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invested practices. This means that actors (some would include here non-human
actors) will seek to sustain power and control within their own knowledge
domains and over their own work practices (Carlile, 2002). Medical consultants,
for example, in part derive their professional power by retaining control over
the diagnosis of patients, and so may be resistant to any change that threatens to
undermine this power. It also helps to explain why apparently successful innova-
tions so often fail to travel into new contexts (see, e.g. the Midland Hospital
case in Chapter 8). In short, changing practice, and the wider systems practices
in which they are embedded, is difficult even where the advantages of doing so
are clear.

>> INNOVATING ACROSS INSTITUTIONAL CONTEXTS

Practice perspectives, and the notion of invested practices, also tells us that, over
time, certain practices gradually become institutionalized – that is, generally
accepted and deeply entrenched in the societies in which we live, and reinforced
by the institutional machinery that supports them. This poses particular challenges
in terms of managing knowledge for innovation, as it means that certain prac-
tices within their own societal contexts are simply not questioned and, therefore,
not easily amenable to, or prepared for, change. For example, early ideas about
Just-in-Time technologies – which were very successfully embraced in Japanese
manufacturing – were initially rejected by managers in the United States because
they simply did not fit with the predominant accepted management knowledge/
practice at the time (Clark, 1987). Indeed there are many examples of innova-
tions that fail to travel across national borders for this reason, or of innovations
that are changed significantly when they do travel, in order to fit the new institu-
tional context (the British game of rugby which changed into American Football
when it travelled to the United States, for example – Clark, 1987).
We do not have space to deal with these issues in depth here (though, see
Clark, 2000; Nelson, 1992; Owen-Smith et al., 2002; Scott and Meyer, 1994;
Swan et al., 1999a). However, it is important to be aware that the institutional
context is a critical aspect of the enabling (or disabling) context for innovation. It
plays an important role in shaping both innovations and also possible approaches
to knowledge creation and to the management of knowledge work. In relation
to the former, institutional differences in the ways in which knowledge is created
and legitimated by different professional groups have been found to have an
important influence on knowledge creation. For example, in our earlier research
comparing knowledge creation processes in different professional settings, we
found that consultants working in the legal profession deployed more heavily
codified forms of knowledge when compared with consultant scientists, who
relied more strongly on experimentation and ‘learning by doing’ (Robertson et
al., 2003). In relation to the latter, research in the biomedical industry has found
broad macro-level differences between the United States, the United Kingdom
and other parts of Europe in terms of how easy it is for knowledge to move across
academic, business and clinical organizations (relational capabilities) and between

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