Making the Big Move in Fast-Response Organizations: Resuscitating Rules as Emergency Work

This on-going inductive study investigates how fast-response organizations embedded in inertial contexts prepare for large-scale transformation. Using the case of an Emergency Department (ED) about to undergo a major relocation as part of the largest health system restructuring in Canada, we show how rules, as key sources of regulatory pressure in the institutional context, are purposively rediscovered, formalized and enacted in situ to enable agency and change. Using the impending “move” as an occasion for change, actors carefully selected specific rules and translated them into socially accepted coordination mechanisms. These mechanisms were then used performatively and materially to legitimate the enforcement of work boundaries with specialist groups of equal or greater power. In this study of rules resuscitation work, we uncover two practices we call reviving rules and enacting protocols. We call these practices projective because they foreground the future-oriented aspect of agency in that shared understandings of anticipated future possibilities alter and shape action trajectories in the “now” as rules are interpreted, invoked and enacted. We conceptualize projective practices as “pro-actions” – in contrast with reactions - aimed at amending existing routinized performance trajectories based on ostensive understandings of what “new” circumstances involve. This work contributes to the literature on organizational change by offering insight into the contextual factors that influence how change preparation is enacted in fast-response organizations that are embedded in inertial contexts.