Imprinting Variation: The Diagnosis of Autism Spectrum Disorder at Two Specialty Clinics
93 Pages Posted: 7 Oct 2014
Date Written: May 17, 2014
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
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