Almost Like a Play’: Discretion and the Health Care Innovation Working Group Emmet Collins


Informality, institutional statements, and rules



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Informality, institutional statements, and rules

The final question that emerges when considering the impact of informal relations is: why? Why do informal relations have an impact at the professional level but not (or at least less so) at the policy level? It is here that the IAD framework can be brought in. By understanding the rules at play in each situation, we can better understand the outcome. The personal level impacts are not mentioned here. As several officials pointed out, IGR is no different from other forms of group interactions where basic social norms apply. Moreover, while good personal relations were the norm, they were also seen as most important in how they pertained to the professional impacts of informality. I focus instead on the second two categories: professional and policy impacts. Four rules are particularly useful in understanding these impacts: aggregation, information, boundary, and position rules.



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