13121: Institutional Integration of Purpose in the Cincinnati Children’s Hospital, 1883-1931 (session 25375)

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How do organizations maintain institutional integrity as they change over time toward new purposes that are deeply valued by stakeholders? We address this question through a historical case study of the Cincinnati Children’s Hospital—an organization that began as a parochial charity that was opposed to medical research and yet, over time, became a leader in pediatric research and healthcare. Our observations suggest a rhetorical process, which we term “institutional integration,” explains this evolution. The institutional integration process involves underlying elements of organizational purpose previously theorized in rhetorical analysis as Scene, Main Characters, and Acts. Our contribution to theory suggests that institutional integrity can be maintained amidst purpose change where a preponderance of these rhetorical elements are maintained at a given point in time, despite more substantial changes to organizational purpose over longer time horizons. In this way we explain how, over an organization’s history, organizational purpose can be changed, while also maintaining institutional integrity and avoiding mission drift. By conceptualizing institutional integrity as a process of institutional integration we thus contribute to recent research on organizations as institutions, organizational purpose, and mission drift.

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