University of Michigan, Ann Arbor, MI, USA.
Med Care Res Rev. 2013 Apr;70(2):115-42. doi: 10.1177/1077558712458539. Epub 2012 Sep 6.
Health care organization leaders and policy makers seeking ways to reform the delivery of health care have become increasingly interested in transformational change. To foster understanding of how organizational transformation occurs and to stimulate further research, we report findings from a systematic review of empirical research on transformational change in the health care and non-health care literature, with a focus on the antecedents, processes (or paths), and outcomes of transformational change. Fifty-six studies, of which 13 were in health care, met our selection criteria. With one exception, all were published since 1990, indicating the recent upsurge of interest in this area. Limited differences were found between health care and non-health care studies. Available research documents the multiplicity of factors affecting change and the complexity of their interactions, but less information is available about the processes of transformational change than about its antecedents and consequences. Research and practice implications are discussed.
医疗保健组织的领导者和政策制定者正在寻找改革医疗保健服务的方法，他们对变革型转变越来越感兴趣。为了深入了解组织变革的发生方式，并激发更多的研究，我们报告了对医疗保健和非医疗保健文献中变革型转变的实证研究的系统回顾结果，重点关注变革型转变的前因、过程（或路径）和结果。56 项研究符合我们的选择标准，其中 13 项研究涉及医疗保健领域。除了一项研究外，所有研究都发表于 1990 年之后，表明该领域的研究兴趣最近有所增加。在医疗保健和非医疗保健研究之间发现了有限的差异。现有研究记录了影响变革的多种因素及其相互作用的复杂性，但有关变革过程的信息比有关其前因和后果的信息要少。讨论了研究和实践的意义。
