Katharina Hohmann - room A34 - 13.30-15.00

Institute of Marketing and Communication Management

Start date: 31 October 2012

End date: 1 November 2012

Coordination in temporary organizations: How hospital emergency teams stabilize and diagnose patients in critical conditions

Hospital emergency departments are sites of bustling activity: incoming phone calls, alarms from vital signs monitors, a nurse pushing a cart with used instruments to the cleaning room, another one carrying a blood sample to the laboratory, two doctors discussing incoming results from pathology. Especially in the resuscitation bays of emergency departments, all these activities appear to be tightly oriented (or co-oriented) towards the critically ill patient lying on the stretcher. The task of stabilizing him or her is the ‘object of concern’ that provides direction to the multiple and distributed activities (Taylor, 2006).

Resuscitation bays are not unique with regards to their centrality of the task. A body of literature concerned with temporary organizations suggests that when diversely skilled people work together on a complex task over a limited period of time (such as a disaster relief, a film production, or a construction project) (Baiden, Price, & Dainty, 2006; Bechky, 2006; Bigley & Roberts, 2001), the task at hand becomes a central focus of their sociality (Faraj & Xiao, 2006). In contrast, hitherto notions of maintaining interpersonal relationships (Saunders & Ahuja, 2006), trust (Meyerson, Weick, & Kramer, 1996), or clear lines of authority (Jones, Hesterly, & Borgatti, 1997) seem to be less relevant for this type of organizations.

Despite the repeated calls for the centrality of the task in temporary forms of organizing (Bennis, 1966; Lundin & Söderholm, 1995), the present literature has been relatively silent on how the task orients and coordinates their distributed activities. This question is of relevance in particular if we do not assume that the task is a clearly given reference point (i.e. producing a film), but rather that it is always only partly known, that it is partly contested, negotiated, and in continuous development (Y. Engeström & Blackler, 2005). The task, or how Taylor (2006) coins it, the ‘object of concern’ emerges in conversation as organizational members co-orient to what the task might be and how to tackle it. At the same time its material quality might make it resist certain constructions and evolve in unanticipated ways (Y. Engeström & Blackler, 2005). In the present paper, we propose to focus on how the object of concern is appropriated in conversations and in material work, and how these appropriations perform in turn on the coordination of work in temporary organizations.

In temporary organizations the task at hand is intimately linked to its temporality – its temporary existence, its urgency, its imminent completion. The literature on temporary organizations has suggested on regard that these organizations are “decoupled from other past, contemporary, or even future sequences of activities” (Lundin & Söderholm, 1995: 446). Consequently, their members draw their attention to a narrowed temporal horizon involving only the immediate present and the near future (Ancona, Okhuysen, & Perlow, 2001; Bakker & Janowicz-Panjaitan, 2009). Yet, similarly to what we argue for the task, also its temporality is not an objective phenomenon that is given by the environment, but time is “composed in and of a set of practices” (Orlikowski & Yates, 2002; Thrift, 2004: 875) and is a hybrid achievement involving multiple actors (Cooren, Fox, Robichaud, & Talih, 2005).

On this basis, we will argue and show how the active appropriation of the task involves a manifold and intricate temporal work that builds on conversation and material practices. We do so by drawing on an ongoing ethnographic study on the coordination practices of hospital emergency teams that temporarily form to stabilize and diagnose a critically ill patient.