Sub-theme 33: Disrupting Organizing Practices in Healthcare

Convenors:
Bjørn Erik Mørk
BI Norwegian Business School, Norway
Wendelin M. Küpers
ICN Business School, France
Davide Nicolini
Warwick University Business School, United Kingdom

Call for Papers


Healthcare practices are in constant development. New technologies, different ways of collaborating within and across organisations and new practices of patients centred care in condition of economic scarcity and shifting institutional constraints fuel the expansion of existing practices and the emergence of new ones. Emerging practices may disrupt existing models of care and working routines and yet changing practices can be difficult as knowledge is heavily “invested in practice” (Carlile, 2002) and new practices may be “competence destroying” (Christensen et al., 2000).
 
In this sub-theme we propose to look forward and examine in depth how emerging technologies, innovative practices of coordination and new models of care may trigger the next wave of disruption in healthcare. The disruptive role of technologies in healthcare practices is a well-established area of research and a wealth of studies exist for example on the implications of new technologies for organising processes (Barrett et al., 2012), expertise (Nicolini et al., 2017), identity reconstruction (Reay et al., 2017), and organizational change towards patient-centred care (Liberati et al., 2015).
 
We invite studies that examine new and recent technologies that are becoming or may soon become disruptive. These include but are not limited to new “medical” technologies such as robotics, 3D printing, nano-technology, hybrid operation rooms, monitoring devices, sensors, and new AI based decision support systems. For example, these technologies may affect the unfolding of medical practices and practitioners’ direct embodied and emotional involvement. Their use affects and is affected by the body and embodiment as media for practice, which is in particular relevant for ethical dimensions in care work (Küpers, 2015).
 
These technologies may also lead to the reconfigurations of practice, the institution of new activities and the emergence of new occupations and communities of practice (Swan et al., 2002); they may modify power relations (Mørk et al., 2010; Lindberg et al., 2017) and trigger ethical dilemmas (Gherardi & Rodeschini, 2016). Many of these new technologies also bring to the fore the role of technology developers and providers, how they interact with healthcare practitioners, and their capacity to affect the healthcare landscape. Finally, new technologies also ask to reconsider the global geography of healthcare innovation. While new technologies are developed globally, traditionally the focus has been on local practices and national contexts. It is therefore paramount that scholars try to understand how local and global practices are linked and affect each other.
 
We also invite studies that address how new healthcare practices may develop through new forms of collaboration and connectivity. The search for new connected forms of healthcare is currently fuelled by the combination of institutional pressures, economic constraints and new technological opportunities. This has led to the emergence of new modes of organising that themselves may become disruptive such as the case of “clinical directorates” in hospitals. Information and communication technologies (ICTs) can also help developing collaborative care practices across organisational boundaries (Aristidou & Barrett, 2017) for example by including families, friends or patient associations. ICTs can also affect patients/practitioners relationships and collaborations, as in diabetes or in telemedicine, by stretching care practices in time and space (Nicolini, 2007).
 
Finally, disruption can stem from the development of new forms of relationships with patients. These changes which are captured by terms such as patient-centred care, patient-centeredness, patient centricity, and so on – imply different relationships between ‘care providers’ and ‘care receivers’ (Mol, 2008) as well as different forms of organising (Randall & Munro, 2010). Indeed, this requires a better consideration of patients’ values, needs and preferences, and her social context but also a reconfiguration of interprofessional relationships and work processes (Keating et al., 2013; Liberati et al., 2015).
 
In line with the general theme of the 2019 EGOS Colloquium on “Enlightening the Future”, this sub-theme aims to attract scholars drawing upon different theoretical or interdisciplinary perspectives and methodologies. We encourage empirically based submissions that focus on the detail of activity, work, and their disruptive effects. Possible questions may include, but are not limited to:

  • How are emerging practices disrupting organising processes in healthcare?

  • What are the consequences of new technologies and medical innovations in practice?

  • How may new technologies enable or constrain patient-centred work?

  • What are the effect of new forms of connectivity?

  • What is the role of boundary work and institutional work in relation to the construction of new practices in care organisations?

  • What kinds of conflicts or dilemmas do disruptive and emerging practices raise?

  • What role may technology providers and financial forces play in these emerging practices?

  • How may entrepreneurship and new business models open up for new ways of delivering care?

  • How do responsive practices of care-workers incorporate an embodied, ethical know-how along with skilful engagement and respectful relationships with patients, families, and co-workers?

