Services provided by primary schools have a significant impact on citizens' living conditions. We need more knowledge of how innovation activities in primary schools should be organized and managed. This article addresses this gap by raising the following question: "Why do municipalities have different ways of organizing preventive work in primary schools and what impact do different organizational approaches have on professionals' judgement and their decisions to call attention to children at risk, their response patterns and interdisciplinary/interagency cooperation?" The qualitative exploration of these questions is based on in-depth interviews with head teachers and teachers in 10 Norwegian municipalities. My findings indicate that institutional entrepreneurship can be essential in creating an arena for "bricolage" or collaborative processes and that, through a new organizational approach, an altered institutional framework contributes to building cooperation among professionals and gives a basis for incremental innovations.