QUASI-MARKET TRANSFORMATION - AN INSTITUTIONALIST APPROACH TO CHANGE IN UK HOSPITALS

Quasi-market transformation (QMT) refers to the process by which the d ominant organizational form in a field is replaced, following the intr oduction of a quasi-market. In this article, analysis of comparative c ase-study data reveals that, until the early 1990s, a common interpret ive scheme, or set of values and norms, underpinned a set of structure s and systems in many UK hospitals. These similarities of form are rep resented as the directly managed (DM) hospital archetype. When change initiatives challenged this archetype, the outcomes were negotiated an d the interpretive scheme remained largely unscathed. Following the in troduction of a quasi-market in 1991, a new trust hospital interpretiv e scheme has emerged. For the first time, UK hospitals have experience d transformation and now display an alternative set of structures and systems. This article explains how the trust hospital archetype has be come legitimized through different tracks of change within individual hospitals.