Toward organizational pluralism: Institutional intrapreneurship in integrative medicine

A critical stage in change toward institutional pluralism occurs when incumbent organizations must begin to integrate diverse logics in their operations. The required institutional work inside organizations at that stage-institutional intrapreneurship-involves distinctive challenges. Incumbent logics are entrenched in organizational routines, status orders, policies, and structures that hamper change and trigger resistance. We used qualitative data from two integrative medicine (IM) programs inside large healthcare organizations to understand how institutional intrapreneurs work to integrate the IM logic in these highly institutionalized organizations. We found that intrapreneurs use opportunistic tactics to create and strengthen organizational free spaces aligned with the new logic, and then leverage the capacity that is developed to extend elements of the new logic into the broader organization. This study suggests that a better understanding of the organizational context helps explain the fate of early-stage efforts toward institutional change.