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Driving for successful change processes in healthcare by putting staff at the wheel

Erlingsdottir, Gudbjörg LU ; Ersson, Anders LU ; Borell, Jonas LU and Rydenfält, Christofer LU (2018) In Journal of Health, Organisation and Management
Abstract

Purpose – The purpose of this paper is to describe five salient factors that emerge in two successful change processes in healthcare. Organizational changes in healthcare are often characterized by problems and solutions that have been formulated by higher levels of management. This top-down management approach has not been well received by the professional community. As a result, improvement processes are frequently abandoned, resulting in disrupted and dysfunctional organizations. This paper presents two successful change processes where managerial leadership was used to coach the change processes by distributing mandates and resources. After being managerially initiated, both processes were driven by local agency, decisions, planning... (More)

Purpose – The purpose of this paper is to describe five salient factors that emerge in two successful change processes in healthcare. Organizational changes in healthcare are often characterized by problems and solutions that have been formulated by higher levels of management. This top-down management approach has not been well received by the professional community. As a result, improvement processes are frequently abandoned, resulting in disrupted and dysfunctional organizations. This paper presents two successful change processes where managerial leadership was used to coach the change processes by distributing mandates and resources. After being managerially initiated, both processes were driven by local agency, decisions, planning and engagement. Design/methodology/approach – The data in the paper derive from two qualitative case studies. Data were collected through in-depth interviews, observations and document studies. The cases are presented as process descriptions covering the different phases of the change processes. The focus in the studies is on the roles and interactions of the actors involved, the type of leadership and the distribution of agency. Findings – Five factors emerged as paramount to the successful change processes in the two cases: local ownership of problems; a coached process where management initiates the change process and the problem recognition, and then lets the staff define the problems, formulate solutions and drive necessary changes; distributed leadership directed at enabling and supporting the staff's intentions and long-term self-leadership; mutually formulated norms and values that serve as a unifying force for the staff; and generous time allocation and planning, which allows the process to take time, and creates room for reevaluation. The authors also noted that in both cases, reorganization into multi-professional teams lent stability and endurance to the completed changes. Originality/value – The research shows how management can initiate and support successful change processes that are staff driven and characterized by local agency, decisions, planning and engagement. Empirical descriptions of successful change processes are rare, which is why the description of such processes in this research increases the value of the paper.

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author
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Change, Healthcare organization, Multi-professional teams, Self-leadership, Staff-driven process
in
Journal of Health, Organisation and Management
publisher
Emerald Group Publishing Limited
external identifiers
  • scopus:85039846051
ISSN
1477-7266
DOI
10.1108/JHOM-02-2017-0027
language
English
LU publication?
yes
id
89ca7dae-04ef-464b-87bf-e97522866d27
date added to LUP
2018-01-30 09:14:11
date last changed
2018-01-30 15:38:31
@article{89ca7dae-04ef-464b-87bf-e97522866d27,
  abstract     = {<p>Purpose – The purpose of this paper is to describe five salient factors that emerge in two successful change processes in healthcare. Organizational changes in healthcare are often characterized by problems and solutions that have been formulated by higher levels of management. This top-down management approach has not been well received by the professional community. As a result, improvement processes are frequently abandoned, resulting in disrupted and dysfunctional organizations. This paper presents two successful change processes where managerial leadership was used to coach the change processes by distributing mandates and resources. After being managerially initiated, both processes were driven by local agency, decisions, planning and engagement. Design/methodology/approach – The data in the paper derive from two qualitative case studies. Data were collected through in-depth interviews, observations and document studies. The cases are presented as process descriptions covering the different phases of the change processes. The focus in the studies is on the roles and interactions of the actors involved, the type of leadership and the distribution of agency. Findings – Five factors emerged as paramount to the successful change processes in the two cases: local ownership of problems; a coached process where management initiates the change process and the problem recognition, and then lets the staff define the problems, formulate solutions and drive necessary changes; distributed leadership directed at enabling and supporting the staff's intentions and long-term self-leadership; mutually formulated norms and values that serve as a unifying force for the staff; and generous time allocation and planning, which allows the process to take time, and creates room for reevaluation. The authors also noted that in both cases, reorganization into multi-professional teams lent stability and endurance to the completed changes. Originality/value – The research shows how management can initiate and support successful change processes that are staff driven and characterized by local agency, decisions, planning and engagement. Empirical descriptions of successful change processes are rare, which is why the description of such processes in this research increases the value of the paper.</p>},
  author       = {Erlingsdottir, Gudbjörg and Ersson, Anders and Borell, Jonas and Rydenfält, Christofer},
  issn         = {1477-7266},
  keyword      = {Change,Healthcare organization,Multi-professional teams,Self-leadership,Staff-driven process},
  language     = {eng},
  month        = {01},
  publisher    = {Emerald Group Publishing Limited},
  series       = {Journal of Health, Organisation and Management},
  title        = {Driving for successful change processes in healthcare by putting staff at the wheel},
  url          = {http://dx.doi.org/10.1108/JHOM-02-2017-0027},
  year         = {2018},
}