Abstract

We introduce the concept of places of social inclusion—institutions endowed by a society or a community with material resources, meaning, and values at geographic sites where citizens can access services for specific needs—as taken-for-granted, essential, and inherently precarious. Based on our study of an emergency department that was disrupted by the threat of the Ebola virus in 2014, we develop a process model to explain how a place of social inclusion can be maintained by custodians. We show how these custodians—in our fieldsite, doctors and nurses—experience and engage in institutional work to manage different levels of tension between the value of inclusion and the reality of finite resources, as well as tension between inclusion and the desire for safety. We also demonstrate how the interplay of custodians’ emotions is integral to maintaining the place of social inclusion. The primary contribution of our study is to shine light on places of social inclusion as important institutions in democratic society. We also reveal the theoretical and practical importance of places as institutions, deepen understanding of custodians and custodianship as a form of institutional work, and offer new insight into the dynamic processes that connect emotions and institutional work.

Highlights

  • We introduce the concept of places of social inclusion—institutions endowed by a society or a community with material resources, meaning, and values at geographic sites where citizens can access services for specific needs—as taken-for-granted, essential, and inherently precarious

  • These theoretical perspectives lay out the importance of a special type of place whose functioning as an institution is integral to democratic society because it fulfills normative social purposes (Francis et al, 2012; Parkinson, 2012). This type of taken-for-granted place has not been explicitly identified or conceptualized in prior research. We label this institution a ‘‘place of social inclusion.’’ Building on the currently disparate approaches, and through our analysis of an empirical case, we develop the definition of a place of social inclusion: an institution endowed by a society or a community with material resources, meaning, and values at geographic sites where citizens have the right to access services for specific needs

  • Our data analysis shows that the public hospital emergency department (ED) we studied can be considered a place of social inclusion across nested levels of societal institution and local place

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Summary

Introduction

We introduce the concept of places of social inclusion—institutions endowed by a society or a community with material resources, meaning, and values at geographic sites where citizens can access services for specific needs—as taken-for-granted, essential, and inherently precarious. Because an institutional approach inherently draws attention to the role of institutions in bringing order, stability, and meaning to society (Scott, 2014), there are obvious synergies in combining aspects of institutional theory with the concept of place Taken together, these theoretical perspectives lay out the importance of a special type of place whose functioning as an institution is integral to democratic society because it fulfills normative social purposes (Francis et al, 2012; Parkinson, 2012).

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