When the Rubber Meets the Road: Isomorphism, Rhetoric, and (Mis) management of Interinstitutional Performance

In 2012 Performance measurement systems (PMSs) became compulsory in the Italian National Health Service (NHS). The objective of this article is to answer the following research question: How do health-care organizations set up their PMSs in order to make them coherent with the institutional context and the intra-organizational dynamics? The findings show how the similar behavior of the organizations may be considered a case of coercive isomorphism. This study confirmed many topics discussed in the performance measurement literature and opens a discussion of some new research questions.