In an era of constant policy growth (known as policy accumulation), effective policy implementation is a growing challenge for democratic governance across the globe. Triage Bureaucracy explores how government agencies handle expanding portfolios of rules, programs, and regulations using 'policy triage' – a set of strategies for balancing limited resources across increasing implementation demands. Drawing on case studies from six diverse European countries, the authors show how organizations' vulnerability to overburdening and their ability to compensate for overload determine why policy implementation succeeds in some cases while it fails in others. Triage Bureaucracy offers a deeper understanding of the organizational dynamics behind effective governance and, by placing bureaucratic actors at the center of the policy process, shows why policy growth often outpaces our ability to implement it – shedding light on the consequences of an ever expanding policy state. This title is also available as Open Access on Cambridge Core.