Why and How Organizational Structures Change: An Integrative Review and Framework

Background: Organisational culture is a critical part of a positive and productive working environment and often presents as an area of ongoing development. The MAGNET recognition program awards recognition to organisations that have positive organisational cultures that meet the standards and criteria. However, the broad impact of MAGNET on hospital culture outside of America remains unclear.Objective: In this study, we explore the impact of MAGNET designation on organisational culture within the nursing context.Methods: An integrative literature review was performed using a systematic search of Medline (Ovid), Embase (Elsevier) and the Cumulative Index to Nursing and Allied Health Literature (CINAHL Ebsco) databases and a combination of subject headings and key words for organizational culture, organizational change and MAGNET hospital, as well as reference chaining was conducted. Using a constant comparative process key categories, themes and subthemes emerged.Results: Twenty-nine key studies were identified and were evaluated utilising two study quality appraisal tools; National Health and Medical Research Council (NH&MRC) levels of evidence and the Polit and Beck critical appraisal tool. Three key categories emerged from the data: (1) nurse practice environment; (2) structure and process models; (3) measurement scales. A key finding was that MAGNET designation appears to enhance organisational culture for nurses and the framework used to introduce MAGNET helps to empower nurses to direct organisational culture in their facility.Conclusion and Implications for Nursing and Health Policy: MAGNET appears to have a positive impact on organisational culture, particularly for nurses. However, lack of standardised evaluation tools used to assess organisational culture associated with MAGNET designation limits comparability of the studies. Generally, the quality of evidence used to develop recommendations was poor to very poor. More, well designed studies undertaken outside of the USA are required.Impact Statement: An in-depth integrative review exploring the impact of MAGNET designation on organisational culture has not been undertaken. In this paper, we have used an integrative review methodology to identify, examine, thematically group and critically evaluate published literature around the impact of MAGNET designation on organisational culture within designated hospitals.

This integrative review identified studies that reported the prevalence of physiotherapeutic interventions for urinary incontinence among postpartum women. This is an integrative literature review study. We used the integrative literature review framework proposed by Whittemore and Knafl to search for relevant literature. The search strategy for electronic databases was developed from the research question and definitions of key concepts, assisted by the librarian. Databases that were searched include Google Scholar, Medline (PubMed), CINAHL, and the Joanna Briggs Institute databases. Both qualitative and quantitative studies that met the inclusion criteria were included. We used the CASP tool to assess the quality of selected papers. The included articles were thematically analyzed. Thirty-six papers met the inclusion criteria for the review. Six themes emerged from the analysis: prevalence of postpartum UI; risk factors for postpartum UI; antenatal pelvic floor muscle training; conservative treatment and quality of life; experiences of postpartum women with UI; and possible coping strategies adopted by women. Most of the articles were quantitative studies (80.5%); 16.6% were qualitative and 2.7% adopted mixed methods. Urinary incontinence is common in postpartum women. Antenatal pelvic floor muscle training is protective against postpartum UI and should be the first-line treatment option.

Interest in resilience engineering for improving organisational safety continues to grow among safety scholars and practitioners, but little attention has focused on a unifying definition, characteristics, and instruments for quantitative measurements. This is a significant gap which can impede efforts at benchmarking and evaluating resilience engineering for organisational safety. This integrative review was undertaken to address this research-practice gap in order to inform a theoretical framework. A five steep integrative literature review process was used to retrieve and critically evaluate peer-reviewed quantitative research articles published or in press from 2003 to November 2019. From the 3884 studies identified, screened, and selected, 17 met the final inclusion criteria. In total, 15 specific instruments were identified, but only four were grounded on a theoretical framework or model—the most common instrument used for included structured surveys. A minimum of three and a maximum of 13 characteristics were measured; however, it is not clear what type of variables they represented. The six most common characteristics included top management commitment, just culture, learning culture, awareness, preparedness, and flexibility. An integrative model of how these can inform a Resilience Climate Questionnaire (RCQ) survey is presented.

