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Over the last two decades, the notion of institutional thickness has become a key reference for a large body of work that has sought to provide profound insights into the link between institutions and regional development. However, only few attempts have been made to reassess the concept, to improve its methodology, and to reflect on its empirical application. The aim of this article is to revise the original concept of institutional thickness. We draw on and seek to contribute to current work in economic geography and related disciplines on the role of organizations and institutions in regional development. We identify some crucial limitations and provide suggestions for how they can be addressed. It is argued that much can be gained by (1) explicitly elaborating on the relation between the organizational and institutional dimensions of thickness, (2) moving beyond overly static views on thickness, (3) developing a multiscalar approach to thickness, and (4) identifying features for assessing thickness in absolute and relative terms. [ABSTRACT FROM AUTHOR]

The focus of this paper is on how organizational change within medical research evolves and is influenced by different types of institutions at different geographical levels, as well as what characteristics of the key individuals are important in enacting institutional opportunities and overcoming hindrances. The paper reveals the complexity of institutions influencing change processes. First, the relations between institutions can be complementary, reinforcing or contradicting, suggesting that individuals initiating change should consider possible responses to institutions contradictory to the initial opportunities, as well as take advantage of reinforcing and complementary norms, rules, and procedures. Second, although different types and levels of institutions have a joint impact on change processes, some institutions are more prominent than others in different phases of the process. Individuals can take advantage of institutional opportunities and overcome hindrances due to their personal qualities and position in the organization. [ABSTRACT FROM AUTHOR]