Implementing organizational change in health and social services

Purpose – To explore the shared experience of organizational change from centralized allocation and control of services and resources to an empowering partnership approach to service delivery in one Canadian home care program. Design/methodology/approach – Applying an interpretive phenomenological design, data from in‐depth interviews with a purposeful sample (n=28) of providers, clients and informal caregivers were analysed using hermeneutic techniques, and validated by member checking and peer review. Findings – The overall experience of change was comprised of two dynamic change patterns: extrinsically introduced organizational development, facilitated by contextual factors; and intrinsically developed transformational change, impeded by the same contextual factors. The patterns together comprised participants' enactment of an answer to the existential question, "To have or to be?" Research limitations/implications – While interpretive research does not elicit generalizable results, the findings of this study illuminate the importance of choosing change strategies appropriate for the intended change, addressing what the change may mean to all involved, and confronting the contextual factors that undermine the change. Practical implications – New strategies are needed if engrained attitudes, values and beliefs about professional service delivery are to be changed. Originality/value – The interpretation exposes the nature of professional practice in health and social services, the impact of this work context on practice, and concrete strategies for managing organizational change.