Predictors for nurses and midwives' readiness towards self-directed learning: An integrated review

To report organisational factors known to positively contribute to nurses' well-being in the workplace. Integrative literature review. Peer-reviewed journal articles using various methodological approaches, and theoretical works, published in English with a focus on organisational factors and nurses' well-being were included. Papers reporting on other healthcare professional groups and/or nursing students were excluded. Data were synthesised into an integrative review, with findings organised theoretically, according to the PERMA model (Positive emotions, Engagement, Relationships, Meaning, Accomplishment), otherwise known as The Well-being Model. Relevant papers published between May 2020 and April 2025 were identified using CINAHL and PsycINFO electronic databases. Search date, April 24, 2025. The review included 18 articles, mostly from Europe and the United States, examining workplace factors that contribute to the health and well-being of nurses. Mapping findings to the PERMA domains showed that organisational support and individual strategies together foster flourishing among nurses. This review highlights both individual factors (such as self-care, strength use and adaptive coping) and organisational structures (including supportive environments, professional development and recognition) that are essential for nurses' well-being and flourishing. However, effective interventions require systemic change, with leadership and education playing key roles in supporting nurses to flourish in the workplace. This review addressed the need to go beyond deficit models of nurses' well-being to pinpoint specific organisational factors that can help nurses to flourish. Prioritising nurse well-being is vital for high-quality, safe and sustainable healthcare systems. Investing in environments where nurses can flourish benefits both individuals and the broader healthcare system. This integrative review was reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. This study did not include patient or public involvement in its design, conduct or reporting.

The business model innovation (BMI) concept has become a well‐established phenomenon of current academic research. While Foss and Saebi's (Journal of Management, 2017, 43, 200–227) seminal literature review on BMI revealed 349 articles on BMI published between 1972 and 2015, an additional number of 1727 articles on the topic have been published since 2016. In contrast to this overall interest in the BMI phenomenon, innovation‐focused journals include only a limited number of publications on BMI. Further, besides the valuable insights and fruitful research directions of extant literature reviews, they tend also to overlook the linkages between traditional innovation management and the majority of BMI research. Given this underrepresentation of BMI research in the innovation management literature, we conduct an integrative literature review to bring the disconnected literature closer together and offer directions for future research. Our literature review applies the review strategy of blending and merging the literature across domains. First, we blend the knowledge base of the BMI domain by applying the Product Development and Management Association (PDMA) Body of Knowledge categories. Second, we merge the literature across domains by developing an integrative framework. As recent BMI literature increasingly converged to two lines of research, our framework differentiates between the relatedness of the BMI and BMI openness. Thereby, we offer new avenues for future research that can enrich the dialogue on BMI research in the innovation management community. These results demonstrate how the BMI domain covers aspects that fit, contribute to, and extend classical innovation‐focused research, how both research domains can be merged to enrich each other, and how future research can foster the dialogue across disconnected domains.

Gamification is an increasingly popular instructional strategy in nursing. The purpose of this integrative review is to explore gamification as it has been applied in nursing literature. This integrative review seeks to ask the question- What aspects of gamification have been explored in nursing literature and what aspects require further exploration? Whittemore, R., & Knafl, K. (2005). The integrative review: Updated methodology. Methodological Issues in Nursing Research, 52(5), 546-553 integrative review framework guided this review. Seventeen articles were reviewed and a quality appraisal tool (developed by Hawker, S., Payne, S., Kerr, C., Hardey, M., & Powell, J. (2002). Appraising the evidence: Reviewing disparate data systematically. Qualitative Health Research, 12(9), 1284-1299) was also used to evaluate the articles. Following the data analysis stage outlined in Whittemore and Knafl's integrative review framework, six themes emerged: construct conceptualization; relationship between engagement, satisfaction, and knowledge retention; knowledge translation, motivation, role of technology, and gamification elements. Gamification is of interest to the nursing profession. More study is needed to better ascertain the relationship between gamification and several of the main themes identified in this review.

