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Disrupted Routines: Team Learning and New Technology Implementation in Hospitals

Amy C. Edmondson, Richard M. Bohmer and Gary P. Pisano
Administrative Science Quarterly
Vol. 46, No. 4 (Dec., 2001), pp. 685-716
DOI: 10.2307/3094828
Stable URL: http://www.jstor.org/stable/3094828
Page Count: 32
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Since scans are not currently available to screen readers, please contact JSTOR User Support for access. We'll provide a PDF copy for your screen reader.
Disrupted Routines: Team Learning and New Technology Implementation in Hospitals
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Abstract

This paper reports on a qualitative field study of 16 hospitals implementing an innovative technology for cardiac surgery. We examine how new routines are developed in organizations in which existing routines are reinforced by the technological and organizational context. All hospitals studied had top-tier cardiac surgery departments with excellent reputations and patient outcomes yet exhibited striking differences in the extent to which they were able to implement a new technology that required substantial changes in the operating-room-team work routine. Successful implementers underwent a qualitatively different team learning process than those who were unsuccessful. Analysis of qualitative data suggests that implementation involved four process steps: enrollment, preparation, trials, and reflection. Successful implementers used enrollment to motivate the team, designed preparatory practice sessions and early trials to create psychological safety and encourage new behaviors, and promoted shared meaning and process improvement through reflective practices. By illuminating the collective learning process among those directly responsible for technology implementation, we contribute to organizational research on routines and technology adoption.

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