A CRITICAL EVALUATION OF CHANGE

A critical evaluation of change within my department/organisation

A critical evaluation of change within my organisation

Introduction

Change is ubiquitous - a constant across public and private sector organisations. Recently, much of the change in the public sector is driven by the application of metrics and structures adopted from the private sector. The establishment of commercial practices and priorities traditionally associated with corporate rationality in the private sector are now evident within public sector organisations such as schools and hospitals.

Successive waves of reform-driven change (Flood, 2000) continue to demand rapid adoption of new practices and priorities by health professionals (HPs). Yet, as recently demonstrated by McNulty and Ferlie (2004), these waves of reform are sometimes reduced to ripples when planned change initiatives give way to HPs' embedded norms and assumptions. Walston and Chadwick (2003, p. 1582) note that HPs' “perceptions of any change effort are extremely important to the success of these restructuring thrusts. Perceptions can substantially influence the results”.

Research on health care organisations often considers the existing organisational culture as a basis for perceptions, and ultimately, resistance to change (Currie, 1996; Merali, 2003). Some studies have identified and made explicit studies of healthcare organisations as comprising various subcultures (Barley, 1988; Kan and Parry, 2004). This paper recognises the need for further research in the area of subcultural influence on organisational change initiatives, and presents an exploratory study of the interpretation, interaction and resulting influence of two or more subcultures on change initiatives within the same organisation in an effort to further advance our understanding of planned change.

The final third of the paper considers the relevance of the participants' experiences in light of what is known about organisational change. We begin the discussion with a review of several ways in which the case aligns with extant literature on contemporary change in healthcare organisations. We then explore the phenomenon of divergent acceptance of change and describe how it links with and extends change management literature. The paper culminates with considerations managers could use to consider the phenomenon of divergent acceptance.

Reform-driven organisational change in the health sector

As HPs are adjusting to normative demands for cultural change within the organisation of work, the differentiation (Martin, 1992; Meyerson and Martin, 1987) within healthcare organisations' cultures (Bloor and Dawson, 1994; Daake and Anthony, 2000) is emphasised. Classifications of subcultures appear regularly in the healthcare literature - nurses (Brooks, 1999; Kan and Parry, 2004), physicians (Floyd et al., 2005) and administrative personnel/managers (Currie, 1996; Merali, 2003) to name three such work-based classifications. A failure to recognise the unique organisational context means that strategic change may end up merely as a ritual function; modified or adopted superficially at an organisational level, resulting in conflict rather than in successfully implemented change goals (Lozeau et al., 2002). Accordingly, Stensaker and Falkenberg (2007) argue that it is not enough for managers to simply plan for change without ensuring clarity in understanding to enhance subsequent enactment of the change process.

A number of explanations of undermined change tend to focus on ...