Ruptures During IT-enabled Change: A Sensemaking and Imbrication Analysis

Focusing on imbrication change as conducted by designers during design and development, we undertook a 2.5-year long case study to examine how 10 hospitals configured technology and planned routine changes as they sought to transform their organizations. Our observations revealed a phenomenon we call ruptures, defined as situations that occur due to breakdowns in the process of IT-enabled change. Ruptures allow us to unpack the temporal process of identifying and resolving instances of disruptive problems during IT-enabled change. Our analysis of ruptures in this context expands the theory of imbrication to account for the role of designers. We demonstrate that three imbrication types—historical, envisioned, and realized—exist cognitively during design and influence the design process. Our results demonstrate how problems arise, how dynamic change unfolds through sensemaking, and how fractal, embedded, imbrications complicate the IT-enabled change process.