 
 

References

  • Aristidou, A., & Barrett, M. (2018): “Coordinating Service Provision in Dynamic Service Settings: A Position Practice Relations Perspective.” Academy of Management Journal, 61 (2), 685–714.
  • Barrett, M., Oborn, E., Orlikowski, W.J., & Yates, J. (2012): “Reconfiguring Boundary Relations: Robotic Innovations in Pharmacy Work.” Organization Science, 23 (5), 1448–1466.
  • Carlile, P.R. (2002): “A Pragmatic View of Knowledge and Boundaries: Boundary Objects in New Product Development.” Organization Science, 13 (4), 442–455.
  • Christensen, C., Bohmer, R., & Kenagy, J. (2000): “Will Disruptive Innovations Cure Health Care?” Harvard Business Review, September/October, 102–112.
  • Gherardi, S., & Rodeschini, G. (2016): “Caring as a collective knowledgeable doing: About concern and being concerned.” Management Learning, 47 (3), 266–284.
  • Keating, M., McDermott, A., & Montgomery, K. (eds.) (2013): Patient-centred Health Care. Achieving Co-ordination, Communication and Innovation. Basingstoke: Palgrave Macmillan.
  • Küpers, W. (2015): “Embodied Responsive Ethical Practice. The Contribution of Merleau-Ponty for a Corporeal Ethics in Organisations.” EJBO – Electronic Journal of Business Ethics and Organization Studies, 20 (1), 30–45.
  • Liberati, E.G., Gorli, M., Moja, L., Galuppo, L., Ripamonti, S., et al. (2015): “Exploring the practice of patient centered care: The role of ethnography and reflexivity.” Social Science & Medicine, 133, 45–52.
  • Mol, A. (2008): The Logic of Care. Health and the Problem of Patient Choice. London: Routledge.
  • Mørk, B.E., Hoholm, T., Ellingsen, G., Edwin, B., & Aanestad, M. (2010): “Challenging expertise: On power relations within and across communities of practice in medical innovation.” Management Learning, 41 (5), 575–592.
  • Nicolini, D. (2007): “Stretching out and expanding work practices in time and space: The case of telemedicine.” Human Relations, 60 (6), 889–920.
  • Nicolini, D., Mørk, B.E., Masovic, J., & Hanseth, O. (2017): “Expertise as trans-situated: the case of TAVI.” In: J. Sandberg, L. Rouleau, A. Langley & H. Tsoukas (eds.): Skilful Performance: Enacting Expertise, Competence, and Capabilities in Organizations. Oxford: Oxford University Press, 27–49.
  • Randall, J., & Munro, I. (2010): “Foucault’s Care of the Self: A Case from Mental Health Work.” Organization Studies, 31 (11), 1485–1504.
  • Reay, T., Goodrick, E., Waldorff, S.B., & Casebeer, A. (2017): “Getting Leopards to Change their Spots: Co-creating a New Professional Role Identity.” Academy of Management Journal, 60 (3), 1043–1070.
  • Swan, J., Scarbrough, H., & Robertson, M. (2002): “The Construction of ‘Communities of Practice’ in the Management of Innovation.” Management Learning, 33 (4), 477–496.
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Bjørn Erik Mørk is an Associate Professor of Innovation at BI Norwegian Business School, Norway, and Honorary Associate Professor at IKON, Warwick Business School, UK. He has conducted research on health care since 2000, and draws upon practice-based perspectives to understand how new technologies and practices in healthcare are related to organising, learning, collaboration and power relations. Bjørn Erik has published in journals such as ‘Human Relations’, ‘Management Learning’, and ‘Industrial Marketing Management’. He was one of the organisers of the international conference on “Organizational Learning, Knowledge and Capabilities (OLKC)” in 2014, and has been convenor of several symposiums and teaching workshops at OLKC.
Wendelin M. Küpers is Professor at ICN Business School in Nancy, France. Combining a phenomenological and cross-disciplinary orientation, his research focuses on embodied, emotional and creative dimensions of responsive and responsible practices in organisations. He has published widely in scholarly journals, and books as well as editing a book-series on “The Practical Wisdom in Leadership and Organization” (Routledge). He has been convenor of sub-themes at different conferences, including EGOS.
Davide Nicolini is Professor of Organization Studies at Warwick University Business School, UK, where he co-directs the IKON research group. He is currently interested in the development of practice-based approaches and how they can be applied to different objects of research in the field of organised work, management and beyond. For many years Davide has been involved in research on health care, and he published extensively, including in journals such as ‘Organization Science’, ‘Organization Studies’, ‘Human Relations’, and ‘Management Learning and Organization’. He has organised several international conferences, and has been convenor of several sub-themes at EGOS.