Page 61 - Journal of Management Inquiry, July 2018

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Figure 5. Printout of the main screen.

system of the tool only grants the manager of the operation head of organizational support). Thus, the OTAP’s inscrip-
theaters and the surgeon who has done the initial categoriza- tions preconfigure action (or, to put it the other way round:
tion the right to change categories; all others are not allowed Actors’ behaviors are bound by the tool) by supporting the
to change them. However, the manager of the operation the- maintenance of shared expectancies; that is, what others will
aters insisted that he would never change a patient’s do once (unexpected) surgeries are registered.
categorization: The OTAP also codifies rules that affect behavior more
directly. For example, whenever the manager of the opera-
I will never change the category, never ever. Although I could. tion theaters wanted to change relevant information in the
And even when a surgeon calls me on the phone and asks me to OTAP (e.g., surgeries or allocated team members) as a reac-
quickly change the categorization because he’s busy, I won’t do tion to unexpected changes, the system requested to answer
that. I tell him that he must log on and make the change himself. several pop-up windows. Most of them offered the options
(First interview manager of operation theaters)
“Yes” and “No.” Counterintuitively, the position of the but-
tons labeled “Yes” and “No” switched places during a series
In addition to the unwritten rule that the manager of the of questions: While the “Yes” button appeared on the left
operation theaters would not make changes to categoriza- side of the first pop-ups, it “suddenly moves to the right,” as
tions, there are other informal rules regarding the reschedul- the manager of the operation theaters complained. While the
ing of surgeries. Rescheduling becomes problematic when manager was annoyed of this feature, he also mentioned that
the surgery program of another department is interfered with he is required to “pay attention to the boxes and actually read
and most employees acted with an awareness of how their the questions” (field notes). The information technology (IT)
actions affected others. To avoid the anger of colleagues, administrator referred to features like these as “digital coer-
there was a strong tendency to stick to the timeslots assigned cion” (Interview IT administrator).
to one’s own department. The only legitimate violations of In addition to being bound by the tool, medical care staff
this unwritten rule were emergency patients of high priority. and surgeons displayed what we call a “can do attitude,” and
Interviewees frequently mentioned that “adhering to rules” put personal sensitivities aside to improvise and respond
and “clear responsibilities” were inevitable to work reliably appropriately to surprise and breakdowns. Some of these
(e.g., manager of operation theaters, Surgeon 2, Surgeon 5, breakdowns relate to the OTAP directly. For example, the