Imprinting Variation: The Diagnosis of Autism Spectrum Disorder at Two Specialty Clinics

93 Pages Posted: 7 Oct 2014

See all articles by Phech Colatat

Phech Colatat

Washington University in St. Louis - John M. Olin Business School

Maria Massolo

Kaiser Permanente - Division of Research

Yinge Qian

Kaiser Permanente - Division of Research

Lisa Croen

Kaiser Permanente - Division of Research

Date Written: May 17, 2014

Abstract

Field-level changes create pressures for organizational change and isomorphism of the organizational field, yet stable practice heterogeneity sometimes results. We study how this is possible by examining a large health maintenance organization, Allied Health, which recently reformed its practices for diagnosing Autism Spectrum Disorder (ASD). Despite homogenizing pressures, substantial variation emerged across Allied’s three specialized ASD clinics. In tracing the difference using qualitative and quantitative data, we find that prior imprints on key individuals led to different diagnostic practices at each clinic, which came to be rendered stable, i.e., imprinted, at the clinic level. Theoretically, we demonstrate that (1) inertial mechanisms of imprinting may unintentionally shape the way that adaptation is enacted in an organization in response to field-level change, and (2) the act of organizational adaptation can lead to new imprints sustained by the microstructures of work. We call this imprinting variation.

Keywords: imprinting, neoinstitutional theory, isomorphism, autism

Suggested Citation

Colatat, Phech and Massolo, Maria and Qian, Yinge and Croen, Lisa, Imprinting Variation: The Diagnosis of Autism Spectrum Disorder at Two Specialty Clinics (May 17, 2014). Available at SSRN: https://ssrn.com/abstract=2505710

Phech Colatat (Contact Author)

Washington University in St. Louis - John M. Olin Business School ( email )

One Brookings Drive
Campus Box 1133
St. Louis, MO 63130-4899
United States

Maria Massolo

Kaiser Permanente - Division of Research ( email )

Yinge Qian

Kaiser Permanente - Division of Research ( email )

2000 Broadway, 3rd Floor
Oakland, CA 94612
United States

Lisa Croen

Kaiser Permanente - Division of Research ( email )

2000 Broadway, 3rd Floor
Oakland, CA 94612
United States

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