This case describes a challenging decision faced by Dr. Elizabeth Clarke, Chair of the Surgery Department, regarding what to do about Dr. Jamie Thompson, an employee causing disruption within the organization. Clarke recently hired Thompson to work as a surgeon in her department but is now getting complaints from many other staff about Thompson's behavior. Thompson is delivering excellent results but ignores systems and processes, and frustrates coworkers. Clarke, who hired Thompson on the recommendation of a colleague, must now step in and address this issue. Students are asked to evaluate the situation Clarke faces and recommend the best course of action.

This is an MIT Sloan Management Review article. "Dysfunctional momentum" occurs when people continue to work toward an original goal without pausing to recalibrate or reexamine their processes, even in the face of cues that suggest they should change course. In the authors' study of firefighting teams as a metaphor for business organizations, where dysfunctional momentum arises daily, they found that it has at least five possible causes: (1) an overemphasis on action and decisiveness, which often precludes meaningful assessment along the way; (2) evaluating people, processes and outcomes against plans rather than reevaluating the plans themselves; (3) the cumulative effects of small changes that can ripple and grow throughout the organization; (4) the tendency to ignore or co-opt disconfirming evidence; and (5) deference to authority even when leaders are not especially in the know. To overcome dysfunctional momentum, the authors conclude, we have to create interruptions -points at which we can ask: What's the story now? Is it the same story as before? If not, how has it changed? And how, if at all, should we adjust our actions? The people in charge need to stop and reassess what is happening around them. Two interconnected factors tend to be instrumental, say the authors. First, individuals have to recognize their own inability to understand fully and predict the unfolding situation by themselves -they have to develop "situated humility."Second, they must actively create or seek out disruptive information -they have to accept interruptions so that people may reevaluate the story they are maintaining in their minds.

Many business thinkers believe it's the role of senior managers to scan the external environment to monitor contingencies and constraints and to use that precise knowledge to modify the company's strategy and design. As these thinkers see it, managers need accurate and abundant information to carry out that role. According to that logic, it makes sense to invest heavily in systems for collecting and organizing competitive information. Another school of pundits contends that because today's complex information often isn't precise anyway, it's not worth going overboard with such investments. How information is interpreted is what should matter to top executives. The role of senior managers isn't just to make decisions; it's to set direction and motivate others in the face of ambiguities and conflicting demands. Top executives must interpret information and communicate those interpretations--they must manage meaning more than they must manage information. So which of these competing views is the right one? Research conducted by academics Sutcliffe and Weber found that how accurate senior executives are about their competitive environments is indeed less important for strategy and corresponding organizational changes than the way in which they interpret information about their environments. Investments in shaping those interpretations, therefore, may create a more durable competitive advantage than investments in obtaining and organizing more information. And what kinds of interpretations are most closely linked with high performance? Their research suggests that high performers respond positively to opportunities, yet they aren't overconfident in their abilities to take advantage of those opportunities.

A decade of research on how and why teams learn--and what happens when they do--suggests that more isn't always better.

High performance is often attributed to an organization's culture. However, culture can just as easily undermine performance when it blinds decision makers to important performance issues and entraps them in unfortunate courses of action from which they cannot disengage. The dynamics of cultural entrapment are explored in the case of the Bristol Royal Infirmary, in which pediatric cardiac surgeries continued for over a 14-year period despite evidence of poor-quality care and performance that was far below that of other comparable pediatric surgical centers. A single organizational process of behavioral commitment explains how the cultural mindset originated and why it persisted. The sequence of small, public, volitional, and irrevocable action; socially acceptable justification for that action; and the potential for subsequent activities to validate or threaten the justification created a causal loop that stabilized subsequent action patterns.