The enduring challenge of change management: new perspectives from nonprofit healthcare practice

The management of change has been, and continues to be, a popular research subject, attracting the attention of academics for much of the last 60 years. It has underpinned the publication of thousands of books, hundreds of thousands of journal articles, and tens of thousands of conference submissions. It has also been and continues to be the subject of many undergraduate and post-graduate subjects at tertiary institutions around the world. Despite this immense growth in knowledge, or perhaps because of it, researchers and practitioners still grapple with the requirements, both at the organisational level as well as the personal level, of what are the ingredients of successful change management. For the most part this historic and ongoing research has substantially focused organisations in the commercial sector, which has led to the integration of knowledge associated with organisational communication, organisational structures, as well as organisational change resistance and readiness. More recent research has focused attention on the individual perspective of change, focusing on personal attributes and the impact of coping with, and therefore addressing, change. This has been undertaken against an ongoing questioning of both the ability to generalise the application of change and the ability to even manage change. The overwhelming focus of this scholarship on organisations in the private sector has neglected the uniqueness of the nonprofit sector and the impact this may have on managing change. The nonprofit sector is characterised by complex revenue generation models for those nonprofits operating in commercial and quasi-commercial activities, the application of hybrid performance measurement criteria, political bias, dichotomy of mission and organizational sustainability in religious-based nonprofits, as well as the challenges of recruitment for nonprofit organisations. The research for this thesis seeks to add to the body of knowledge on change management from the perspective of the nonprofit sector. Accordingly, it investigates change management as viewed through the personal experiences of change recipients. Results point to the impact of four key characteristics that require a more substantial focus in planned changed models when applied to nonprofits. These include formal reflection for change agents and change recipients, development of trust and confidence in organisations before the actual change, focusing on the individual experience of change, and the sequencing of events from a planning perspective. The findings, embodied in this thesis, originating from a single case study, may have broader implications for a wider cross-section of nonprofit organisations, and, accordingly, warrant further research amongst a broader population of nonprofit organisations. Possible implications may also exist for further investigation of the implications of these findings for the commercial sector. Whilst change management has a long and rich research history, we may not have yet reached the end point. This thesis hopefully contributes in small part along the journey.