Why health-care teams don't change: chronicity and collusion.

Organizational chronicity exists in many health-care settings. This syndrome organizes the agency's approach to problems, dampens enthusiasm about the possibility of change, and fosters a climate in which change behaviors are undermined and sabotaged. The authors identify collusion, characteristics of the health-care team, errors of the internal training staff, and consultant errors as four significant contributors to organizational chronicity, and offer strategies for changing settings in which chronicity is the norm.