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Journal of Public Policy Journal of Public Policy

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Understanding institutional conversion: the case of the National Reporting and Learning System

Published online by Cambridge University Press:  15 June 2012

Anneliese Dodds  and
Naonori Kodate
Anneliese Dodds
Affiliation:
Department of Sociology and Public Policy, Aston University, Birmingham, UK
Naonori Kodate
Affiliation:
School of Applied Social Science, University College Dublin, Ireland
Corresponding
E-mail address:
a.dodds@aston.ac.uk
naonori.kodate@ucd.ie
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Abstract

This article focuses on one type of institutional change: conversion. One innovative approach to institutional change, the “political-coalitional approach”, acknowledges that: institutions can have unintended effects, which may privilege certain groups over others; institutions are often created and sustained through compromise with external actors; and institutions’ external context can vary significantly over time, as different coalitions’ power waxes and wanes. This approach helps explain the conversion of one institution drawn from the UK National Health Service, the National Reporting and Learning System. However, the shift of this system from producing formative information to facilitate learning to promote safer care, towards producing summative information to support resource allocation decisions, cannot be explained merely by examining the actions of external power coalitions. An internal focus, which considers factors that are normally viewed as “organisational” (such as leadership and internal stability), is also required.

Keywords

Institutional change institutional conversion health care patient safety
Type
Research Article
Information
Journal of Public Policy , Volume 32 , Issue 2 , August 2012 , pp. 117 - 139
Copyright
Copyright © Cambridge University Press 2012

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