Connective Routines

Connective Routines: Effects of Work Routines on Service Innovations in Health Care
Marlot Kuiper, i.c.w. prof. dr. Mirko Noordegraaf, dr. Kim Loyens

Professional service organizations try to deliver innovative services. Due to external pressures – cost constraints, client demands, risks – collaboration, efficiency and quality are called for. The health care field struggles with implementing basic and rather ‘simple’ quality and safety improvements which have nevertheless major effects on health care quality. It proves to be difficult to implement everyday standards such as safety rules, hygiene procedures, logistical guidelines, checklists, operating procedures.

Generally, service providers either focus on competencies of individual professionals or system interventions to produce innovative services, irrespective of context. This research reframes the search for competency by focusing on work routines as contextualized and taken-for-granted activity patterns. We argue that the usage of standards is affected by professional routines. By looking at routines, we connect individual and organizational levels and study what we call ‘institutional competency’. Theoretically, we link debates on professional fields, professional work, professionals and their competencies to the study of institutionalized practices and (organizational) routines, in order to develop a more relational understanding of ‘competent’ health care delivery.

The Netherlands Organization for Scientific Research (NWO) provided a research grant for a PhD project (NWO Onderzoekstalent; Marlot Kuiper MSc, supervised by prof. Mirko Noordegraaf and dr. Kim Loyens, Utrecht School of Governance), which allows us to examine our research question: What explains the effects of work routines on service innovations in health care, and how can connective routines be established?