Leading Through Rapid Change Management.

Change in health care has become rapid and continuous. Much decision-making processes guiding change management are derived from organizational literature which is heavily reflective of managerial perspectives. These perspectives represent and aim to serve only a small subgroup of organizational members. However, change is complex, fragile, and has higher rates of success and sustainability when change management strategies reflect a multitude of organizational voices. There is a dearth of literature exploring the intersect between organizational and nursing discourses on the subject of rapid and continuous change in health care. Multitheoretical, multimethodological, and multidisciplinary informed approaches to methodological decision making are needed to link organizational and nursing discourses in ways that will offer alternative perspectives on the subject of change. Furthermore, critically guided multitheoretical, multimethodological, and multidisciplinary methodologies are timely and important in organizational research. Critically guided research seeks to analyze taken-for-granted assumptions and institutionalized practices seeking alternative perspectives and alternative sources of organizational knowledge. Exploring alternative perspectives from a critical lens recognizes the impact predominant discursive influences have on change management and the subsequent impact on organizational members’ working lives. This article will explore how Kincheloe’s discussions of the critical bricolage serve to support combining critical organizational methodologies (guided by Alvesson and Deetz) with a voice-centered relational method of data analysis (guided by Brown and Gilligan) to create a critical interpretive methodology that explores the voices of nurses as they experience rapid and continuous change in health care.

Effective change management requires five main steps: assessing the situation, planning the change, putting the plan into practice, analyzing the results, and ensuring that the change is safe and effective in the organization. This research is in-depth about “Organizational Change Management: Effective Strategies in Facing Global Challenges.” Through the literature study method, this research examines more deeply how to implement an effective change management strategy to face an era of boundless global competition characterized by rapid changes in the business environment and advances in communication and information technology. In this effective strategy, it is necessary to involve employees and leaders who change the paradigm of thinking to face the rapid changes in the business environment in global competition for the success of the transformation.

In order to bridge the gap between rapid technological changes and the healthcare environment, and to alleviate the burden of nursing tasks, the need for change management must be recognized. Understanding nurses' perceptions of generative artificial intelligence (AI) is essential for the successful implementation of nursing change management. However, existing studies are mostly exploratory in nature, focusing on the utility and applications of generative AI technology. There is a lack of research on its implications for the nursing environment and nursing management. The purpose of this study is to explore in depth the perceptions of nurses at cancer specialty hospitals regarding the application of generative AI, as well as the environmental and contextual factors involved. This study conducted in-depth interviews with nurses at National Cancer Center, the first cancer specialty hospital in South Korea, from July to August 2024. The semistructured questionnaire was developed based on clinical nursing practice guidelines, and participants were selected considering the various characteristics and situations of nursing tasks. First, nurses at the cancer specialty hospital recognized change management factors in the areas of 'basic nursing,' 'therapeutic intervention,' 'nursing during examinations,' 'infection control,' and 'nursing administration.' Second, limitations of change management such as 'decline in nursing proactivity,' 'difficulties in building rapport with patients,' 'difficulties in providing personalized nursing care,' 'patient information breach' and 'unclear accountability' were identified. Third, preparation strategies for change management such as 'nurse competency improvement,' 'legal protection,' 'establishing standardized processes,' and 'awareness improvement' were identified. Based on the research findings, academic and practical implications for the application of generative AI in nursing and strategies to enhance nurses' readiness for its implementation are presented.

As the digital market grows, businesses must embrace digital transformation (DT) to remain competitive. The integration of digital technologies has redefined business operations, models, and customer engagement. However, successful DT is not solely a technological initiative—it requires robust change management (CM) to address resistance, enhance organisational agility, and ensure long-term sustainability. This study presents the first bibliometric analysis to explore the intersection of DT and CM, offering a comprehensive view of how scholarship in these domains has evolved. Using VOSviewer and Biblioshiny, we conduct co-citation and co-occurrence mapping to identify influential studies, emerging trends, and persistent research gaps. Scopus was chosen as the primary database for material processing, given its extensive coverage of peer-reviewed literature across disciplines. In addition, data sources such as surveys, databases, and digital archives were integrated to provide valuable insights and contextual depth, ensuring a more nuanced and holistic analysis. The findings highlight the growing importance of DT and underscore the critical role of leadership, skill development, and effective technology implementation in driving change. Our study reveals that research in this area increasingly emphasizes the integration of technology with management practices and employee engagement. By combining bibliometric analysis with diverse data sources, this article not only maps the trajectory of DT and CM research but also identifies opportunities for future investigation. Ultimately, the study calls for a comprehensive approach that blends technological innovation, managerial processes, and workforce adaptability to help organisations thrive in an era of rapid digital change.

