To achieve organization-wide goals, sometimes multiple local groups must synchronize their learning activities. This paper uses an ethnographic study of a cancer treatment center to develop theory on organizational learning by identifying a process that helped synchronize learning across many local and interdependent groups by taking advantage of hierarchy. Change agents—in this case, consultants—identified the managers of the various groups that would need to change for an organization-wide goal to be achieved, and they met with each manager to renegotiate his or her formal obligations. Through the renegotiation process, the managers came to better understand the organization-wide goal, and the change agents better understood each group's work. After the managers understood and accepted their renegotiated obligations, they changed how they administered resources and expectations in their groups, and the members of their respective groups adapted their practices in response. This process illustrates how the obligations associated with hierarchical positions can be renegotiated in ways that develop improved understanding and, when changed, can shape local activities to favor new goals.
This paper develops a new understanding about how "client managers"—those using platform labor markets to hire and manage workers—attempt to maintain control when managing skilled contractors. We conducted an inductive field study analyzing interactions between client managers and contractors in software development "gigs" mediated by a platform labor market. The platform provided multiple tools client managers could use for control, including in response to unexpected events. We found that, when managers used the tools to exert coercive control over contractors acting unexpectedly, it backfired and contributed to uncompleted project outcomes. In contrast, when they refrained from using the tools for coercive control in such circumstances and instead engaged in what we call collaborative repair, their actions contributed to completed project outcomes. Collaborative repair refers to interactions that surface misaligned interpretations of a situation and help parties negotiate new, reciprocal expectations that restore trust and willingness to continue an exchange. Client managers' attempts at collaborative repair yielded fuller understanding of project-related breakdowns and shared investment in new expectations, facilitating effective control and completed projects. This study extends prior theories of control by characterizing the new client manager role created by platforms and demonstrating how initiating repair is integral for managers' capacity to accomplish control in these comparatively brittle work relationships.
This paper shows how mesolevel structures support effective coordination in temporary groups. Prior research on coordination in temporary groups describes how roles encode individual responsibilities so that coordination between relative strangers is possible. We extend this research by introducing key tenets from team effectiveness research to theorize when role-based coordination might be more or less effective. We develop these ideas in a multimethod study of a hospital emergency department (ED) redesign. Before the redesign, people coordinated in ad hoc groupings, which provided flexibility because any nurse could work with any doctor, but these groupings were limited in effectiveness because people were not accountable to each other for progress, did not have shared understanding of their work, and faced interpersonal risks when reaching out to other roles. The redesign introduced new mesolevel structures that bounded a set of roles (rather than a set of specific individuals, as in a team) and gave them collective responsibility for a whole task. We conceptualized the mesolevel structures as team scaffolds and found that they embodied the logic of both role and team structures. The team scaffolds enabled small-group interactions to take the form of an actual team process with team-level prioritizing, updating, and helping, based on newfound accountability, overlapping representations of work, and belonging—despite the lack of stable team composition. Quantitative data revealed changes to the coordination patterns in the ED (captured through a two-mode network) after the team scaffolds were implemented and showed a 40% improvement in patient throughput time.
Many studies examine the division of labor inside organizations. Yet there is also an expected division of labor between organizations and their clients, which research to date has tended to ignore or has treated as static and easily accepted by both parties. How might clients change the expected division of labor with a service organization? We developed this question while studying an academic cancer center (ACC), where patient activists led a movement to bring to light the burdensome invisible work they and their families did to coordinate their treatment. They shared their own stories, developed formal channels for collecting more stories, and worked to broadcast the growing set of stories across ACC. Their stories became a resource for change and mobilized a coalition of staff allies. Coalition members drew on the patient stories to develop a new diagnostic framing of the "Cancer Tax"—the burdensome coordination work ACC required of patients. They also developed a prognostic frame for how ACC could help, which inspired a new program that took on some of the patients' coordination tasks. In this way, the patients' stories created new awareness of the problem and provided resources for staff allies to make the case for taking on some of the patients' invisible work. This study shows that clients can effectively influence organizational change through movements fueled by personal narratives (for instance, lessening the coordination work they must do to coproduce complex services). Funding: This work was supported by Co-Investigators on the Cancer Center Transformational Initiative, funded by Stanford Health Care for $500,000 per year, 2012–2019. Supplemental Material: The e-companion is available at https://doi.org/10.1287/orsc.2022.1627 .
In many workplaces, temporary teams convene to coordinate complex work, despite team members having not worked together before. Most related research has found consistent performance benefits when members of temporary teams work together multiple times (team familiarity). Recent work in this area broke new conceptual ground by instead exploring the learning and performance benefits that team members gain by being exposed to many new partners (partner exposure). In contrast to that new work that examined partner exposure between team members who are peers, in this paper, we extend this research by developing and testing theory about the performance effects of partner exposure for team members whose roles are differentiated by authority and skill. We use visit-level data from a hospital emergency department and leverage the ad hoc assignment of attendings, nurses, and residents to teams and the round-robin assignment of patients to these teams as our identification strategy. We find a negative performance effect of both nurses' and resident trainees' partner exposure to more attendings and of attendings' and nurses' exposure to more residents. In contrast, both attendings and residents experience a positive impact on performance from working with more nurses. The respective effects of residents working with more attendings and with more nurses is attenuated on patient cases with more structured workflows. Our results suggest that interactions with team members in decision-executing roles, as opposed to decision-initiating roles, is an important but often unrecognized part of disciplinary training and team learning. Funding: This work was supported by the New Faculty Startup Fund from Seoul National University; Harvard Business School; Stanford Center for Work, Technology, and Organization; and Stanford Center for Designing Organizational Change. Supplemental Material: The online supplement is available at https://doi.org/10.1287/orsc.2022.1585 .
Prior studies that examine how new expertise becomes integrated into organizations have shown that different occupations work to legitimate their new expertise to develop credibility and deference from other organizational groups. In this study, we similarly examine the work that an expert occupation did to legitimate their expertise; however, in this case, they were legitimating practices that they actually considered illegitimate. We report findings from our 20-month ethnography of data analysts at a financial technology company to explain this process. We show that the company had structured data analytics in ways similar to Bechky's idea of a captive occupation: They were dependent on their collaborators' cooperation to demonstrate the value of data analytics and accomplish their work. The data analysts constantly encountered or were asked to provide what they deemed to be illegitimate data analysis practices such as hacking, peeking, and poor experimental design. In response, they sometimes resisted but more often reconciled themselves to the requests. Notably, they also explicitly lowered their stated standards and then worked to legitimate those now illegitimate versions of their expert practices through standardization, technology platforms, and evangelizing. Our findings articulate the relationship between captive occupations and conditions wherein experts work to legitimate what they consider illegitimate practices.