Institutions in Elder Sign provide the resources to the characters outside of the museum. The game effect is replacing some or all of the entrance locations with ones that have different options and effects.

This PDF provides 30 optional institutions. Some are existing institutions, others are defunct institutions from the era, and a few are taken from fiction. All are modified to suit the Elder Sign world and game mechanics.

The purpose of using institutions is to provide variety of game play. They are not designed or intended to make the game easier or harder, although depending upon the Great Old One, herald, and investigators it is likely that some will do so.

https://boardgamegeek.com/filepage/144950/elder-sign-institutions-varying-entrance-locations