According to the philosopher Hegel, people and governments never learn from history—a depressing thought for reformers. One of the worries about the current restructuring of the NHS1,2 is that reformers are failing to learn from previous mistakes and that the public health function will emerge seriously damaged. In the April JRSM Professor Walter Holland3 called for much deeper scrutiny of the latest proposals, in the light of past experience and future needs. Similar anxieties have been expressed elsewhere4,5. On 26 February the RSM's Section of Epidemiology and Public Health debated the motion, The current government reorganization of the structure of the NHS will damage the public health function. Participants were asked to put aside concerns6 about yet another round of reorganization, restructuring and reapplication for posts and to focus on whether this further tidal wave of change could be justified in terms of outcome. One theme was people's attitudes—whether, before the changes come in, the glass is perceived to be half full or half empty—or, as a member of the audience quipped, three-quarters full. Proposers of the motion argued against yet another change before systems have been allowed to settle, or to be properly evaluated, from previous reorganizations. Opposers claimed this was a pessimistic reactionary view, unfitted to the change-agent role claimed by public health specialists. But, ran the counter-argument, agents of change exist to achieve reforms rather than become victims as in a cruelly reversing and distorting mirror; the turmoil of successive changes has left little time or energy to make the required impacts on surveillance, disease prevention and healthcare planning. Yet, argued the opposers, it is precisely because of the perceived poor impact on population health that more change is necessary: the current government focus acknowledges the worsening of many health inequalities over the past three decades; one aim of the reform, and one of the three aims of the primary care trusts (PCTs) that will have responsibility for the public health function, is to base public health activities more directly at the primary care level and so make them more effective, with new opportunities for influencing decisions and networking across community and agency boundaries. Critics reject this argument, declaring that dispersal into small units will cause the public health function to become marginalized. So, a shift of balance to improve the service, or a shift of blame to another part of the health system? Another theme was the chaos caused by reorganization and the tendency of change to destabilize. Here the metaphor shifted from the half-full/half-empty glass to whether we should be looking for green shoots rather than dying roots. Restructuring is painful but potentially fruitful, claimed the supporters of further reorganization: the current change merely acknowledges that structure should follow definition of function. Against this was cited the narrow function apparently perceived for public health by the Government—the tackling of health inequalities by promotion of screening, rapid access clinics and the like. Surveillance of disease, the need for stable population bases for calculating incidence or prevalence, and effective control and prevention of infectious disease have been effectively demoted in priority. But only if we let it be so, claimed supporters of the changes: the regional and PCT public health capacity will include large budgets for public health, and productive discussions across many sectors are already in progress. An inevitable theme was whether this reorganization is politically based or evidence based. According to the proposers of the motion, certainly not evidence based: the plans were prepared hastily and with scant consultation. In their view the specialty, always vulnerable to political influence, would become effectively politicized, with practitioners suffering further loss of independence; there had been no published evaluation or detailed assessment of the earlier ‘reforms’, and announcements such as the NHS Plan in 2000 made no mention of the wide-scale structural upheaval now about to occur. Opposers argued for a more positive view of the inherent political nature of public health, pointing to international influences such as the World Health Organization's Alma-Ata declaration relating to ‘Health for All’7, which the current reforms address more closely than any previous reorganization. They pointed out that the repositioning of the public health function also acknowledges the need to work closely with those responsible for housing and social care. The counterargument was that these grand aims could have been achieved through modification of the existing public health structure; would PCTs be able to devote the necessary energy to the public health aims on their agenda, given the strong emphasis on secondary-care performance indicators? There are different types of change, as well as varying attitudes and philosophies that may influence change outcomes: on both sides there was acceptance that management of change is a core skill for public health specialists. Proposers argued for slower, more considered, change based on evidence and evaluation; also that behavioural, not structural, change should be the core strategy. Opposers cited the history of public health and its perceived failures, as well as changing expectations, declaring that the time was right for revolution. There was no agreement on whether such rapid change would be destructive—for example, through loss of skills if experienced practitioners left the specialty. The question of out-of-hours cover remains unresolved following publication of the plans for the new agency for environmental and infection surveillance8 (already renamed the Health Protection Agency)—another major imminent change for public health. Yet there is scope for optimism. Opposers of the motion referred to new opportunities, renewal of enthusiasm and a structure to support the much-needed cultural shift. As for the threat of professional isolation in the new smaller units, electronic communications could provide the necessary networking. Is all change good? Clearly not, yet the change rhetoric is a contemporary force and there is more emphasis on resilience to change than on clarifying how it should be defined and implemented9. This, in my view, was the essence of the debate—although, as a proposer of the motion, I must declare a bias. The motion was carried by 22 votes to 16, with several abstentions; and the frank exchange of views belied the accusation that our specialty is already irretrievably politicized. Even if, as the vote indicated, the NHS reorganization will damage the public health function, we can confidently expect another reorganization in a few years' time. People working in public health are certainly accustomed to managing change.

