When Relationships Get in the Way: The emergence and persistence of care routines

Abstract

Past research has shown that routines can be a vehicle for both stability and change in organizations. It is unclear however how this relationship alters and solidifies over time. In this paper, the changing behaviours of three newly formed teams within a domiciliary care organization are tracked over a period of two years. It was seen that self-reinforcing processes shaped the emergence and persistence of action patterns within these groups. The first process achieved coordination benefits which drove the emergence of routines, as ‘action patterns’ were first negotiated and then assigned to members of the care team. The second self-reinforcing process involved sets of expectations which deepened interpersonal relationships between the care worker and client. The impact of both these processes, altered the ostensive-performative duality, as routines emerged and persisted over time. This study therefore highlights the changing dynamics of stability and change within routines, and the key role played by social relations in this process.