Coherence in the use of a performance measurement system and compatibility between institutional logics in public hospitals

Purpose - This study aims to explore how the use of a performance measurement system (PMS) reflects the compatibility between institutional logics at different levels. It emphasises the centrality of institutional logics behind actors’ expectations. Design/methodology/approach - Drawing on pragmatic constructivism, the study assumes that a PMS is used coherently when it realises the values and beliefs of the actors involved. This requires that actors communicate and understand one another (communication coherence) and accept the PMS in use (value coherence). The study argues that a coherent use of a PMS reflects the compatibility between the institutional logics at the same (field levels) or different levels (field and societal levels). The empirical evidence comes from a large public hospital located in the south of Italy. Findings - The empirical results describe episodes that highlight how the coherence in the use of PMS reflects the compatibility of institutional logics at different levels and episodes where the compatibility can be hindered by problems in the coherent use of the PMS related to value and communication coherence. A lack of communication and value coherence is highlighted in the use of PMS as “compromising accounts”. Originality/value - The study sheds light on how coherence in the use of PMS reflects the compatibility between the institutional logics involved at different levels, suggesting that a focus on one prevailing logic must be avoided. The study extends logics compatibility beyond the field level to the societal level.