Objective: To determine an appropriate survey instrument to evaluate the impact of organizational structures on the work environment of intensive care nurses. Background: Internationally the demand for intensive care is increasing. Solely increasing bed capacity is not sustainable. Large capacity multi-specialty Intensive Care Units are emerging as the preferred organizational model with benefits resulting from optimizing operational synergies and economies of scale. The impact of this organizational transition on intensive care nurses is not well understood. An appropriate survey instrument for intensive care nurses is required. Design: Integrative literature review. Data Sources: CINAHL, PubMed, EMBASE and OVID Nursing databases searched for studies published between 2005 and 2013. Review methods: An integrative review and quality assessment of the studies was undertaken to select nurse outcome measures associated with organizational structures across a range of acute and critical care settings. Congruence between nurse outcome measures and nurse survey instruments tested in the literature was assessed to select instruments for further psychometric evaluation. Results: Thirty-one cross sectional quantitative studies, from fourteen countries, were reviewed. Twenty one nurse outcome measures associated with organizational factors were identified and a total of twenty five survey instruments used in the studies reviewed. Assessment of congruence and psychometric properties determined that a combination of two instruments is required to comprehensively assess the organizational environment of nurses working in intensive care units. Conclusion: The environment of nurses working in intensive care is effectively evaluated with an instrument that combines subscales from the Practice Environment Scale-Nurse Work Index and Maslach’s Burnout Inventory.

BackgroundThe increasing availability of technology devices or portable digital assistant devices continues to change the teaching-learning landscape, including technology-supported learning. Portable digital assistants and technology usage have become an integral part of teaching and learning nowadays. Cloud computing, which includes YouTube, Google Apps, Dropbox and Twitter, has become the reality of today’s teaching and learning and has noticeably improved higher education, including nursing education.ObjectivesThe aim of this integrative literature review was to explore and describe technology usage for teaching and learning in nursing education.MethodA five-step integrative review framework by Whittemore and Knafl was used to attain the objective of this study. The authors searched for both empirical and non-empirical articles from EBSCOhost (health information source and health science), ScienceDirect and African Journals Online Library databases to establish what is already known about the keywords. Key terms included in literature search were coronavirus disease 2019 (COVID-19), digital learning, online learning, nursing, teaching and learning, and technology use.ResultsNineteen articles were selected for analysis. The themes that emerged from this review were (1) technology use in nursing education, (2) the manner in which technology is used in nursing education, (3) antecedents for technology use in nursing education, (4) advantages of technology use in nursing education, (5) disadvantages of technology use in nursing education and (6) technology use in nursing education amidst COVID-19.ConclusionTechnology in nursing education is used in both clinical and classroom teaching to complement learning. However, there is still a gap in its acceptance despite its upward trend.ContributionThe findings of this study contribute to the body of knowledge on the phenomenon of technology use for teaching and learning in nursing education.

To synthesise the literature on the experiences of giving or receiving care for traumatic brain injury for people with traumatic brain injury, their family members and nurses in hospital and rehabilitation settings. Traumatic brain injury represents a major source of physical, social and economic burden. In the hospital setting, people with traumatic brain injury feel excluded from decision-making processes and perceive impatient care. Families describe inadequate information and support for psychological distress. Nurses find the care of people with traumatic brain injury challenging particularly when experiencing heavy workloads. To date, a contemporary synthesis of the literature on people with traumatic brain injury, family and nurse experiences of traumatic brain injury care has not been conducted. Integrative literature review. A systematic search strategy guided by the PRISMA statement was conducted in CINAHL, PubMed, Proquest, EMBASE and Google Scholar. Whittemore and Knafl's (Journal of Advanced Nursing, 52, 2005, 546) integrative review framework guided data reduction, data display, data comparison and conclusion verification. Across the three participant categories (people with traumatic brain injury/family members/nurses) and sixteen subcategories, six cross-cutting themes emerged: seeking personhood, navigating challenging behaviour, valuing skills and competence, struggling with changed family responsibilities, maintaining productive partnerships and reflecting on workplace culture. Traumatic brain injury creates changes in physical, cognitive and emotional function that challenge known ways of being in the world for people. This alters relationship dynamics within families and requires a specific skill set among nurses. Recommendations include the following: (i) formal inclusion of people with traumatic brain injury and families in care planning, (ii) routine risk screening for falls and challenging behaviour to ensure that controls are based on accurate assessment, (iii) formal orientation and training for novice nurses in the management of challenging behaviour, (iv) professional case management to guide access to services and funding and (v) personal skill development to optimise family functioning.

