Abstract
Municipal health and care services face escalating sustainability challenges driven by demographic shifts, increasing complexity of user needs, and persistent workforce shortages. This study examines how institutional logics shape organisational responses to these pressures in Norwegian municipalities. Drawing on qualitative interviews with managers and frontline staff across short-term care units, home care, rehabilitation, and everyday coping services, we identify three dominant logics: professional (care, medical, and mastery), managerial (administrative/financial, operational and coordination), and the policy/societal logic.
These logics coexist but often collide, creating tensions in decision-making, resource allocation, and service design. Our analysis shows that organisational actors engage in selective coupling and hybridisation strategies to reconcile competing demands.
We argue that understanding institutional logics provide critical insights into why some policy ideas are adapted while others are resisted, and how structural changes succeed or fail at the local level. The paper contributes to organisational research by linking sustainability challenges to the micro-dynamics of institutional complexity, offering implications for policy implementation and the design of sustainable care models.