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

Andrea Herepath, Martin Kitchener

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Abstract

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.
LanguageEnglish
Pages1113-1139
Number of pages26
JournalOrganization Studies
Volume37
Issue number8
Early online date16 Feb 2016
DOIs
StatusPublished - Aug 2016

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Repair
Medicine
Plasticity
Breach
Health
Institutional work
Rhetoric
Elaboration

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When small bandages fail : the field-level repair of severe and protracted institutional breaches. / Herepath, Andrea; Kitchener, Martin.

In: Organization Studies, Vol. 37, No. 8, 08.2016, p. 1113-1139.

Research output: Contribution to journalArticle

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