COLLABORATIVE RESEARCH: Antecedents of Complexity in Healthcare Routines

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AbstractThe goal of this research is to understand how social and technological factors contribute to the complexity of organizational routines in healthcare. We know that complexity is influenced by the way work is organized, but current theory and methods do not provide useful ways to examine this relationship. This research will develop and test new methods for analyzing the complexity of healthcare routines using electronic medical records (EMR) and interviews from a range of clinical specialties at the University of Rochester Medical Center, including Dermatology, Dermatologic Surgery, Orthopedics, Pediatric Oncology, and Radiation Oncology. This research will deepen our understanding of the factors that drive the complexity of healthcare organizations, a context where there is an urgent need for better ways of organizing. This project will provide a way to analyze the complexity of healthcare routines, and better understand complexity as a factor in the cost and quality of healthcare.Complexity is a basic concept in the science of organization, and routines are the fundamental way that organizations accomplish work. However, the state of the art in organizational science currently provides no valid, reliable way to measure or compare their complexity. This research will demonstrate a novel, graph-theoretic methodology that incorporates social and material dimensions into the portrayal of routines. This methodology can be used to assess and compare the influence of various antecedents on the complexity of clinical routines. This project will also result in new research infrastructure, in the form of algorithms and software that can be applied in future research on any kind of process or routine. This new research infrastructure is particularly timely and valuable because of the increasing availability of digital trace data, such as the electronic medical record data used here.