When small bandages fail : the field-level repair of severe and protracted institutional breaches

Herepath, Andrea and Kitchener, Martin (2016) When small bandages fail : the field-level repair of severe and protracted institutional breaches. Organization Studies, 37 (8). pp. 1113-1139. ISSN 0170-8406

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We present the first elaboration of the field-level institutional repair work enacted by government inquiry reports into severe and protracted breaches of the institution of medicine in the English National Health Service. Our examination of the interplay between the rhetorical argumentation strategies communicated, the modes and types of institutional work conveyed, and the institutional pillars targeted for repair enhances understanding of field-level institutional repair work in three ways. First, our analysis of forensic and deliberative rhetoric reveals how these communicate aligned ethos, logos, and pathos appeals in a tactical buttressing manner that simultaneously harnesses maintenance, adapted creative and disruptive modes of institutional work. Ensuing repair work is primarily directed to the regulatory and normative pillars of the breached institution, though their consequential effects seek to realign the cultural-cognitive pillar. Second, adapted creative and disruptive modes interact to generate elaborative and/or eliminative institutional work. This fosters a dynamic form of institutional maintenance, wherein the breached institution evolves in order to endure within the changing terrain of the field. Finally, our elaboration of field-level institutional repair work offers insight into the relative plasticity of the institution of medicine, and contributes to understanding of the dark side of institutional work.

Item Type:
Journal Article
Journal or Publication Title:
Organization Studies
Additional Information:
The final, definitive version of this article has been published in the Journal, Organization Studies, 37 (8), 2016, © SAGE Publications Ltd, 2016 by SAGE Publications Ltd at the Organization Studies page: http://oss.sagepub.com/ on SAGE Journals Online: http://online.sagepub.com/
Uncontrolled Keywords:
?? institutional workgovernment inquiry reportsrhetorical institutionalismhealthcarefield-level institutional repair workorganizational behavior and human resource managementstrategy and managementmanagement of technology and innovation ??
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Deposited On:
23 Nov 2015 13:12
Last Modified:
20 Jun 2024 00:17