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While high-impact events such as natural disasters and infectious disease pandemics have increased significantly in recent decades, we know little about how hospitals effectively organize and respond to surges, or sudden, unanticipated escalations in treatment needs. To address this gap, we conducted a longitudinal study of five multi-hospital health care systems in the U.S., as they experienced and worked through surges in demand associated with the COVID-19 pandemic. We discover a variety of organizational-level tactics that hospitals engage to effectively manage surge capacity, defined as a hospital's ability to manage surges that challenge or exceed present capacity to treat patients. We organize these tactics into an emerging, conceptual framework explaining three dimensions of hospital surge capability: overseeing capacity management efforts, managing capacity supply and managing capacity demand. We conclude that effective surge capability involves the dynamic adaptation of capacity at the hospital level, which is accomplished through the organizing of various surge response tactics. These tactics fit together to provide hospitals a strategic approach to surge management. We contribute to the surge management literature by developing a framework to explain effective surge response that extends beyond the accumulation of adequate space, staff, stuff, and structures and that addresses surges in demand at the hospital, as opposed to response unit (e.g., an Emergency Department) or community-wide levels. [ABSTRACT FROM AUTHOR]

In this paper, we extend Larson and Lizardo's (2015) institutional movement logics (IML) approach to analyze the structure and dynamics of the social movement field in the United States from 1960 to 1995, a pivotal period in its history. We examine the empirical implications, as they relate to the IML approach, of two of the most influential contemporary macrolevel approaches in social movement theory today: Armstrong and Bernstein's (2008) "multi-institutional politics" (MIP) perspective and Meyer and Tarrow's (1998) "social movement society" (SMS) thesis. We apply multiple correspondence analysis (MCA) to event data taken from the Dynamics of Collective Action dataset to elicit the most salient combinations of issues, tactics, and targets characteristic of the field in three subperiods: 1960-1972, 1973-1987, and 1988-1995. This analysis reveals six dominant IMLs structuring the field across the three subperiods. Consistent with the MIP argument, these logics are not state-centric, being distributed across a wide-variety of targets and feature a wide variety of issues beyond those explicitly oriented to policy change. Contradicting the SMS predictions, we find very little movement towards the emergence of state-centric logics combining disruptive and nondisruptive tactics. Finally, our analysis uncovers an IML that is explicitly organized around a "racial formation" project of white supremacist violence persisting through the entire period. This is a development that is not accounted by any of the major macrolevel theories in contemporary movement scholarship. We close by outlining the substantive and theoretical implications of our results and provide suggestions for further research on the structuration of contention in social movement fields beyond the U.S. context. [ABSTRACT FROM AUTHOR]

Social movement scholarship has long projected an image of social movement organizations (SMOs) as highly adaptable vehicles ably responding to changing environments. Though SMOs unquestionably change, how common change is has been largely overlooked in the literature. Organizational theories (e.g., structural inertia theory), as well as some empirical evidence of SMO change, suggest that organizations in fact display more stability than change. Studies of organizational change point to obstacles and opportunities, both internal to organizations and externally in their environments, that inhibit or promote organizational change. This study takes up these two questions: (1) How common is change among SMOs? (2) What shapes an SMO's ability to change? The analysis draws evidence from a study of forty left-wing SMOs active in Seattle, Washington between 1999 and 2005. It examines their changing issues, tactics, and targets across an eventful period of expanding and contracting political opportunities. The results support an insight from structural inertia theory that organizations more readily change those aspects that are peripheral to their resource mobilization function. Specifically, SMOs in Seattle are more than twice as likely to change their targets and tactics than their issues. Issues lie at the core of an SMO's identity and ability to mobilize support. The analysis also shows that these organizations are more likely to adapt if they have experience with change, are older, and have broad goals. Changes in the political context have the unexpected effect of discouraging SMO change as political opportunities contract. [ABSTRACT FROM AUTHOR]