Making Hospitals Governable: Performativity and Institutional Work in Ranking Practices

Rankings have become ubiquitous in public service settings. Although there are high hopes that comparative analysis leads to improved processes and outcomes, there is also a growing criticism of rankings as creating perverse effects. In this article, we analyze how public service governance is affected by rankings with a special focus on how, in what ways, and to what extent organizations are made into governable entities as a response to rankings. The article is based on a detailed ethnographic study in three Dutch hospitals, using insights from actor-network theory and institutional work, combining the concepts of performativity and institutional work.