Organizing as becoming: Contradictory isomorphic pressures in a university hospital setting

Studying a university hospital undergoing radical organizational change, the paper discusses the creation and constitution of new leadership roles. The discussion focuses on how respons-es to isomorphic pressures are related to local variations of organizational structures and pat-terns of institutionalization. Variation occurs in terms of two different discourses, creating dif-ferent types of legitimacy, and is explained by combining an institutional approach and the becoming perspective based on the notion of timespace, thus bridging realism and social con-structivism. Theoretically, the paper points to how realism and social constructivism can be bridged by focusing timespace within a qualitative methodology. Practically, the paper lends more support to new public governance than to the prevailing discourse of new public man-agement.