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Variability as a source of stability: Studying routines in the elderly home care setting

Stockholm University School of Business, aes{at}fek.su.se

While it is agreed that there can be a difference between the routine as inscribed in artefacts, the ostensive aspect of the routine and its performative aspect, little is known about the relationship between these parts of the routine. Further, while authors acknowledge that there is variability in routines as performed, the contemporary literature says less about the sources of this variability. Using empirical data from the Swedish community care setting, the present article explores the workings of and relationship between the different aspects of `the home-help delivery routine'. The article also explores the sources of variability in workers' execution of this routine in situ. The article provides rich illustrations of the differences between the routine as inscribed in artefacts, as `articulated patterns' and the workers' performance of the routine in specific situations. In contrast to the argument that alignment between these aspects contributes to stability in the routine, this article claims that divergences between them promote stability. The article highlights how factors in the local context, including exceptions created by technology, constitute sources of variability in the routine. It further shows how values in the contemporary society, adopted by individuals as emotional-ethical principles, shape individuals' performance of the routine and thereby generate variability in the routine. In general, the article underlines the importance of considering the cultural context in which the routine is situated, at micro- and macro-level, when analysing its operation. Indeed, factors beyond the routine influence individuals' conception of and execution of the routine.

Key Words: artefact • elderly care • emotional labour • healthcare organizations • public management • routines

Human Relations, Vol. 61, No. 11, 1617-1644 (2008)
DOI: 10.1177/0018726708096640


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