Coordination in fast-response organizations

Organizational coordination has traditionally been viewed from an organizational-design perspective where rules, modalities, and structures are used to meet the information-processing demands of the environment. Fast-response organizations face unique coordination challenges as they operate under conditions of high uncertainty and fast decision making, where mistakes can be catastrophic. Based on an in-depth investigation of the coordination practices of a medical trauma center where fast-response and error-free activities are essential requirements, we develop a coordination-practice perspective that emphasizes expertise coordination and dialogic coordination. We argue that expertise coordination practices (reliance on protocols, community of practice structuring, plug-and-play teaming, and knowledge sharing) are essential to manage distributed expertise and ensure the timely application of necessary expertise. We suggest that dialogic coordination practices (epistemic contestation, joint sensemaking, cross-boundary intervention, and protocol breaking) are time-critical responses to novel events and ensure error-free operation. However, dialogic coordination practices are highly contested because of epistemic diifferences, reputation stakes, and possible blame apportionment.