Organizing with Numerical Surveillance: Data and Actions In a Healthcare Organization

In this work in progress we attempt to understand the powerful and transformative role of analytics and “numbers” in organizational settings. The context is a healthcare system in the US that introduced in 2017 a process improvement (PI) strategy relying on measuring the everyday activities of employees and making those results public within the hospital. An ethnographic study allowed us to capture relevant organizational tensions that arose from the introduction of the PI initiative and the consequences of increased transparency. Key tensions are associated with the transparency of practices, and how this unfolds in a team of individuals with different expertise and responsibilities. We were able to observe a shift of the hospital from a professional towards a machine bureaucracy, where individuals are increasingly held accountable for their actions according to processes measured, outcomes examined and then made transparent. The overall study aims to explore the organizational consequences of using data-driven technologies to manage individual’s everyday practices, and so raises the question of how numerical surveillance will affect organizations.