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Defining and Measuring Organizational Transformation in Health Care: A Systematic Literature Review
Lauren Clack1,2, Jason Smith3, Martin Charns3,4
1University of Zurich, Switzerland.
Medical Care Research and Review : MCRR
|August 13, 2025
Summary
Healthcare organizational transformation requires empirical evidence. This review found recurring themes like leadership and engagement but noted weak research designs and a lack of standardized measures, indicating a need for more rigorous studies.
Area of Science:
- Healthcare Management
- Organizational Studies
- Health Services Research
Background:
- Systemic improvements in healthcare necessitate organizational transformation.
- Empirical literature on whole-organization transformation in healthcare is fragmented.
- Understanding the process and measurement of transformation is crucial.
Purpose of the Study:
- To systematically review empirical studies on whole-organization transformation in healthcare.
- To identify common themes, processes, and measures of transformation.
- To assess the methodological rigor of existing research.
Main Methods:
- Systematic literature review of 36 empirical studies on healthcare organizational transformation.
- Analysis of study aims (analytic vs. descriptive), research designs, and evaluation models.
- Identification of recurring themes and measures of transformation.
Main Results:
- Studies varied in aims and publication venues; few defined transformation.
- Most studies used weak research designs and lacked common transformation measures.
- Distributed leadership, staff engagement, and culture change were key themes for success.
- Two-thirds used models to guide change, but evaluation models lacked consistency.
- Most articles reported successful transformations.
Conclusions:
- The current literature on healthcare organizational transformation is methodologically weak.
- There is a significant need for more rigorous, theory-driven research.
- Standardized measures and robust designs are essential for advancing the field.
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