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Repairing Breaches with Rules: Maintaining Institutions in the Face of Everyday Disruptions

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  • Emily D. Heaphy

    (School of Management, Boston University, Boston, Massachusetts 02215)

Abstract

This study reveals the institutional work required to maintain taken-for-granted beliefs about roles in the face of everyday breaches of role expectations. Through a comparative qualitative study of hospital-employed patient advocates in teaching and Veterans Health Administration hospitals, I demonstrate that patient advocates repair breaches in the taken-for-granted beliefs about the patient, family, and staff roles in hospitals. My research shows that patient advocates skillfully used rules—or formal policies and procedures—to restore, clarify, or initiate organizational changes in rules, all to maintain institutionalized role expectations. This analysis expands our understanding of the work of maintaining institutions by specifying how constellations of roles are maintained in the face of breaches of role expectations and across different institutional contexts. It highlights the roles of pressure specialists and furthers theorizing on individual agency by specifying how rules can be source of individual agency.

Suggested Citation

  • Emily D. Heaphy, 2013. "Repairing Breaches with Rules: Maintaining Institutions in the Face of Everyday Disruptions," Organization Science, INFORMS, vol. 24(5), pages 1291-1315, October.
    • Handle: RePEc:inm:ororsc:v:24:y:2013:i:5:p:1291-1315
    DOI: 10.1287/orsc.1120.0798
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    References listed on IDEAS

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    Cited by:

    1. Maxim Voronov & Mary Ann Glynn & Klaus Weber, 2022. "Under the Radar: Institutional Drift and Non‐Strategic Institutional Change," Journal of Management Studies, Wiley Blackwell, vol. 59(3), pages 819-842, May.
    2. Daskalopoulou, Athanasia & Palmer, Mark, 2021. "Persistent institutional breaches: Technology use in healthcare work," Social Science & Medicine, Elsevier, vol. 289(C).
    3. Hafsi, Taïeb & Hu, Hao, 2016. "Sectoral innovation through competing logics: The case of antidepressants in traditional Chinese medicine," Technological Forecasting and Social Change, Elsevier, vol. 107(C), pages 80-89.
    4. Kurt Sandholtz & Daisy Chung & Isaac Waisberg, 2019. "The Double-Edged Sword of Jurisdictional Entrenchment: Explaining Human Resources Professionals’ Failed Strategic Repositioning," Organization Science, INFORMS, vol. 30(6), pages 1349-1367, November.

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