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


  • Jody Hoffer Gittell

    () (Heller School for Social Policy and Management, Brandeis University, 415 South Street, Waltham, Massachusetts 02454)


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.

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  • Jody Hoffer Gittell, 2002. "Coordinating Mechanisms in Care Provider Groups: Relational Coordination as a Mediator and Input Uncertainty as a Moderator of Performance Effects," Management Science, INFORMS, vol. 48(11), pages 1408-1426, November.
  • Handle: RePEc:inm:ormnsc:v:48:y:2002:i:11:p:1408-1426

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    References listed on IDEAS

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    1. repec:gam:jsusta:v:9:y:2017:i:12:p:2336-:d:122936 is not listed on IDEAS
    2. Khosla, Nidhi & Marsteller, Jill Ann & Hsu, Yea Jen & Elliott, David L., 2016. "Analysing collaboration among HIV agencies through combining network theory and relational coordination," Social Science & Medicine, Elsevier, vol. 150(C), pages 85-94.
    3. William D. Barta & Deborah Shelton & Cheryl Cepelak & Colleen Gallagher, 2016. "Promoting a Sustainable Academic–Correctional Health Partnership: Lessons for Systemic Action Research," Systemic Practice and Action Research, Springer, vol. 29(1), pages 27-50, February.
    4. Peter Tsasis & Jenna M. Evans & Linda Rush & John Diamond, 2013. "Learning to Learn: towards a Relational and Transformational Model of Learning for Improved Integrated Care Delivery," Administrative Sciences, MDPI, Open Access Journal, vol. 3(2), pages 1-23, June.
    5. Cécile Godé-Sanchez, 2008. "Les Pratiques De Coordination En Environnement Volatile : Le Cas Des Forces Aeriennes Françaises En Situation Operationnelle," Post-Print hal-00293535, HAL.
    6. Rubinstein, Saul & Martin-Rios, Carlos & Erhardt, Niclas & Hoffer Gittell, Jody & George, Varghese P., 2016. "Organizational responses to uncertainty in the airline industry: Changes in patterns of communication networks," Journal of Air Transport Management, Elsevier, vol. 57(C), pages 217-227.
    7. Eitan Naveh & Tal Katz-Navon & Zvi Stern, 2005. "Treatment Errors in Healthcare: A Safety Climate Approach," Management Science, INFORMS, pages 948-960.
    8. Chowdhury, Sanjib & Miles, Grant, 2006. "Customer-induced uncertainty in predicting organizational design: Empirical evidence challenging the service versus manufacturing dichotomy," Journal of Business Research, Elsevier, vol. 59(1), pages 121-129, January.
    9. Jean Guillaume Forand & Jan Zapal, 2017. "The Demand and Supply of Favours in Dynamic Relationships," CERGE-EI Working Papers wp605, The Center for Economic Research and Graduate Education - Economics Institute, Prague.
    10. Isabelle, Bouty & Cécile, Godé & Carole, Drucker-Godard & Pascal, Lièvre & Jean, Nizet & François, Pichault, 2012. "Coordination practices in extreme situations," European Management Journal, Elsevier, vol. 30(6), pages 475-489.
    11. Samer Faraj & Yan Xiao, 2006. "Coordination in Fast-Response Organizations," Management Science, INFORMS, pages 1155-1169.
    12. Koen H. Heimeriks & Geert Duysters, 2007. "Alliance Capability as a Mediator Between Experience and Alliance Performance: An Empirical Investigation into the Alliance Capability Development Process," Journal of Management Studies, Wiley Blackwell, vol. 44(1), pages 25-49, January.
    13. Chowdhury, Sanjib, 2011. "The moderating effects of customer driven complexity on the structure and growth relationship in young firms," Journal of Business Venturing, Elsevier, vol. 26(3), pages 306-320, May.
    14. Jean Guillaume Forand & Jan Zapal, 2017. "The Demand and Supply of Favours in Dynamic Relationships," Working Papers 1705, University of Waterloo, Department of Economics, revised Sep 2017.
    15. Deneckere, Svin & Euwema, Martin & Van Herck, Pieter & Lodewijckx, Cathy & Panella, Massimiliano & Sermeus, Walter & Vanhaecht, Kris, 2012. "Care pathways lead to better teamwork: Results of a systematic review," Social Science & Medicine, Elsevier, vol. 75(2), pages 264-268.
    16. Meyer, Chris R. & Skaggs, Bruce C. & Nair, Sudhir & Cohen, David G., 2015. "Customer Interaction Uncertainty, Knowledge, and Service Firm Internationalization," Journal of International Management, Elsevier, vol. 21(3), pages 249-259.
    17. Randall D. Cebul & James B. Rebitzer & Lowell J. Taylor & Mark E. Votruba, 2008. "Organizational Fragmentation and Care Quality in the U.S. Healthcare System," Journal of Economic Perspectives, American Economic Association, vol. 22(4), pages 93-113, Fall.
    18. Jody Hoffer Gittell & Kim Cameron & Sandy Lim & Victor Rivas, 2005. "Relationships, Layoffs, and Organizational Resilience: Airline Industry Responses to September 11," EERI Research Paper Series EERI_RP_2005_06, Economics and Econometrics Research Institute (EERI), Brussels.
    19. Markus C. Becker, 2012. "Distributed Knowledge and its Coordination," Chapters,in: Handbook of Knowledge and Economics, chapter 20 Edward Elgar Publishing.
    20. Driessen, Paul H. & Kok, Robert A.W. & Hillebrand, Bas, 2013. "Mechanisms for stakeholder integration: Bringing virtual stakeholder dialogue into organizations," Journal of Business Research, Elsevier, vol. 66(9), pages 1465-1472.
    21. Steven Blader & Claudine Gartenberg & Rebecca Henderson & Andrea Prat, 2015. "The Real Effects of Relational Contracts," American Economic Review, American Economic Association, vol. 105(5), pages 452-456, May.
    22. Stephen Frenkel & Karin Sanders & Tim Bednall, 2013. "Employee perceptions of management relations as influences on job satisfaction and quit intentions," Asia Pacific Journal of Management, Springer, pages 7-29.
    23. repec:wsi:ijitmx:v:14:y:2017:i:05:n:s0219877017500274 is not listed on IDEAS
    24. Schoenherr, Tobias & Narayanan, Sriram & Narasimhan, Ram, 2015. "Trust formation in outsourcing relationships: A social exchange theoretic perspective," International Journal of Production Economics, Elsevier, vol. 169(C), pages 401-412.


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