Intervention outcomes in practice: an exploratory study of natural organisational intervention case studies

Natural interventions take place without input from external researchers and practitioners. A better representation of this data source advances the literature on the outcomes that require change as perceived by employees and organisations. We draw on this data source by reviewing 19 natural organisational interventions from the English and Welsh National Health Service to examine the outcomes employees and organisations seek to change. Drawing on these interventions, which seek to improve how work is designed, organised, and managed, we propose a scaffold of outcomes that seeks to capture the interdependencies between outcomes. Where proximal resources (Learning and Decent Work) provide the basis for distal outcomes (Wellbeing, Performance, and Workforce), rather than treating wellbeing and performance as isolated endpoints, we postulate that multiple outcomes function as interdependent resources that build organisational change capability over time through virtuous gain spirals. From an empirical perspective, we highlight the distinction between proximal shifts and distal impacts, with implications for how success is measured across multiple levels. This work demonstrates the need to engage and align internal stakeholders, all the while ensuring that intervention outcomes reflect actual internal organisation needs, and that interventions are not dominated by the perspectives of researchers and the research literature.