Management of organisational changes in a case of de-institutionalisation

J Health Organ Manag. 2011;25(4):355-84. doi: 10.1108/14777261111155010.

Abstract

Purpose: This paper seeks to explore the development of a discharge programme in one learning disability hospital in Scotland. The study aims to concentrate on organisational developmental changes in that institution. The model of the management during the discharge programme was investigated. The aim of the study is to explore how the discharge programme developed, as seen under the lens of organisational change, in order to find out what kind of model of management is more suitable in similar programmes.

Design/methodology/approach: A case study was employed. Data were collected by means of interviews. The interviews followed a structured format. The sample of the study had to be a purposive sample and the method of snowball sampling was used; finally, 28 interviews were conducted. A grounded approach was adopted for the data analysis. The software program QSR "NUD*IST" (version "N6") was used as a technical tool, in order to facilitate the data analysis.

Findings: The findings of this study show that various management models were adopted in the four phases of the discharge programme. These different models represent a "quest" by the institution's management regarding the most appropriate model for managing the discharge programme. This study shows that this goes on continuously in organisations under transition until they settle down to a more permanent state.

Originality/value: It was concluded that management models, which are composed of characteristics from the organic theory of organisational management, could apply in discharge programmes. The data gathered enabled the researcher to arrive at a model of management which is suitable for managing organisational changes in discharge programmes, the named "stakeholder management model".

MeSH terms

  • Deinstitutionalization*
  • Health Care Reform
  • Humans
  • Interprofessional Relations
  • Interviews as Topic
  • Learning Disabilities / rehabilitation*
  • Organizational Case Studies
  • Organizational Innovation
  • Patient Discharge*
  • Rehabilitation Centers
  • Scotland
  • Social Work / methods*