Page 57 - Journal of Management Inquiry, July 2018

Gärtner and Huber 271

Figure 2. Screenshot of the OTAP.
Note. OTAP = operation theater allocation plan.

operation theaters (software and hardware breakdowns, operations. In addition, the allocation of operation time to
delays, etc.). The challenge to get the work done efficiently departments is the result of negotiations between the special-
and with high quality despite uncertainties frequently creates ized departments and the hospital management, which takes
a need for mindful organizing. We assume that our research place 2 times per year. To further complicate matters, labor
site is not substantially different from other hospitals in terms regulations have to be respected, the entire operation team
of having established highly reliable work practices by mind- (surgeon, anesthetist, nurses) needs to be coordinated, and
ful organizing. sterilized operating instruments must be made available.
The hospital of our case has a capacity of 300 beds, and is These issues are reflected in a guidebook on operating the-
treating emergency and elective patients in 15 different spe- ater rules and procedures, which is part of a larger quality
cialized departments (e.g., orthopedic and trauma surgery, assurance program across the hospital. Some of the OTAP’s
neurophysiology, dentofacial surgery, urology). All depart- main functionalities are based on rules from this guidebook.
ments of the hospital share the five central operating the- As the OTAP is part of the hospital’s management informa-
aters, and each theater is assigned to a specific department. tion system, it is connected to other modules and functional-
Normally, each department only uses the assigned theater, ities. We focus on the OTAP because it is the one tool on
but in cases of unexpected events (emergencies, schedule which all actors in and around the operation theaters consis-
overrun, etc.), there may be changes. Availability of the oper- tently drew on.
ating theaters is found to be scarce, and it needs to be orga-
nized as to which operating room is occupied by which team Data Collection and Analysis
(specialized surgeon, anesthetist, nursing staff) and with
what medical instruments. This is managed by use of the The empirical study draws on three sources of data: inter-
OTAP. views, observations, and documents. First, we conducted a
The OTAP is a computer-based tool that provides infor- set of 21 interviews (Phase 1): We interviewed hospital’s top
mation about the planned, ongoing, and forthcoming surger- executives, surgeons, and heads of departments (15), the
ies in the five operation theaters (see Figure 2). Its most manager of the operating theaters (interviewed twice), the
obvious features are that it displays the ongoing surgeries head of nursing (1) as well as the management accounting
within the five operation theaters as a set of boxes, and shows team (3). A practice-based approach needs scholars to
additional information when the user clicks on the boxes rep- become involved in their field of study to get to know the
resenting the surgeries. Managing time slots via the OTAP is specifics of the challenges at hand. This is even more impor-
a practically complex task, as it concerns that the operation tant in our case because exploring the role of materiality
theaters are used efficiently and for the most important should not rely on interview data alone. Thus, as a second