Abstract

Through a social science approach rooted in grounded theory, this research paper provides a form of an uncertainty theory in organizations, exploring how alternate forms of rationality and approaches to dealing with uncertainty result in variation in energy efficiency related actions and outcomes. Through data analysis, structural conditions are identified, frames for considering energy efficiency are uncovered, and two approaches for dealing with uncertainty are interpreted. Hospitals that approach uncertainty by 'Demanding Certainty' make use of one of two frames: 'Temporal Silos' or' Alternate priorities'. These hospitals communicate by presenting, selling and confirming, resulting in risk avoiding organizations where individuals absorb associated risks, and long-term energy efficiency implementation stalls. Hospitals that approach uncertainty by 'Managing Complexity' envision energy efficiency as complementary to patient care and driving long-term resiliency. These hospitals communicate through negotiation and collaboration, expanding thinking beyond short term budgetary intervals, driving resiliency and bridging operational silos. Organizations, and not individuals, absorb risks associated with energy efficiency, and implementation of initiatives occur over longer time horizons.

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