The growing demand of mental health services among the population and the stigma associated with mental health conditions have resulted in a shortage of skilled nurses competent in delivering quality care to persons experiencing mental health conditions. This suggests the need to develop a systematic and comprehensive curriculum to prepare nursing students for a career in mental health nursing. An integrative review on empirical studies was conducted based on Cooper's five-stage integrative review framework to investigate the different pedagogies and to highlight the elements of an effective curriculum for teaching mental health nursing. All quantitative, qualitative, and mixed-method studies published between 2009 and 2019 that examined pedagogies in mental health nursing for nursing undergraduates were included in this review. Databases of interest included PubMed, Cochrane, PsycINFO, Embase, Scopus, Web of Science, and ProQuest Dissertations and Theses. To ensure methodological rigour and validity, the 23 included studies were independently evaluated by two authors through critical appraisal tools developed by Joanna Briggs Institute for quantitative and qualitative studies. Results from this review were categorized into three themes: (i) the deployment of simulation; (ii) pedagogies in enhancing critical thinking; and (iii) importance of consumer-oriented educational experiences. These results suggested that students would benefit substantially from in-depth discussions, critical reflections, and real-life experiences. Mental health nursing curricula should incorporate simulations, pedagogies for critical thinking, and consumers' lived experience to supplement the clinical rotations.

Cancer survivorship and quality of life outcomes of adolescents and young adults with lymphoma: An integrative review.

ABSTRACTAimTo synthesise understanding of family‐inclusive adult inpatient care using systematic integrative literature review.BackgroundInclusion of the extended family network (termed whānau by Indigenous New Zealanders) in bedside care is a person‐centred practice speaking to cultural diversity and aligning with principles of Indigenous inclusivity. Although patient‐and‐family/whānau‐centred care is not new, feedback from patients, whānau and clinical audits indicates variability in providing whānau‐inclusive care.Design and MethodsWe used an integrative literature review methodology to draw on qualitative and quantitative evidence published between 2000 and 2024. Five databases were systematically searched for eligible papers in January 2025, including MEDLINE (via Ovid), CINAHL Plus (via EBSCO), Web of Science, Scopus and PsycINFO (via Ovid) and quality assessment criteria were applied to included studies. Data were synthesised using thematic analysis.ResultsOf 5325 identified papers, 27 met the inclusion criteria. Thematic analysis yielded three themes that captured experiences of family/whānau inclusion in inpatient care, including factors that helped or hindered inclusion in an acute hospital setting: (1) culturally safe behaviours foster family‐inclusive care, including relational care; (2) culturally unsafe behaviours and unwelcoming hospital environments hamper family inclusivity and (3) effective communication practices are variable, with poor communication described as a more common family/whānau experience.ConclusionThis comprehensive integrative review identified limited evidence about the experience of family/whānau inclusion in acute care. Inclusion was variable and dependent on health professional willingness, cultural acumen and environmental factors. Experiences were negatively influenced by perceived risks to effective care, including culturally unsafe care and environments and poor communication. The experiences of non‐Māori are an underexplored element of family‐inclusive care and warrant further investigation.Implications for the Profession and Patient CareGreater understanding of patient and family/whānau bedside care experiences is critical to fostering family/whānau‐inclusive inpatient care and evidence‐based organisation‐wide quality improvement worldwide. Findings have implications for how families are communicated with and integrated into care and for policies such as visiting hours. Professional training and policy work is needed to build health professionals' confidence in family‐focused consultation, integration in care and logistical solutions to workload management.ImpactThis integrative review synthesises patients' and family experiences of family‐inclusive inpatient care and incorporates Indigenous/First Nations views as a unique contribution.This review highlights the need to embed cultural safety training into nursing workforce development to serve vulnerable and underserved populations better.Local organisational and broader policy changes are needed to allow flexibility with inpatient care to foster family inclusivity and improve inpatient care.Contribution to the Wider Global Clinical CommunityIndigenous‐sensitive practices are an essential facilitator to accessing culturally responsive healthcare services and are key to serving vulnerable and underserved populations and fostering inclusion and equity in healthcare provision. Evidence synthesised by this review has provided insight into Indigenous views of family‐centric care in Aotearoa. We note gaps in knowledge about views of Indigenous/First Nations populations globally in this context.Reporting MethodFollowing the EQUATOR guidelines, the PRISMA‐S checklist was applied.Patient or Public ContributionNo patient or public contribution was made due to the literature review design.

