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PurposeIn the face of numerous explanations for why AI-driven decision support systems (DSS) have failed to deliver on their promise of improving organizational decision-making, this paper problematizes the under-theorized mismatch between the design of DSS and the actual decision-making processes that the technology is supposed to support. We examine this mismatch by studying the implementation of a DSS in the intensive care unit (ICU) of a large academic hospital.Design/methodology/approachBased on 27 months of ethnographic fieldwork, we contend that the studied DSS was designed on the assumption that individual intensivists are responsible for making life-critical discharge decisions at one particular moment in time.FindingsHowever, our study of actual decision-making practices reveals that discharge decision-making is instead a protracted process, involving multiple actors fragmented across time and space. To account for these complexities, we advocate for a “dynamic routines” perspective, which highlights the actual patterns of action pursued throughout a clinical decision-making process.Originality/valueOur application of this perspective contributes to a more granular understanding of discharge decision-making, which can help future DSS designers better grasp the peculiarities and complexities—or “anatomy”—of the decision-making process. We also suggest integrating an “anticipatory ethnographic approach” into the design and pre-implementation phases of future DSS to help bridge the current gap between design assumptions and actual decision-making practices.
PurposeIn the face of numerous explanations for why AI-driven decision support systems (DSS) have failed to deliver on their promise of improving organizational decision-making, this paper problematizes the under-theorized mismatch between the design of DSS and the actual decision-making processes that the technology is supposed to support. We examine this mismatch by studying the implementation of a DSS in the intensive care unit (ICU) of a large academic hospital.Design/methodology/approachBased on 27 months of ethnographic fieldwork, we contend that the studied DSS was designed on the assumption that individual intensivists are responsible for making life-critical discharge decisions at one particular moment in time.FindingsHowever, our study of actual decision-making practices reveals that discharge decision-making is instead a protracted process, involving multiple actors fragmented across time and space. To account for these complexities, we advocate for a “dynamic routines” perspective, which highlights the actual patterns of action pursued throughout a clinical decision-making process.Originality/valueOur application of this perspective contributes to a more granular understanding of discharge decision-making, which can help future DSS designers better grasp the peculiarities and complexities—or “anatomy”—of the decision-making process. We also suggest integrating an “anticipatory ethnographic approach” into the design and pre-implementation phases of future DSS to help bridge the current gap between design assumptions and actual decision-making practices.
How do we change social orders to deliver a sustainable future? A growing literature in organization studies argues that meta-organizations are part of the answer. Meta-organizations have been shown to be well equipped for tackling grand challenges, yet paradoxically they also tend to resist change due to their inertia. In this paper, we move beyond the question of whether and how meta-organizations act as vectors of transition to address the question of how some of the defining organizational attributes of meta-organizations – which we call ‘meta-organizationality’ – create tensions for sustainability transitions. We argue that these tensions result from frictions between the imperatives of transitions, i.e. conditions for achieving broad socio-technical transformations for sustainability, and the imperatives of meta-organizations, i.e. the implications resulting specifically from their meta-organizationality. We unpack four tensions, which we frame as ‘multi-referentiality–directionality’, ‘layering–diffusion’, ‘dialectical actorhood–coordination’, and ‘multi-level decidedness–reflexivity’. We argue that transformative meta-organizations are those that successfully navigate these tensions to produce sociotechnical system changes. This work has several implications for organization studies, meta-organization studies and transition studies, and offers several avenues for research.
Hardly any other management concept sounds as hackneyed as strategy, and at the same time hardly any other concept in organizational science is as vaguely defined. As a means of escaping the conceptual tangle, this article suggests a systems theory-based definition which allows us to sort out the various threads of the strategy discussion. Strategy, according to this interpretation, entails programs that search for the means to achieve previously defined goals. This makes it possible to systematically link classical notions of strategy to discussions concerning organizational theory. Casting the concept of strategy in terms of systems theory enables us to resolve the artificial contradiction between strategy and structure, clarify the relationship between end and means, determine the relationship between a plan and its practical implementation, relativize the importance of strategies, and explain the surprising limitation of the strategy discussion to businesses.
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