پرستاری و موسسات در حال تغییر خدمات شهری: فرآیندهای کارآفرینی در سازمان های مختلف بخش دولتی

The notion that there is strong connection between the private sector and entrepreneurship has resulted in entrepreneurship in the public sector being neglected. This in turn leads to theoretical, practical and political shortcomings. The role of entrepreneurs as change agents is captured in the concept ‘institutional entrepreneurs’, but most studies focus on actors on the higher levels. This article sheds light on previously forgotten or ignored entrepreneurial processes, those taking place within the middle levels of the public sector, and which result in institutional change. We elaborate on the characteristics of the entrepreneurial processes and their prerequisites. The framework draws on the tension between entrepreneurship and the institutional context, and suggests a multi-level approach, drawing on insights from both entrepreneurship studies and new institutional theory. The cases highlight the importance of being able to create alliances and find sponsors to ensure freedom of action and grant legitimacy. The enabling and constraining aspects of the institutional context are illustrated and discussed.

In both public debate and mainstream research, the concept of entrepreneurship is still associated with the start of businesses within the private sector (for example, Davidsson & Delmar, 2006; NUTEK, 2007). Numerous studies discuss entrepreneurship in the new economy, but we also need to look beyond its purely economic aspects (Hjorth & Steyaert, 2003). In this paper, we take a Schumpeterian point of departure, and claim that entrepreneurship exists in all types of settings (1934/1994) and is constructed in time and place. The notion that there is a strong connection between entrepreneurship and the private sector has resulted in entrepreneurship in the public sector being underestimated (Sundin & Tillmar, 2007). This leads to both theoretical, practical and political shortcomings, as entrepreneurship and entrepreneurs, are important for the development of society in other ways than through starting businesses, for example, through effecting change. Public sector organizations are among the arenas, which entrepreneurship studies have neglected. Indeed, the sector is often considered as the absolute opposite of entrepreneurship. Consequently, there is still a lack of empirical studies on entrepreneurship in the public sector (Bartlett & Dibben, 2002; Morris & Jones, 1999), and especially of studies focusing on the entrepreneurial processes within their contexts (cf. Gartner, 1989). The role of entrepreneurs as change agents is captured in the concept ‘institutional entrepreneurs’ (DiMaggio, 1988). To date, a clear majority of the studies of intraorganizational entrepreneurs focus on actors on a higher level and/or in private companies. Goals and strategies, however, are not fulfilled by those working in the higher echelons alone, but by all members of the organization. This is particularly obvious in service-producing organizations. In research on management, the importance of first-line-managers and middle managers is often emphasized. However, creativity and entrepreneurship on the middle and lower levels of the hierarchy need to be explored. This article is based on two cases of institutional entrepreneurship within the public sector started and driven by people in a middle position in the organizational hierarchy—one from a County Council and one from a Municipality. This way, we contribute to the re-contextualization and re-conceptualization of entrepreneurship. We have chosen to report processes that have come to an end. When the processes started, the visions for change were very entrepreneurial. One process aimed at decentralizing the making of ‘time-tables’ for the employees at a university hospital. This I thought was unacceptable…this had to change… the entrepreneur in question commented the previous system. Now, the decentralized way of making ‘time-tables’ is conventional. This illustrates that the common truth of today can be the result of the battles of yesterday. In that respect, our second case is of the same kind. It concerns the idea and practice of public sector employees starting firms of their own, as so called ‘alternative’ suppliers of goods and services. This is now the dominating rhetoric and practice, although when it started it was met with resistance and was questioned. The entrepreneurs studied were successful in eventually managing to alter institutions. The aim of this article is to elaborate on the characteristics of the entrepreneurial processes taking place in the organizational middle within the public sector. What characterized the entrepreneurial processes driven from this organizational level? What where the contextual prerequisites for the processes? Why did the entrepreneurial actions of these public sector employees result in institutional change? The notion of institutional entrepreneurship emanates from two different research traditions: entrepreneurship and new institutionalism in organization studies. Generally speaking, entrepreneurship studies represent a voluntaristic perspective, paying much attention to the actor and actions, whereas institutional theory is said to represent a more deterministic view, attributing more importance to structure. Our cases and analyses can be read as a matter of structure vs. action (cf. Giddens, 1984), or stability vs. change. Yet, the two research traditions seem to be approaching each other. Within new institutional theory, the interest in change and in the role of individual actors is increasing (Battilana, 2006; Johansson, 2002) and within entrepreneurship studies, the importance of contextual embeddedness is being recognized (Hjorth, Johannisson, & Steyaert, 2003; Jack & Anderson, 2002). This article contributes to this trend, in the sense that we take a multi-level approach, incorporating the individual-, organizational-, and sector levels of analysis in order to understand the entrepreneurial processes and the institutional change they result in. In this way, we hope to contribute to the dialogue between entrepreneurship studies and other academic fields (Gartner, Davidsson, & Zahra, 2006), in this case new institutional theory within organization studies. The multi-level approach taken is a result of our empirical findings, which suggest that the institutional context in time and space has great influence on the entrepreneurial processes as well as on the prerequisites for institutional change. In the next section, we start by explaining the methodology used in this study. Then, our framework of analysis is outlined and contextual prerequisites in the Swedish public sector are elaborated on. We then describe the case stories of first the Nurse and the time-tables, and then the Civil Servant and the alternative providers. These case stories are followed by a discussion of the described entrepreneurial processes in theoretical terms, before conclusions are outlined.

