Democratizing and Professionalizing Risk Work: The Institutional Work of Hospital Risk Managers

This paper seeks to better understand the way hospital risk managers work at the institutionalization of risk management by examining how they draw upon their risk-related practices as a basis for institutional change. From an inductive study of hospital risk managers in the Quebec healthcare sector, we provide a situated account of the institutionalization of the practices that risk managers deploy at the organizational and field levels. More specifically, our results show that their practices form two broader recursive forms of institutional work, namely democratizating risk work at the intra-organizational level and professionalizing risk work at the extra-organizational level. We argue that their recursive relationship demonstrates how the risk work done at one level facilitates the risk work done at the other. The paper ends by discussing the importance of gaining a better understanding of how the risk manager role and its institutional work are linked together.