Objective Major system change can be stressful for staff involved and can result in
'subtractive change'–that is, when a part of the work environment is removed or ceases to …

Background: The reconfiguration of specialist hospital services, with service provision
concentrated in a reduced number of sites, is one example of major system change (MSC) …

Background Organisational change in health systems is common. Success is often tied to
the actors involved, including their awareness of the change, personal engagement and …

Background The centralisation of specialist cancer surgical services across London Cancer
and Greater Manchester Cancer, England, may significantly change how patients …

Background There are longstanding recommendations to centralise specialist healthcare
services, citing the potential to reduce variations in care and improve patient outcomes …

Objective Major system change (MSC) has multiple, sometimes conflicting, goals and
involves implementing change across a number of organizations. This study sought to …

Objectives Regional centres and their rural hinterlands support significant populations of
non-metropolitan Australians. Despite their importance in the settlement hierarchy and the …

Objectives To explore the experiences of governance and incentives during organizational
change for managers and clinical staff. Study Setting Three primary care settings in E ngland …

Purpose–This paper seeks to present findings from a longitudinal action research study
aimed at exploring one such innovation. Little is known about the micro‐level impact of …

Many types of organisation are difficult to change, mainly due to structural, cultural and
contextual barriers. Change in public hospitals is arguably even more problematic than in …