Translating to Maintain Existing Practices: Micro-tactics in the implementation of a new management concept
研究通过医院实施价值医疗的案例，发现翻译者会采用忽视、维持和替代三种微观策略，在改变部分实践的同时维持大多数现有做法，这取决于他们对制度逻辑的解读。
Research has demonstrated how the translation of a new management concept into organizational practices is impacted by the translators’ engagement with their local context. We expand this literature by demonstrating how a heterogeneous institutional context prompts translators to create practice change and also practice maintenance. Building upon an interpretive analytical framework we offer a way forward to examine relationships between societal institutions and distributed collective work in change processes. Our longitudinal qualitative study based upon interviews and observations examines how the concept of value-based healthcare was translated at a hospital. The translators developed three micro-tactics: disregard, maintenance and displacement, grounded in their narration of practice changes. Translators enacted institutional logics differently at the levels of meaning and practice when they framed, rationalized and contextualized the potentialities of a new concept, and this complexity provided the possibility of various practice outcomes. We contribute to the understanding of translation by demonstrating how a heterogeneous institutional context encourages translators to change selected practices but also to decouple and maintain most of the existing practices due to their enactment of institutionalized rationalities. Moreover, we discuss how translation outcomes are impacted by collaborating actors’ shared interpretations of their institutional context. Collaborating translators need to agree on whether and what practice change is valuable for the organization, and change is only possible when they interpret that they have the leverage to align a new idea with dominant institutional logics.