Coordinating Mechanisms in Care Provider Groups: Relational Coordination as a Mediator and Input Uncertainty as a Moderator of Performance Effects

A model of how coordinating mechanisms work, and routines work byenhancing interactions among participants is proposed, and all three coordinating mechanisms, including routines, were found to be increasingly effective under conditions of uncertainty.

Abstract

This paper proposes a model of how coordinating mechanisms work, and tests it in the context of patient care. Consistent with organization design theory, the performance effects of boundary spanners and team meetings were mediated by relational coordination, a communication- and relationship-intensive form of coordination. Contrary to organization design theory, however, the performance effects of routines were also mediated by relational coordination. Rather than serving as a replacement for interactions, as anticipated by organization design theory, routines work by enhancing interactions among participants. Likewise, all three coordinating mechanisms, including routines, were found to be increasingly effective under conditions of uncertainty.