The Sustainability and Spread of Organizational Change: Modernizing Healthcare, 1st Edition (Paperback) book cover

The Sustainability and Spread of Organizational Change

Modernizing Healthcare, 1st Edition

Edited by David A. Buchanan, Louise Fitzgerald, Diane Ketley


304 pages | 7 B/W Illus.

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pub: 2006-12-07
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This important book examines issues affecting the sustainability and spread of new working practices. The question of why good ideas do not spread, ‘the best practices puzzle’, has been widely recognized. But the ‘improvement evaporation effect’, where successful changes are discontinued, has attracted less attention. Keeping things the way they are has been seen as an organizational problem to be resolved, not a condition to be achieved. This is one of the first major studies of the sustainability of change focusing on the example of the NHS, by a unique team of health service and academic researchers. The findings may apply to a variety of other settings.

The agenda set out in 2000 in The NHS Plan is perhaps the largest organization development programme ever undertaken, in any sector, anywhere. The NHS thus offers a valuable ‘living laboratory’ for the study of change. This text shows that sustainability and spread are influenced by a range of issues - contextual, managerial, political, individual, and temporal. Developing a processual perspective, this fresh analysis considers policy implications, and strategies for managing sustainability and spread. This book will be essential reading for students, managers, and researchers concerned with the effective implementation of organizational change.


'This book is a must for those planning and implementing change. Its key message is that sustainability and spread are intimately linked and it helpfully outlines the complex mediators of such challenging social processes. For those researching health care settings, the book offers significant insights into relevant theory and signposts valuable scholarship in this area.'

Sue Dopson, Rhodes Trust University Reader in Organisational Behaviour, Saïd Business School, University of Oxford

'The NHS Modernisation Agency supported a wide-ranging attempt to reform a major public service. Drawing on case studies from five years of that experience, this volume brings a rare combination of intellectual rigour and practical insight to two of the central challenges that confront such programmes of change. It will prove a valuable resource to managers, practitioners, students and researchers in healthcare and beyond.'

Edward Peck, Professor of Public Services Development and Director, Health Services Management Centre and School of Public Policy, University of Birmingham

Table of Contents

Part 1: Context 1. Changing by Numbers 2. Improvement Evaporation: Why Do Successful Changes Decay? 3. The Best Practices Puzzle: Why are New Methods Contained and not Spread? Part 2: Experience 4. View from the Top: Opening the Box on Spread and Sustainability 5. Shades of Resistance: Understanding and Addressing Scepticism 6. Tracking Sustainability: Lessons from the Patient Booking Timeline 7. Spreading and Sustaining Change: The Patient Booking Case Experience 8. Layers of Leadership: Hidden Influencers of Healthcare Improvement 9. Spreading and Sustaining Change: The Cancer Collaborative Case Experience 10. High Impact: Key Changes in Cancer Care 11. Spreading can be Easy: The ‘See and Treat’ Experiment Part 3: Implications 12. The Sustainability and Spread Story: Contributions to Theory 13. Sustaining Change and Avoiding Containment: Practice and Policy 14. Researching Major Change: Issues and Dilemmas

About the Series

Routledge Studies in Organizational Change & Development

It is often stated that some 70% of all change projects fail. Though this figure can be disputed, it is nevertheless clear that managing change is one of the most difficult tasks facing organizations today. In response to this, writers offer a wide range of theories and advice designed to aid managers and scholars in understanding and managing change, but which seem merely to overwhelm them with a profusion of competing and conflicting advice and approaches. In many respects, change is a field which epitomises the ‘rigor-relevance’ debate. We have many approaches to change which are built on sound research and robust theories, but which appear to lack relevance for managers. We also have a vast array of nostrums, practices and tools which managers use, but which appear to lack methodological or theoretical foundations.

The aim of this series is to cut through the confusion surrounding the study and practice of change by providing comprehensive and in-depth studies of existing and emerging approaches to change. The rationale for the series is that we cannot understand organizational change sufficiently nor implement it effectively unless we can evaluate the various approaches in terms of the evidence which underpins them, what they seek to achieve and how and where they can be applied. In particular, the series seeks to address, but is not limited to, the following questions:

  • What are the emerging themes in the field of organizational change?
  • Which theories and approaches to change have stood the test of time?
  • What are the key debates within the field?
  • How has the field been influenced by and incorporated newer approaches to organizational life, such as postmodernism, social constructionism, critical realism, and complexity theories?
  • What is the current status of OD (organization development)?
  • To what extent have countries in Asia, Africa, the Middle East and South America developed their own distinct approaches to change?
  • How are developments such as social media and virtual organizations affecting the way organizations perceive and carry out change?
  • Do successful organizations adopt different approaches to change than unsuccessful ones, or do they use the same approaches but more effectively?

Learn more…

Subject Categories

BISAC Subject Codes/Headings:
BUSINESS & ECONOMICS / Organizational Behavior