The article investigates organisational drivers and restrainers of innovation in hospitals on the background of different institutional logics. It presents evidence from a multiple case study in Polish hospitals, which reveals different dynamics on the micro-, meso- and macro-level of organisations in enabling and implementing new procedures and technologies. In particular, the study documents an ambiguous influence of medical professionalism as a specific logic in the healthcare sector, which can affect innovation positively as well as negatively. The article therefore proposes a managerial framework based in innovation action commitment to control the effects of professionalism in healthcare. © The Author(s) 2022.