Different timetables for change: understanding processes in reorganizations--a qualitative study in a psychiatric...

It is well-known that a decrease in economic resources in health care results in increased workload, stress and pressure on personnel. The main aim of this study was to explore and understand how personnel in health care were influenced by multiple obligations in the context of a changing surrounding.

Personnel within psychiatry were interviewed in an open-ended, interactive mode. The transcribed interviews were analysed using grounded theory as the method of study.

These professionals working within a turbulent work situation experienced a struggle between external demands and internal obligations of an ethical or ideological character. For many of them earlier psychological contracts were broken, earlier organizational culture was overthrown and their professional authority was threatened. They were required to change or abandon well-established professional identities. Fundamental changes such as the transition of theoretical framework or revision of internal obligations have quite a different timetable from a technical change of method or organizational structure.

The findings of two timetables for change should be addressed when considering reorganizations. If these findings are applied to personnel in health care, seeing them also as patients in the system may be avoided.

The different timetables for external change and internal reorganization, with support from findings in in-depth interviews, have not been described until now.