Health care organization leaders and policy makers seeking ways to reform the delivery of health care have become increasingly interested in transformational change. To foster understanding of how organizational transformation occurs and to stimulate further research, we report findings from a systematic review of empirical research on transformational change in the health care and non-health care literature, with a focus on the antecedents, processes (or paths), and outcomes of transformational change. Fifty-six studies, of which 13 were in health care, met our selection criteria. With one exception, all were published since 1990, indicating the recent upsurge of interest in this area. Limited differences were found between health care and non-health care studies. Available research documents the multiplicity of factors affecting change and the complexity of their interactions, but less information is available about the processes of transformational change than about its antecedents and consequences. Research and practice implications are discussed.
[Show abstract][Hide abstract] ABSTRACT: To investigate whether an accreditation program facilitates healthcare organizations (HCOs) to evolve and maintain high-performance human resource management (HRM) systems.
Cross-sectional multimethod study.
Healthcare organizations participating in the Australian Council on Healthcare Standards Evaluation and Quality Improvement Program (EQuIP 4) between 2007 and 2011.
Ratings across the EQuIP 4 HRM criteria, a clinical performance measure, surveyor reports (HRM information) and interview data (opinions and experiences regarding HRM and accreditation).
Healthcare organizations identified as high performing on accreditation HRM criteria seek excellence primarily because of internal motivations linked to best practice. Participation in an accreditation program is a secondary and less significant influence. Notwithstanding, the accreditation program provides the HCO opportunity for internal and external review and assessment of their performance; the accreditation activities are reflective learning and feedback events.
This study reveals that HCOs that pursue highly performing HRM systems use participation in an accreditation program as an opportunity. Their organizational mindset is to use the program as a tool by which to reflect and obtain feedback on their performance so to maintain or improve their management of staff and delivery of care.
International Journal for Quality in Health Care 04/2014; DOI:10.1093/intqhc/mzu039 · 1.76 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: There is a need for person-centred approaches and empowerment of staff within the residential care for older people; a movement called 'culture change'. There is however no single path for achieving culture change. With the aim of increasing understandings about cultural change processes and the promotion of cultural values and norms associated with person-centred practices, this article presents an action research project set on a unit in the Netherlands providing care for older people with dementia. The project is presented as a case study. This study examines what has contributed to the improvement of participation of older people with dementia in daily occupational and leisure activities according to practitioners. Data was collected by participant observation, interviews and focus groups. The results show that simultaneous to the improvement of the older people's involvement in daily activities a cultural transformation took place and that the care became more person-centred. Spontaneous interactions and responses rather than planned interventions, analysis and reflection contributed to this. Furthermore, it proved to be beneficial that the process of change and the facilitation of that process reflected the same values as those underlying the cultural change. It is concluded that changes arise from dynamic, interactive and non-linear processes which are complex in nature and difficult to predict and to control. Nevertheless, managers and facilitators can facilitate such change by generating movement through the introduction of small focused projects that meet the stakeholders' needs, by creating conditions for interaction and sense making, and by promoting the new desired cultural values.
Health Care Analysis 07/2014; DOI:10.1007/s10728-014-0280-9 · 1.02 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: A review of the literature on organizational culture change suggests that the field might benefit from studies combining both etic (researcher) and emic (employee) perspectives to examine individuals’ views regarding how and why their culture has changed. This paper seeks to deepen researchers’ knowledge of how individuals perceive organizational culture change by undertaking a two-part study within an organization that has undergone planned cultural change initiatives. More specifically survey (i.e. etic view) data and interview (i.e. emic view) data are used to explore: (1) factors associated with (a) whether an individual will perceive that culture change has occurred, and (b) whether they categorize this change as for the better, for the worse or one that could not be categorized using these two labels; and (2) individuals’ rationales for why the culture has changed. The findings are mixed regarding the extent to which they support or refute existing research on organizational culture change.
Academy of Management Annual Meeting Proceedings 10/2014; 2014(1):17132-17132. DOI:10.5465/AMBPP.2014.17132abstract
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