When you consider that our grouping instincts are optimized for 50-person hunter-gatherer bands where everyone knows everyone else, it begins to seem miraculous that modern-day large institutions survive at all.
Well—there are governments with specialized militaries and police, which can extract taxes. That's a non-ancestral idiom which dates back to the invention of sedentary agriculture and extractible surpluses; humanity is still struggling to deal with it.
There are corporations in which the flow of money is controlled by centralized management, a non-ancestral idiom dating back to the invention of large-scale trade and professional specialization.
And in a world with large populations and close contact, memes evolve far more virulent than the average case of the ancestral environment; memes that wield threats of damnation, promises of heaven, and professional priest classes to transmit them.
But by and large, the answer to the question "How do large institutions survive?" is "They don't!" The vast majority of large modern-day institutions—some of them extremely vital to the functioning of our complex civilization—simply fail to exist in the first place.
I first realized this as a result of grasping how Science gets funded: namely, not by individual donations.
Science traditionally gets funded by governments, corporations, and large foundations. I've had the opportunity to discover firsthand that it's amazingly difficult to raise money for Science from individuals. Not unless it's science about a disease with gruesome victims, and maybe not even then.
Why? People are, in fact, prosocial; they give money to, say, puppy pounds. Science is one of the great social interests, and people are even widely aware of this—why not Science, then?
Any particular science project—say, studying the genetics of trypanotolerance in cattle—is not a good emotional fit for individual charity. Science has a long time horizon that requires continual support. The interim or even final press releases may not sound all that emotionally arousing. You can't volunteer; it's a job for specialists. Being shown a picture of the scientist you're supporting at or somewhat below the market price for their salary, lacks the impact of being shown the wide-eyed puppy that you helped usher to a new home. You don't get the immediate feedback and the sense of immediate accomplishment that's required to keep an individual spending their own money.
Ironically, I finally realized this, not from my own work, but from thinking "Why don't Seth Roberts's readers come together to support experimental tests of Roberts's hypothesis about obesity? Why aren't individual philanthropists paying to test Bussard's polywell fusor?" These are examples of obviously ridiculously underfunded science, with applications (if true) that would be relevant to many, many individuals. That was when it occurred to me that, in full generality, Science is not a good emotional fit for people spending their own money.
In fact very few things are, with the individuals we have now. It seems to me that this is key to understanding how the world works the way it does—why so many individual interests are poorly protected—why 200 million adult Americans have such tremendous trouble supervising the 535 members of Congress, for example.
So how does Science actually get funded? By governments that think they ought to spend some amount of money on Science, with legislatures or executives deciding to do so—it's not quite their own money they're spending. Sufficiently large corporations decide to throw some amount of money at blue-sky R&D. Large grassroots organizations built around affective death spirals may look at science that suits their ideals. Large private foundations, based on money block-allocated by wealthy individuals to their reputations, spend money on Science which promises to sound very charitable, sort of like allocating money to orchestras or modern art. And then the individual scientists (or individual scientific task-forces) fight it out for control of that pre-allocated money supply, given into the hands of grant committee members who seem like the sort of people who ought to be judging scientists.
You rarely see a scientific project making a direct bid for some portion of society's resource flow; rather, it first gets allocated to Science, and then scientists fight over who actually gets it. Even the exceptions to this rule are more likely to be driven by politicians (moonshot) or military purposes (Manhattan project) than by the appeal of scientists to the public.
Now I'm sure that if the general public were in the habit of funding particular science by individual donations, a whole lotta money would be wasted on e.g. quantum gibberish—assuming that the general public somehow acquired the habit of funding science without changing any other facts about the people or the society.
But it's still an interesting point that Science manages to survive not because it is in our collective individual interest to see Science get done, but rather, because Science has fastened itself as a parasite onto the few forms of large organization that can exist in our world. There are plenty of other projects that simply fail to exist in the first place.
It seems to me that modern humanity manages to put forth very little in the way of coordinated effort to serve collective individual interests. It's just too non-ancestral a problem when you scale to more than 50 people. There are only big taxers, big traders, supermemes, occasional individuals of great power; and a few other organizations, like Science, that can fasten parasitically onto them.
In the early 1990s I spent rather a lot of time listening avidly to the sort of thing advertised in the small ads in the back of The Wire: where the far end of post-hardcore-punk rock music, the far end of jazz and the far end of twentieth-century classical (Schoenberg is the barest start of the good stuff) converged. Most people would call this hideous racket, and I must admit that, despite all the thought that went into it, this was an aspect I would have called a feature. Disappointment was going to a concert of modern stuff and hearing something that sounded like a film soundtrack or a soundscape rather than an assault on the senses.
This is something of what I mean when I distinguish "good" or "worthwhile" from "of no cultural impact" - the latter speaks of listenership and influence on other artists. This is difficult to quantify, but (to use the example of friends doing music degrees) an academic composer who puts their stuff on the net and blogs and tweets about it and hangs out on 4chan /mu/ will have more impact than an academic composer who has nothing available. That's the point at which the bug of art impacts the windscreen of arts industry.
I am also deeply sceptical of the notion that art progresses in the manner of technology or science. It's made of memes and lines of influence can certainly be traced (you can even usefully do cladistics on them) and some stuff comes after other stuff. There's simple stuff, there's complex stuff, there's the simplicity on the far side of complexity (you could pick up a guitar and write a punk rock song, but you are unlikely to sling those three chords as effectively as the Sex Pistols did). But we don't study Shakespeare or Chaucer because they're just the precursor to the amazingly advanced stuff we do now (in the manner of Newton being first-year stuff) - we study it because it's good in itself. No-one listens to Beethoven or Bach as a precursor to current brilliance, they listen to it because it's good in itself. Canons are, in practice, constructed retrospectively from tastes at the time; the historiography (the history of the history) of art is itself a fruitful field of study in attempting to work out what's going on. Everyone from Shakespeare down is just trying to write a good one this time out.
(komponisto will, I suspect, consider me a barbarian at the gates at this point.)
Edit to add: Art doesn't progress as such because the point of art is to have an effect - on the artist and/or the listener. The aim is to press the audience's buttons. (There is a commonplace of art pontification that states that only if the artist is the test subject can the art be of true quality.) Beethoven listed what pressed his personal buttons, komponisto finds that a good and useful description of what presses his buttons. But I would be very surprised if komponisto did not test his own compositions by listening and seeing if they pressed his buttons, rather than just checklisting an algorithm. Obviously it is possible for science to actually advance this process - there is science fiction concerning scanning brains to make superstimuli so powerful as to be fatally addictive - but the human brain seems to do remarkably well at this already, massively iteratively testing possible artistic elements to see what seems to stick.
tl;dr: the constant is pushing the buttons of yourself and/or the audience in a given time, place and culture. All else is ways to get to that.
Bonus: The most horrible music I know of is my precious collection of Whitehouse. Early industrial band, amazingly still extant. Hideous screaming music that in itself seems to offend as much as the lyrics. It's what you play back at the neighbours when they've played that Robbie Williams song for the fiftieth time in a row. CDs available here.