Resourcing a Technological Portfolio: How Fairtown Hospital Preserved Results While Degrading Its Older Surgical Robot

Abstract

Here I theorize about a common challenge that research on technology and organizing has not yet considered: how organizations preserve results given the challenges of managing increasingly heterogeneous technological portfolios. I do so via a study of how a top-tier hospital allocated scarce resources across two surgical robots. After acquiring its second robot, the hospital divided resources between the older and newer robots to build its surgical capacity: it allocated the best available infrastructure to the new robot, and it prioritized assigning inexperienced talent to the new technology to facilitate use and skill development. The hospital then adjusted its resources to build on initial successes, committing both the best available maintenance and more-complex surgical cases to the newer robot. These dynamics inadvertently degraded the older robot, making it increasingly difficult to use. In response, more-experienced surgeons and staff made do with the degrading system: they developed and mastered workarounds, and they developed a venting cycle with management. Their actions reduced concerns about the older technology and stabilized the situation for the hospital, such that for years this portfolio resourcing process facilitated satisfactory outcomes on organizational goals such as growth, new capability, and patient care. But by shunting scarce resources away from the older technology, this process also stressed the experienced talent (even as it built their resilience) and limited exploration of changes that could benefit the hospital.