When Surprises Become Routine: Practice Transition in Fast-Response Distributed Environments

While several studies have looked at the transition between practices when actors are faced by surprising events, little is known about practice transition when these events become routine. Understanding the challenge of routinized surprises is particularly important for high-reliability organizations, where the focus is on high quality and error-free performance. A major source of the routinization of practice transitions is the prevalence of information technology (IT) in work environments, which require constant shifts between non-IT and IT-enabled practices. This research investigates the process through which practice transitions become routine based on an ethnographic study of a Telestroke system, in which successful practice transitions are critical for the delivery of stroke treatments in a timely manner.