Abstract
Purpose. The purpose of this research was to explore and discover staff's personal experience of careline integration and restructuring. The critical behaviors gathered are organized in a category scheme of unique and powerful experiences of adapting to large-scale organizational change (LSOC). Theoretical framework. The phenomenon of "Large-Scale Organizational Change" (LSOC), as conceived and developed by Mohrman and Associates (1989), was chosen as the conceptual framework for the research. LSOC is defined as a lasting change in the character of an organization that significantly alters its performance, and the alterations are not temporary; the organization becomes different and remains different. Methodology. The critical incident technique was selected as the appropriate methodology to collect and analyze reports of clinical staff receptivity to a large-scale organizational change, specifically, the integration into carelines in a metropolitan federal healthcare system. The methodology incorporates a set of procedures for collecting descriptive accounts of incidents or behaviors through interviews that significantly affect a particular goal. Sixty-two care providers who had experienced careline integration were selected to be interviewed. Critical events or behaviors were extracted from the accounts and grouped to form separate facilitating and hindering categories indicative of employee receptivity to large-scale organizational change. Findings. Results of this research indicate that large-scale organizational change can potentially lead to nonreceptivity among employees if not properly managed. This research suggests that if employees clearly understand the reason and vision of the changes, well-informed and empowered as partners in the decision-making processes concerning the changes, they exhibited facilitating behaviors. One of the unique results of this research was the respondents' limited but real optimism that hindering behaviors can be improved. Conclusions and recommendations. The execution approach to change is a reality-based approach; leaders envision and discuss specific needed actions. In practical terms, the findings suggest that an effective strategy to reduce hindering behaviors is to be a visible partner providing timely information and explanations regarding proposed changes. More research is needed in reducing the numbers of counterproductive activities and self-fulfilling patterns of behavior that keep participants from fully engaging with the changes staff must make.