Organisational development in a rural hospital in Australia

Objective This paper analyses an organisational development project that aimed to change the organisational culture and improve people management systems and processes. The questions addressed were: was the change process a success; how was success defined; and what were the barriers to its progress? Methods We examined the process of change over a 3-year period. The organisational development intervention is described and analysed. Qualitative methods, including document review, in-depth interviews and focus groups, participant observation, newsletters and diary entries were used to gather the data. A variant of competing values was used to analyse the data. Results We sought to build trust with all managers and encouraged reflection by conducting feedback sessions, presentations, workshops and one-on-one and group discussions. A cross-site action group was established to encourage organisation-wide participation in the project. However, it was clear that stakeholders had different understandings and perceptions of the problems facing the organisation. The project faltered when a leadership development intervention was organised. Conclusions The existence of at least four different organisational ‘worlds’ and identities, according to different professional groupings with different goals, languages and values, was evident. The relationship between the researcher and subjects was key in terms of whether the researcher is seen as an ‘expert’ or as a ‘facilitator’. In bringing about change, we need to work with the Chief Executive Officer in empowering others. Hence, the researchers need to engage in continual dialogue across boundaries and within groups as well as at individual levels to provide support for organisational change. What is known about the topic? Evidence suggests that change processes often fail, that success in one part of the organisation may not translate into organisation-level performance and that change may fail to deliver expected organisation-wide results. Fluctuating organisational expectations may render managers unable to understand the shifting world and the confusion, anxiety and stress that middle managers experience as part of the change process may impede decision making. What does this paper add? This paper reports on a single case study of an organisational development project in a rural health service in Australia. The contribution of this paper is in demonstrating the different worlds of each of the actors involved. Moreover, it shows that building relationships is key. What are the implications for practitioners? The relationship between the researcher and subjects is key in terms of whether the researcher is seen as an ‘expert’ or as a ‘facilitator’. The researchers need to engage in continual dialogue across boundaries and within groups, as well as at individual levels, to provide support for organisational change. The research also demonstrates the importance of middle managers in facilitating communication between senior management and employees.