provides a literature review of the

concepts of hybrid organizations and institutional work.

We then outline the methodology section, including our

research approach and data analysis. Afterwards, we

present and discussour findings, and,finally, we highlight

the implications and limitations of our study.

Managing multiple logics in hybrid

organizations

Hybrid organizations can be defined as thecombination of

multiple organizational identities (Pratt and Foreman,

2000; Albert and Adams, 2002; Albert and Whetten

1985; Corley et al., 2006), multiple organizational logics

(Battilana and Dorado, 2010; Greenwood et al.,2010;

Pache and Santos, 2013), and multiple organizational

forms (Hannan and Freeman, 1986; Haveman and Rao,

2006). The concept of hybrid organizations is central to

the discussion of thecreation of new organizational forms

(Haveman and Rao, 2006; Tracey et al.,2011),because

new organizations, ‘no matter how radical, are

combinations andpermutations of what was there before’

(Padgett and Powell, 2012: 2). Tr aditional studies on

hybrid organizations have mainly focused on market

logic, which was considered the best way to maximize

profits (Thornton, 2004; Thornton et al.,2012).An

example of these hybrid organizations is the

managerialization of health care systems (Reay and

Hinings, 2005), such as the new public management

(NPM) in the UK (Ferlie et al., 1996). NPM policies

aimed to modernize and make more effective the UK

public sector by applying private-sectors management

techniques and processes to the National Health Service

(NHS). However,NPM has been highly criticizedbecause

it mainly focused on the private sector logics and

dismissed the logics of public benefits, so that it did not

often lead to effectiveness (Ferlie et al.,2003). Indeed, this

initial literatureexemplified how such hybridcombination

of logics (e.g., private versus public logics) was regarded

as imposing and problematic.

In contrast, literature highlights that the concept of

hybridity has been used often to characterize

organizational forms in the third sector. Although these

organizationsare still associated to ‘boundaries,problems,

fuzzinessand changeability’(Brandsenet al., 2005:. 750),

they also bring many benefits to the society, such as

helping more disadvantaged groups. Within the third

sector, social enterprises represent an example of welfare

hybridity that merges third, public, and private-sector

R. Valsecchi et al.

©2018 The Authors European Management Review published by John Wiley & Sons Ltd on behalf of European

Academy of Management (EURAM)

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