Perceptions and Misperceptions of Major Organizational Changes in Hospitals: Do Change Efforts Fail Because of Inconsistent Organizational Perceptions of Restructuring and Reengineering?

Abstract

Over the past decade, many hospitals have invested in major restructuring and/or reengineering efforts designed to enhance their competitiveness by improving product quality and/or reducing costs. For a variety of reasons, these significant changes have not been systematically evaluated. This research provides an objective look at the results of restructuring/reengineering hospitals and an examination of the influences on employee perceptions of reengineering's outcomes. This research demonstrates that employees, including upper management, had little or no objective knowledge of the outcomes of their change efforts. However, perceptions of all employees involved in a major change effort are critical if their full participation is to be sustained. The ultimate sustainability of many hospital strategic change efforts may rest largely on subjective assessments of its outcomes. The research reported here suggests that such perceptions vary significantly by organizational level and may not be stable over time. While the passage of time sees improvements in managers' perceptions of reengineering results, line personnel become increasingly skeptical and less positive. Further objective research is encouraged to more definitely distinguish the impact of employee perceptions on change efforts' outcomes and sustainability.