McGill U. - Desautels Faculty of Management, Canada
While existing research has examined challenges associated with formulating and enacting rules in organizations, less is known about how newly introduced rules evolve and become stabilized in organizations that depend on them. To address this question, we conducted a 2-year ethnographic study that documented the relocation of an emergency department (ED) at a leading University-affiliated hospital in Canada to a new state-of-the-art facility. The relocation changed the patient population, disrupting patient flow practices. To address these disruptions, the ED introduced and negotiated new rules. We traced five rule trajectories, we label emerging, optimizing, reviving, eroding, and materializing, which reflect ED members’ skillful efforts to coordinate and manage overwhelming demands for its services. Our findings suggest that while the deployment of rules improved patient flow, it also unintentionally reconfigured the role relationships among professionals both within and between various units over time. Our study contributes to the literature on organizational rules by providing a processual account of how newly introduced rules evolve and stabilize over time. Contrary to existing coordination research which maintains that rules can either constrain emergent practices or clarify ways of working, our research suggests that rule deployment can yield both productive and counterproductive consequences for coordination practices as rules evolve.