The Emergence of Change in Unexpected Places: Resourcing across Organizational Practices in Strategic Change

Abstract

In our longitudinal, in-depth case study of strategic change within the English National Health Service we compare three practices related to contracting healthcare services. Contrary to what we would have believed from the extant literature, we found that the most profound change did not emerge in practices that witnessed the greatest increase in the quantity of resources or in which change agents were given the highest degree of control. Instead, change emerged in a practice that was not treated as a priority and that subsequently attracted interest from a very limited number of individuals. Our findings contribute to the resourcing literature by showing that the ability to use resources is shaped by how they are valued and distributed and that strategic change initiatives can act as triggers for resource revaluations and redistributions. Specifically, we demonstrate that strategic change initiatives may contribute to the emergence of favorable conditions for change in practices that do not become associated with valued resources. This is because a lack of valued resources attracts limited interest from stakeholders, thereby allowing changes to emerge as powerful agents face minimal coordination costs and scrutiny when attempting to align arrangements with their own interests. Our study thereby shows how and why change initiatives can trigger divergent developments across multiple practices and lead to change emergence in unexpected places. It also highlights the role of what we call resourcing space in contributing to emergent change.

Cutting the Cord: Mutual Respect, Organizational Autonomy, and Independence in Organizational Separation Processes

“…Our data emerged from a broader study of strategic change implementation in the English National Health Service (NHS) that the first author conducted in conjunction with an academic research program on healthcare service procurement and healthcare systems management (see also Wiedner, Barrett, and Oborn, 2017). During this study the complexity of organizational separation between two units became apparent.…”

Career Resourcing and the Process of Professional Emergence

“…Schemas, in turn, motivate and enable subsequent actions, in a cycle that can recursively reinforce existing structures, or be a source of endogenous structural change by building on prior actions in an ampliative and spiraling way (Feldman, 2004;Feldman & Worline, 2011;Howard-Grenville, 2007). A resourcing perspective has been primarily used for understanding how individual action and interaction effects organizational change (e.g., Feldman, 2004;Howard-Grenville, 2007;Wiedner et al, 2016); however, it is a useful general framework for understanding how actions can change any sort of structure, making it suitable for analyzing the processes linking career actions and professional emergence.…”

“…The literature on resourcing in organizational theory has its roots in research on organizational routines (Feldman, 2004;Feldman & Orlikowski, 2011). Consistent with these roots, resourcing has been conceptualized as a process that unfolds through interactions between diverse people who are interconnected through their work (Feldman, 2004;Howard-Grenville, 2007;Wiedner et al, 2016). In extant research, small divergences in how people enact a routine, or how they value current working patterns as a means of accomplishing important and valued organizational goals (i.e.…”

Future of clinical leadership: the critical role of front-line doctors

“…Here, political dynamics involved efforts to either focus attention on how a change might advance a broad but valued goal, such as meeting community health needs, or to convincingly show at least some doctors that a change might advance a more pragmatic goal that was important to them 20 21. Political dynamics between doctors also shaped the implementation of eight service improvement initiatives in both acute and primary care settings in the NHS,5 as well as the implementation of clinical commissioning processes within a single UK region 25…”