Mitigating Hazards Through Continuing Design: The Birth and Evolution of a Pediatric Intensive Care Unit

Peter Madsen (), Vinit Desai (), Karlene Roberts () and Daniel Wong ()
Additional contact information
Peter Madsen: Haas School of Business, University of California, Berkeley, 545 Student Services 1900, Berkeley, California 94720-1900
Vinit Desai: Haas School of Business, University of California, Berkeley, 545 Student Services 1900, Berkeley, California 94720-1900
Karlene Roberts: Haas School of Business, University of California, Berkeley, 545 Student Services 1900, Berkeley, California 94720-1900
Daniel Wong: 6400 Christie Avenue №3413, Emeryville, California 94608

Organization Science, 2006, vol. 17, issue 2, 239-248

Abstract: Often, researchers study organizations in which design is largely in place and the design process is shrouded in the distant past. However, the design process can have dramatic implications for how organizations function. This paper reports a specific attempt to design one organizational subunit, a pediatric intensive care unit (PICU), to function under difficult circumstances. The founders aimed to create a highly reliable and safe unit, but implementing their vision required continuous effort. The unit needed constant buffering from external pressures and a dissimilar parent organization, and these forces shaped the unit’s ultimate design. Through the presentation of this case, we discuss the impact of design on the organization, its members, and the larger hospital organization to which the unit belonged. The study reveals that the PICU’s design was an ongoing effort and its most stable component was a vision of distributed knowledge and decentralized intensive care. We conclude by discussing implications of the case for organizational design theory and practice.

Keywords: high-reliability organizations; pediatric intensive care; healthcare; safety; organizational design (search for similar items in EconPapers)
Date: 2006
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (15)

Downloads: (external link)
http://dx.doi.org/10.1287/orsc.1060.0185 (application/pdf)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:inm:ororsc:v:17:y:2006:i:2:p:239-248

Access Statistics for this article

More articles in Organization Science from INFORMS Contact information at EDIRC.
Bibliographic data for series maintained by Chris Asher ().