Path coherence and disruption in routine dynamics

Area of Science:

• Organizational Behavior
• Information Systems
• Sociology

Background:

• Clinical documentation routines are crucial for healthcare operations.
• Technological disruptions, like Electronic Health Record (EHR) system upgrades, can significantly alter these routines.
• Understanding the dynamics of routine change is essential for organizational adaptation and efficiency.

Purpose of the Study:

• To propose and validate a novel mechanism, path coherence, for predicting routine dynamics.
• To investigate how path coherence influences the persistence and formation of clinical documentation routines.
• To explore the theoretical implications of path coherence for organizational path dependence, resilience, and inertia.

Main Methods:

• Utilized evidence from a disruption in clinical documentation routines within five outpatient clinics.
• Employed latent factor network models to analyze routine dynamics before and after an EHR system upgrade.
• Defined and measured path coherence based on the continuity of situational attributes (who, what, when, where, why) across sequential events.

Main Results:

• Coherent paths were up to 14 times more likely to persist than less coherent paths.
• Coherent paths were up to 40 times more likely to form compared to less coherent paths.
• Path coherence emerged as a significant predictor of routine persistence and formation.

Conclusions:

• Path coherence offers a novel, predictive mechanism for understanding routine dynamics in organizations.
• The findings suggest that path coherence plays a critical role in organizational path dependence, influencing resilience and inertia.
• The study provides a new theoretical lens for analyzing how routines evolve in response to change.