Shaping the Buildings that Shape Us: The Entanglement of Space and Care Coordination
Bibliographic record
Abstract
In the rare event that a hospital confronts radical change, care activities must remain performant despite disruptions and unanticipated influences, otherwise patients may lose their lives. The reliable coordination of care work is central to this challenge because critically ill patients must get the appropriate treatment at the right time by the right specialists in the most cost-effective manner possible. Recent organizational research has shown that care coordination practices are emergent and socially situated but has paid less attention to the spatial context in which care work unfolds. Yet, the latter has direct implications for what is possible in the delivery of patient care. In this paper, we examine what happens to the work of neonatal intensive care when a leading Canadian hospital relocates to a newly built and equipped CAN$ 3 billion super hospital with a vastly different spatial layout and equipment arrangements. Through a two-year ethnographic field study of neonatal intensive care work before, during and after ‘the move’, we examine how space and coordination practices are transformed so that care activities can “travel” reliably. We show how and why care activities initially broke down as they were transported to a new socio-spatial setting and elaborate the process by which they were reconstituted to re- establish performance. In so doing, we explore the material- spatial basis of coordinating and deliver a material rather than a cultural or institutional account of radical change.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.011 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.004 |
| Science and technology studies | 0.028 | 0.092 |
| Scholarly communication | 0.017 | 0.010 |
| Open science | 0.003 | 0.019 |
| Research integrity | 0.002 | 0.004 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".