Caught in organized ambivalence: institutional complexity and its implications in the German hospital sector

Figures & data

Table 1. Dealing with organized ambivalence (in the light of Ashforth et al. 2014).

Configuration	Sensemaking pattern	Major ‘trap’
Dominance (of one logic/ orientation)	CEOs: instilling market orientation in management and staff	Awareness of this orientation being hard to communicate internally and externally
Compromise (doing justice to two competing logics simultaneously)	Medical directors and central nurses: setting priorities in a context of competing expectations	Concessions with respect to welfare orientation, but unsustainable arrangements
Avoidance (giving low emphasis to one of the two logics and glossing over the related tensions)	[option not on offer]	Both market orientation and welfare orientation (patients’ needs) impossible to ignore
Holism (leaning on both market orientation and welfare orientation, with the prospect of synergies)	Both/and thinking around opposed orientations	No consistent response concerning - the relationship between CEOs and healthcare professionals - the handling of competing logics in the mind set of healthcare professions

Ashforth, B. E., K. M. Rogers, M. G. Pratt, and C. Pradies. 2014. “Ambivalence in Organizations: A Multilevel Approach.” Organization Science 25 (5): 1453–1478. doi:10.1287/orsc.2014.0909.

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