Sustainability-as-practice: A case study of managers’ micro-strategic work to integrate sustainability with business practices in a healthcare multinational

This dissertation applies a micro-strategic perspective to the phenomenon of integrating sustainability into business practices. It is the result of a 3-year single case study of a corporate sustainability programme, through its different stages of development from formation to business integration. The company is a Denmark-based, global healthcare corporation, which in 2007 launched an ambitious sustainability programme; "Action for Health". The programme works with non-profit partners in emerging markets, to improve healthcare related to the company's main business areas.
Sustainability practices are increasingly prevalent in corporations and their institutional landscape. An abundance of networks, consultancies, think-tanks, blogs, books, tools and organizations is devoted to the development of corporate sustainability practices, yet deeper integration of sustainability practices with business strategies has only been practiced by few. Reports show that managers are interested in integrating sustainability with business strategy, and they believe it is pivotal to future success and growth, but they are uncertain how to practically do so. Sustainability, as all new practices, draws on unfamiliar meanings and creates tensions with existing practices. Theory has thus far not clearly addressed the strategic challenges of overcoming these tensions. By applying a micro-lens to the implementation of sustainability in one corporation, this dissertation aims to do so.
The research question is: How do managers execute a vision of sustainability integration into the micro-strategic processes of everyday corporate life?
To answer this question, the dissertation adopts a qualitative and constructivist methodological approach. It aims to interpret meanings of social behaviour, not to put these on formula for improved managerial behaviour, but to understand better the activity, choices and dilemmas of managers in the selected case. The case is an instrumental case study, meaning that it is used as an illustration of a larger social issue. Its findings are through the lenses of Strategy as Practice (SaP) theory and amplified by Institutional Logics. Scholars in both these theoretical communities argue that we need a stronger understanding of social phenomena from the perspective of the individuals engaged in their maintenance and making, which is in this study methodologically achieved by following managers in their everyday strategic actions and deliberations. By doing so, the study reveals a highly emergent way of strategizing sustainability, ripe with tension and ambiguity across several stages and layers of management. This tells a different story than what current literature purports about sustainability integration, and instead of prescribing or normatively assessing sustainability strategy, it investigates the underlying socialized premises on which managers understand sustainability, and how these affect managers' approaches and actions towards integration of new and old practices.
The study shows how strategic action concerning the sustainability programme is influenced by two sets of logics: On one side an existing set of business logics, with which managers understand the company's goals to grow, generate profit to shareholders within a short time-frame and work efficiently to these ends. And on the other side a less prevalent set of "social" logics, which comprises ethical values, long-term impact, and the creation of better societies. The sustainability programme's aims encompass both logics, but managers are less familiar with the social logic. This creates strategic confusion, in which an informal practice based on strong business logics, corrodes the formal social practice. Through lengthy experimentation, managers are able to address the inconsistencies and locate an existing set of corporate practices, in which the sustainability objectives can be integrated as an asset rather than an add-on to business objectives and strategies.
The dissertation contributes to three literatures:
Firstly, it contributes to The SaP perspective by extending its core framework, which argues that strategy as practice develops through iterations of practitioners, their daily praxis and the larger practices, which practitioners create, maintain and draw on. The practices level in The SaP perspective has thus far been theorized as both strategic activity itself and an institutional level of practices that guide activity. This guidance, argue SaP scholars, comes mainly from the strategy field itself. This dissertation shows that practices that guide strategic activity are much broader and come from a multitude of institutional fields and practices, in the case identified as amongst other sustainability, shareholder value and national health care policy. Particularly in projects and units peripheral to core corporate strategy, may experimentation with new and foreign practices unfold. The challenge is to integrate their work with existing corporate practices, so it can create value for the company – without absorbing the new practices to the extent of assimilation.
Secondly, it contributes to Institutional Logics by building on analytical insights from the application of a micro-study to the IL perspective. IL scholars have expressed the need for understanding IL in micro practices, but not many such studies have been conducted. By doing so, I reveal the need for further analytical distinction of logics and suggest a layering of Institutional Logics in orders, logics and types. This serves to understand the empirical plurality of logics' forms, and to sharpen our attention to the complexity of their amalgamation in daily social praxis.
Finally it contributes to the extensive CSR literature by pointing attention to the strategic implications of sustainability practices, and arguing that a deeper understanding of strategy gives scholars alternative understandings of companies' seeming reluctance in CSR execution. It shows that experimentation is a core element in integrating the largely foreign logics of a "social" orientation with current business practices, and poses the opportunity for CSR scholars to investigate the layers of logics assigned to the sustainability phenomenon by corporate practitioners.
The dissertation concludes with insights for practice, limitations and avenues for further research.