The creation and survival of an academic health science organisation: counter-colonization through a new organizational form?

This paper describes and analyses the creation and development of an Academic Health Science Centre (AHSC) as a major organizational innovation diffusing in the health knowledge economy, internationally. Drawing on an institutionalist model utilized in an earlier study of a failed merger in the USA (Kitchener, 2002), we explore empirically why the creation of this new AHSC in the UK produced very different organizational outcomes. Whereas institutionalist framing predicts ‘sedimented’ instability and repeated contest between managerialist and embedded (and ultimately, dominant) professional logics, the higher levels of clinical-academic engagement in our case exerted ‘upwards’ institutional pressure, creating a more stable, collaborative form. Our paper challenges and develops the institutionalist model, and explores the possibility of ’counter-colonization’ through a new organizational form invented in the academicclinical domain.