The interplay of roles and routines: situating, performances and patterning in the emergency department
Journal of Health Organization and Management
ISSN: 1477-7266
Article publication date: 7 April 2020
Issue publication date: 9 June 2020
Abstract
Purpose
While previous research acknowledges the influence of roles on routine dynamics, roles are largely taken for granted. The purpose of this paper aims at examining how roles and routines interplay in accomplishing work in organizations.
Design/methodology/approach
A four-year ethnography of an emergency department (ED) at a university hospital was conducted through observations, interviews and documents.
Findings
Roles and routines are formed by scripted and unscripted patterns, which are brought into performances following a situational assessment. Performances trigger patterning processes prompting the co-construction of role and routine patterns.
Practical implications
This study highlights the importance of designing flexible structures. Managers can benefit from identifying unscripted patterns critical to work performance and making them part of scripted patterns. Managers should contemplate the influence that individuals, their relations and context have on how work is done.
Social implications
This study suggests that the existence of different patterns impacts the length of wait times in EDs, a societal issue worldwide because of the effects that waiting can have on the patient's health condition and the unnecessary costs it carries. This study can help design solutions to decrease wait times.
Originality/value
This paper contributes to research on routine dynamics by providing a more nuanced explanation of the sources of endogenous change and how these enable organizational stability and flexibility.
Keywords
Acknowledgements
This article is based on the author's doctoral research. The author is grateful to her doctoral supervisors, Mattias Jacobsson, Malin Näsholm and Markus Hällgren, and all the participants in the study. The author also thanks Professor Helen Dickinson, Associate Editor, and two anonymous reviewers for their insightful comments and suggestions.
Citation
Rosales, V. (2020), "The interplay of roles and routines: situating, performances and patterning in the emergency department", Journal of Health Organization and Management, Vol. 34 No. 4, pp. 409-425. https://doi.org/10.1108/JHOM-12-2019-0342
Publisher
:Emerald Publishing Limited
Copyright © 2020, Emerald Publishing Limited