Public sector organizations continue to re-organize in response to reform imperatives but are they more innovative when they transform to market or customer orientations? This paper examines what we call innovating-in-practice in a hospital emergency department, a local government council and a corrections centre by analyzing how work organization dualities are negotiated using a practice theory lens. In public sector work, work dualities and tensions are often created when reform initiatives are introduced, requiring existing work practices to be challenged and changed. Our empirical illustrations expose the messiness and enmeshing of various practitioner interests, relations, materialities and purposes of practice in ways that restrict or embrace innovation. Innovating-in-practice 'troubles' the structural limitations of conventional approaches to organizing or designing for innovation, suggesting in contrast, the value of more fluid processes for reinventing work that emerge from accommodating work organization dualities and interrogating the complexities of practice-based accomplishments.