Abstract
Purpose
This case study aims to shed light on what went wrong with the introduction of new surgical suture in a Dutch hospital operating theatre following a tender. Transition to working with new surgical suture was organized in accordance with legal and contractual provisions, and basic principles of change management were applied, but resistance from surgeons led to cancellation of supplies of the new suture.
Design/methodology/approach
Researchers had access to all documents relevant to the tendering procedure and crucial correspondence between stakeholders. Seventeen in-depth, 1 h interviews were conducted with key informants who were targeted through maximum variation sampling. Patients were not interviewed. The interviews were recorded, transcribed and analysed by discourse analysis. A trial session and workshop were participatively observed. A cultural psychological perspective was adopted to gain an understanding of why certain practices appear to be resistant to change.
Findings
For the cardiothoracic surgeons, suture was more than just stitching material. Suture as a tactile element in their day-to-day work environment is embedded within a social arrangement that ties elements of professional accountability, risk avoidance and direct patient care together in a way that makes sense and feels secure. This arrangement is not to be fumbled with by outsiders.
Practical implications
By understanding the practical and emotional stakes that medical professionals have in their work, lessons can be learned to prevent failure of future change initiatives.
Originality/value
The cultural psychological perspective adopted in this study has never been applied to understanding failed change in a hospital setting.
This case study aims to shed light on what went wrong with the introduction of new surgical suture in a Dutch hospital operating theatre following a tender. Transition to working with new surgical suture was organized in accordance with legal and contractual provisions, and basic principles of change management were applied, but resistance from surgeons led to cancellation of supplies of the new suture.
Design/methodology/approach
Researchers had access to all documents relevant to the tendering procedure and crucial correspondence between stakeholders. Seventeen in-depth, 1 h interviews were conducted with key informants who were targeted through maximum variation sampling. Patients were not interviewed. The interviews were recorded, transcribed and analysed by discourse analysis. A trial session and workshop were participatively observed. A cultural psychological perspective was adopted to gain an understanding of why certain practices appear to be resistant to change.
Findings
For the cardiothoracic surgeons, suture was more than just stitching material. Suture as a tactile element in their day-to-day work environment is embedded within a social arrangement that ties elements of professional accountability, risk avoidance and direct patient care together in a way that makes sense and feels secure. This arrangement is not to be fumbled with by outsiders.
Practical implications
By understanding the practical and emotional stakes that medical professionals have in their work, lessons can be learned to prevent failure of future change initiatives.
Originality/value
The cultural psychological perspective adopted in this study has never been applied to understanding failed change in a hospital setting.
Original language | English |
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Pages (from-to) | 319-330 |
Number of pages | 12 |
Journal | Journal of Organizational Change Management |
Volume | 33 |
Issue number | 2 |
Early online date | 18 Feb 2020 |
DOIs | |
Publication status | Published - 2020 |
Funding
We thank all research subjects, on both sides of the aisle, for their participation in this case study on a topic that involves them deeply into their professional groups. Also, we thank the anonymous reviewers for their insightful feedback on an earlier draft.
Keywords
- change management
- cultural psychology
- discourse
- emotion
- health care management
- medical practices
- operating theatre