This article contributes to research on institutional as well as public sector entrepreneurship through studying entrepreneurship on the middle level in the organizations. It is our contention that entrepreneurs holding positions on this level within the public sector have not, to date, been given due attention. In consequence, until now we knew little about the characteristics of the entrepreneurial processes, forces that drive these institutional entrepreneurs and the contextual prerequisites. Through taking a multi-level approach and by illustrating the interplay between the levels of analysis, this article has contributed to the process whereby entrepreneurship theories are enriched by new institutional theories and vice versa. In each stage of the entrepreneurial processes, the entrepreneurs, the organizations and the sector in crisis as well as the international institutional environment in terms of the NPM-inspired idea on travel, were all integral parts. We have illustrated that the Nurse and the Civil Servant were embedded in an/a (inter)national environment, where institutionalized ideas and activity forms influence the freedom of action they are able to create. The enabling aspects of these institutions involve the possibilities for example of borrowing organizational solutions or making tactical use of ideas on travel, be they efficiency, privatization or something else. As noted by others, this implies that the dichotomy between imitation and innovation is being blurred (Rehn & Vachhani, 2006; Sevón, 1996; cf. also Schumpeter, 1934/1994). The proactiveness and persistence of the entrepreneurs eventually resulted in institutional change. The cases show that institutional entrepreneurship is not only embedded in space, but also in a specific time (Czarniawska, 2005; Czarniawska & Joerges 1996), something only explicitly touched upon by a few previous studies of institutional entrepreneurship (cf. Battilana, 2006; Lawrence & Phillips, 2004). Had the entrepreneurial initiatives not been in line with the master idea of the time, institutional change may not have been possible and the projects soon forgotten. The turbulence within the specific organizations was also enabling. Further, the social aspects of the entrepreneurial processes have been illustrated, since change may not have been possible without attracting sponsors and coalition partners. The entrepreneurs were necessity-driven, in the re-conceptualized sense of being convinced of the necessity to realize change. This incitement is not often mentioned either in mainstream entrepreneurship research or in studies of public entrepreneurs. The cases illustrate that re-conceptualization is connected to re-contextualization. As we find entrepreneurship where we most often do not look for it, we also find a context not often talked of as being supportive for entrepreneurship. The cases illustrate the importance of entrepreneurs on the middle levels within organizations having sponsors and coalition partners at various levels, that is to say, not only in the higher echelons of the administrative organizations, but also on the political level of these public organizations. Entrepreneurship is context-specific and as the context changes, entrepreneurship also has to be re-contextualized. The entrepreneurs themselves play a key role. The entrepreneurial processes illustrated were bottom-up, driven by local needs and context-dependent organizational solutions. Even if the time for the ideas had come, they far from implemented themselves. The truths of today are still a result of the battles of yesterday, and these battles were fought by the entrepreneurs.