People and teams matter in organizational change: Professionals' and managers' experiences of changing governance and incentives in primary care

Pamela Smith, Helen Allan, Fiona Ross, Richard Byng, Sara Christian

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives
To explore the experiences of governance and incentives during organizational change for managers and clinical staff.

Study Setting
Three primary care settings in England in 2006–2008.

Study Design
Data collection involved three group interviews with 32 service users, individual interviews with 32 managers, and 56 frontline professionals in three sites. The Realistic Evaluation framework was used in analysis to examine the effects of new policies and their implementation.

Principal Findings
Integrating new interprofessional teams to work effectively is a slow process, especially if structures in place do not acknowledge the painful feelings involved in change and do not support staff during periods of uncertainty.

Conclusions
Eliciting multiple perspectives, often dependent on individual occupational positioning or place in new team configurations, illuminates the need to incorporate the emotional as well as technocratic and system factors when implementing change. Some suggestions are made for facilitating change in health care systems. These are discussed in the context of similar health care reform initiatives in the United States.
Original languageEnglish
Pages (from-to)93-112
Number of pages19
JournalHealth Services Research
Volume49
Issue number1
Early online date5 Jul 2013
DOIs
Publication statusPublished - Feb 2014

Keywords

  • illness and disease
  • health policy/policy analysis
  • emotions
  • chronic
  • relationships
  • healthcare

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