Reputation and Legitimacy

The aim of this study is to map the principal reputation risks and threats to legitimacy in the processes of organisational change among the three cases in question. The key focus is on the core aims and dilemmas associated with transformation into a municipal enterprise form. According to the results, isomorphic forces affect the institutional process in enhancing and diminishing the isomorphism, and in simultaneously creating dilemmas that pose a risk to the organisation’s reputation and threaten its legitimacy. The findings further highlight the need to investigate strategic dilemma management as a tool for controlling reputation risks and legitimacy in the management of change in the public-healthcare sector.