The Impact of Organisational Changes on Teamwork in Healthcare: A Systematic Review

Healthcare organisations have to frequently undergo significant reforms, ranging from structural reforms to operational modifications, to address evolving challenges, such as an ageing population, technological advancements, and emerging diseases. These organisational changes significantly affect teamwork in healthcare, which is a critical component for ensuring patient safety, enhancing clinical performance, and maintaining staff satisfaction. The relationship between organisational changes and teamwork is ill-defined. PubMed, Scopus, ProQuest, and Web of Science (WOS) databases were searched for relevant literature on the impact of organisational changes on teamwork processes and outcomes in healthcare settings. Based on predefined selection criteria, 24 studies were considered suitable for inclusion; data from these studies were synthesised using thematic analysis. Three primary themes of organisational changes-organisational restructuring, operational changes, and adaptive response and capacity development-which affected team dynamics in various ways, were identified. Both planned and emergent changes produce mixed effects on teamwork; while planned changes are aimed at improving cooperation and efficiency and minimising negative impacts, they may inadvertently disrupt teamwork. In contrast, emergent changes can encourage resilience and adaptability within teams. Finally, the success of organisational changes in improving teamwork outcomes depends heavily on implementation strategies, contextual factors, and team characteristics. This review highlights the importance of employing established change management frameworks to address the complexities of organisational change. Further research, particularly from low- and middle-income countries, is essential to develop strategies and approaches for establishing effective healthcare teams in diverse settings.