The Institution is, to me, one of the most fundamental aspects of Spinespur, and a quintessential collection of horror genre tropes. Let's take a good hard look at the strengths and weaknesses of this Agenda.
Agenda Strengths: The Institution has some very big hitters in melee, and Doc Akron in "Doctor Mode" generates Fear Tokens every turn. This means the longer the game goes on, the greater your resources, unlike most agendas. Almost none of the models in the Agenda carry lootable weaponry (Doc Akron has a short blade), so you don't have to be concerned with supplying your opponent. Half of the Agenda has the "Dust to Dust" special rule, which means you don't leave corpse tokens. This "resource control" can be very critical when fighting certain other factions, such as the Dark Faith or the Graveyard.
Agenda Drawbacks: Inside every silver lining, there's a dark cloud. In this case, there's a complete and total lack of ranged ability. Doc Akron has 2 shock globes, and Composites can lob their heads once per round (with a disastrous result on their physical traits until the end phase, so be careful when you use it.)
Doctor Akron- Doctor Akron is quite possibly the best "trope fusion" you're ever going to find. A hybrid of Doctor Frankenstein and Doctor Jekyll Akron is a mad scientist who not only builds followers out of spare parts (let that sink in for a second...), but also transforms into a vicious brutish killing machine. Brains and brawn all in one package, with the subtle drawback that he cannot be both at the same time. In the form of Doctor Akron, you get an automatic fear token generator ((special rule)) and a grit bubble to utilize it. In the form of The Beast, you get a killing machine that effectively has twice as many actions in close combat ((special rule)) so he's a solid threat to massed minions and big bads alike.
Hack: if Akron is Dr. FrankenJekyll then Hack is Adam Vorhees. Hack is Doctor Akron's chief enforcer- a tractor trailer with a chainsaw as a hood ornament. When used effectively (and with a little luck from the dice), Hack can almost single handedly turn a game. A mix of Adam ("Frankenstein's Monster") and Jason Vorhees of the Friday the 13th series, Hack is a butcher plain and simple. One of the most effective killing machines in the game, it's really hard not to take him in matches.
Primes: While Hack might have been first in line for brawn, he's a little otnay ootay ightbray. The Primes are a far better specimens of physical and mental acumen, possessing mental attributes nearly as strong as the good Doctor's, while still being very competent in a fight. In addition, their "Heed me, Fleshlings" special rule is almost mandatory if you intend to bring Trauma Hounds. Primes limit your opponent's ability to scavenge corpse tokens. Due to their "Dust to Dust" rule, they leave nothing behind.
Little Ones- Reanimated Corpses are creepy. Reanimated midget corpses are a special kind of creepy. Little Ones are the good Doctor's "children", specially made from the corpses of children, with adult heads to incorporate a larger brain. Not that they use it much. The main advantage to the little ones is their ability to leap in front of wounds that would injure Dr. Akron. Awww.... self-sacrificing zombie midget-babies. It's so touching, in a "bad touch" kinda way... Little ones also have a specialized "gang up" ability which allows them to attempt to trip something larger than they are if enough of them are in base to base. Not great combatants on their own, but useful for letting Hack, Prime, Composites, or The Beast get the drop on people.
Composites- Let's try this again.... Reanimated Corpses are creepy. Reanimated Corpses with extra limbs stuck on at odd angles are extra creepy. Composites have two special things going for them. They are your only agenda model (aside from Doctor Akron himself) who have any ranged capability, and they can try to wrangle Trauma Hounds. While these models are definitely impressive in their own right, a perverted part of my hobby mind is looking forward to the... "conversion capabilities".... of these guys.
Trauma Hounds- If you're trying to put these guys in, and you don't have Primes or Composites... don't. Just don't. Read this to see why. Trauma hounds can be very effective for their cost... but you have to sacrifice actions from other models (primes or composites) to make it happen. Just keep in mind that this "value buy" comes with a hidden price tag. Trauma Hounds limit your opponent's opportunity to scavenge weaponry, as their "weapons" are not removable.
Tactics: You need to close in, and you need your heavy hitters to make it there. This generally requires a Speartip assault, or some other strategy where you're only engaging at one point at a time, and generally in superior numbers or power. You don't move exceptionally fast, and if you're bringing meatshields from the Agenda (Little Ones or Trauma Hounds) you'll be slowed up a little more. Use terrain to your advantage, and try to keep anything worth shooting out of sight.
Non Agenda Options: Dopplegangers make shooting primary targets difficult, so are worth looking into. Thugs make cheap human shields that don't slow you down (keep them at 7 points, you're expecting them to die, so cheaper is better.)