Purpose This study develops a new integrative framework that embeds digital technologies as core quality drivers, unlike prior models, which were treated only as supplementary tools. The study investigates systematic understanding and enhancement of quality in the tourism and hospitality industry, despite its inherent complexity and subjective nature. It examines how established quality management frameworks, such as TQM, ISO standards and SERVQUAL, can enhance customer satisfaction and service delivery. Design/methodology/approach The study proposes a novel integrative framework that treats digital technologies not as peripheral tools but as constitutive elements that actively reshape how service quality is defined, delivered, and measured in tourism. We conceptually develop and analytically validate this framework using a systematic integrative literature review. The study synthesizes existing theories, identifies gaps, evaluates established quality management tools and assesses the transformative role of digital enablers. This comprehensive, evidence-based model is particularly well-suited for digital tourism. Findings Quality remains crucial to achieving customer satisfaction in tourism, despite its subjective nature and the challenges associated with defining and measuring it. Digital technologies dissolve the provider–consumer boundary. They transform quality into a real-time, algorithmically mediated construct shaped by social validation (e.g. UGC and sustainability signals) rather than internal compliance. Implementing these frameworks effectively can improve organizational performance, increase customer loyalty and enhance competitive advantage. Research limitations/implications The focus of this study is on conceptuality and excludes empirical data or case studies. Future research could verify the conclusions by utilizing these frameworks in specific tourism environments and measuring their outcomes. Moreover, the variety of tourism services may necessitate customizing standard quality tools. Practical implications By mapping quality practices onto digital touchpoints, managers can deploy AI-powered personalization and sentiment analytics to monitor and enhance guest experiences in real-time. Managers can implement this framework by mapping legacy quality practices (e.g. ISO process controls) onto digital touchpoints (e.g. AI-driven sentiment analytics) to enable real-time quality measurement and control. Social implications The tourism sector’s improved service quality leads to better customer experiences, job satisfaction for employees, and sustainable business practices. The promotion of social and cultural exchange is a result of its support for economic growth in regions where tourism is a significant industry. Originality/value Prior studies adequately examined quality frameworks (e.g. TQM and SERVQUAL) or digital technologies in isolation. This study presents a novel integrative conceptual framework that repositions digital technologies–not as peripheral tools, but as constitutive elements that actively reshape the definition, delivery and measurement of service quality. Unlike previous conceptual models that treat digital technologies as external or supplementary, our framework embeds them as constitutive elements because they reshape how quality is perceived, delivered and measured in the tourism experience. This reconceptualization theoretically challenges the notion of quality as a static and provider-defined construct. The study proposes it instead as a dynamic, co-created phenomenon shaped in real-time by digital interactions.

Purpose– The purpose of this study is to identify how knowledge sharing literature has discussed task, structure, technology and people as elements of organizational change and to examine the interactions between the four elements of knowledge sharing.Design/methodology/approach– The research questions guiding the study are: How do organizational change elements influence knowledge sharing? and What are the critical elements of organizational change in relation to knowledge sharing? Based on Leavitt’s (1965) organizational change model, 133 articles published between 2000 and 2012 from 13 journals were reviewed and analyzed.Findings– The total number of articles covering task, structure, technology and people in knowledge sharing was 49, 79, 49 and 97, respectively. Of all references, 97 articles (72 per cent) discussed the important aspects of people, and 79 articles (59 per cent) emphasized the influential role of organizational structure in knowledge sharing. The highest frequency of interactions (48 articles) was the interaction between structure and people (Interaction 5).Research limitations/implications– To capture broader phenomena on knowledge sharing in organizational change, multiple data sources and a variety of journals with a longer timeframe should be collected and a more comprehensive review should be conducted. All perspectives of organizational change were not applied to this study. Theoretically, this study attempted to illuminate how knowledge sharing has been explored through the lens of four elements in organizational change and the interactions between the elements. This study attempted to expand the use of Leavitt’s (1965) model by applying interactive relationships among the elements to knowledge sharing.Practical implications– The findings can advance strategic and managerial practice by informing the planning and development of knowledge sharing associated with change in organizations. A key question is how to identify the major component of change which will trigger the other changes in the current architecture of knowledge sharing in their organizations. This study suggests that elements of structure and people, when organization face either planned or unplanned change, are critical for successful knowledge sharing by making the interactive connections with other components of change.Originality/value– The contributions of this study are that it provides an integrative review in selected journals of knowledge sharing in terms of organizational change. By examining how knowledge sharing studies have addressed the four change factors and multi component changes, this study explains one change in knowledge sharing leads to multi-component changes. Additional contribution is that it makes connections between knowledge sharing and organizational change.