Chapter 2 Institutional Power and Organizational Space: How Space Constrains Micro-level Action in the Emergency Department

The authors contribute to scholarly understanding of the interplay between macro-level institutions and micro-level action by focusing attention on the ways the power of institutions works through mundane organizational spaces to constrain individuals as they interact with organizations. The authors explore these macro- and micro-connections between institutions and organizational spaces through a qualitative inductive study of an emergency department in a public hospital in Australia. Analyzing observational and interview data related to a waiting room and a corridor, their findings show how the systemic power of the state and the medical profession impacts micro-level action through organizational spaces. The authors find that the medical profession exerted power in a system of domination over marginalized patients through the waiting room as an exclusion space. At the same time, the state exerted discipline power over professional subjects through the corridor as a surveillance space. Individual resistance to institutional power over the ED was controlled by policing deviance in the surveillance space and ejecting resisters to the exclusion space. Their findings contribute to the literature by opening up new insight into how mundane organizational spaces convey institutional power by dominating and disciplining micro-level actions.