Coping with contradictions: hybrid professionals managing institutional complexity

This article deals with how organizations cope with institutional complexity. By applying theories of translation, we follow the lead of those arguing that attention has to be given to the microprocesses of institutional complexity. Thus far, empirical studies focusing on such processes have been rare. Among those studies undertaken, analyses of structures and practices have dominated while analyses of the interpretations and construction of meaning of involved actors have been neglected. We thus undertook an empirical study of the introduction of a national report on quality comparisons in health care. This report contained four conflicting institutional logics—a democratic logic, a professional logic, a managerial logic, and a market logic. We investigated the conflicts between these logics and how the conflicts were managed. The findings of the study contribute to institutional theory by suggesting that a new type of soft actor—the hybrid professional—is likely to be influential in organizations characterized by institutional complexity. The reason for this is found in the character and work of the hybrid professionals, where an important part of their work was to construct problems and solutions that aligned with all the logics at play.