Healthcare organizations must have the ability to adapt to rapid environmental changes and respond to evidence-based needs. One of the key prerequisites for the effective implementation of these changes is organizational readiness for knowledge translation (KT). The aim of this study is to identify the dimensions and components of organizational readiness for implementing KT in medical universities in Iran. This research was conducted using a scoping review approach based on the Arksey and O'Malley framework. A comprehensive search was performed without a time limitation in international databases such as PubMed, Scopus, Web of Science, and Persian databases MagIran and SID. Out of 4540 identified documents, 14 articles were included after screening and final assessment. After extracting the dimensions and components from the reviewed studies, five dimensions and 14 components were identified, as follows: Organizational Climate (culture of readiness and innovation, intra- and inter-organizational interactions, organizational dynamics), Organizational Support (development and training opportunities, financial resources, capacity building and organizational performance improvement), Change Management (strategies and change implementation capacity, leadership support), Organizational Context (knowledge management in the organization, organizational structure and technological advancement, social capital), and Human Resources (self-efficacy and motivation, leadership, collaboration and participation). This scoping review identified five key dimensions-Organizational Climate, Organizational Support, Change Management, Organizational Context, and Human Resources-comprising 14 components that constitute organizational readiness for KT. To enhance readiness, health system managers and policymakers must understand the importance of utilizing research evidence and, through skill development and fostering participation, create the necessary environment for implementing knowledge.

This study examines how leaders of career services units manage organizational change to meet the evolving needs of their internal and external stakeholders. These leaders are increasingly required to spearhead significant changes within their teams and across their institutions to adapt to rapid changes in the higher education sector and the workforce. One-on-one semi-structured interviews were conducted with 17 leaders of career services units at 4-year institutions in the United States who had recently managed an organizational change process. General Inductive Analysis was used to code transcripts of these interviews and identify major themes and associated subthemes. The five major themes found in the data were: 1) identifying the motivations for organizational change, 2) gaining buy-in from internal stakeholders, 3) developing and communicating a vision for change, 4) supporting direct reports through the change process, and 5) defining and measuring success. This study suggests that career service leaders are productively employing change management strategies to secure support from senior leadership, generate buy-in from faculty, and manage the experiences of their direct reports. The findings also indicate that these leaders are aware of the importance of a strong vision and a data management strategy for organizational change, but that they often had difficulty enacting these to their fullest potential. The study closes with recommendations for how career services leaders can benefit from learning more about the field of change management and applying its tenets to their organizational change efforts.--Author's abstract

The imposed gender quota intervention on board compositions aimed to counter the deeply rooted in the society underlying gender discourse, is debated by both, the business utility case and the social justice concerns. Results related to quota effectiveness have been inconsistent at best in the literature. By connecting the common underlying denominator of both problem-oriented perspectives, we argue that the effectiveness of the quota policy will invariably depend upon the capacity of the change management to effectively recruit, appoint and integrate women as well as make good use of its new potential, without which the inherent benefits of board diversity are lost. To study such we use an in-depth case study situated in the financial industry, following the ECB announcement of mandatory board gender quotas. We find that the top down and rapid change and implementation is too quick and too painful. Women hold less important positions inside the board and are prone to a gendered discussion in terms of skills that is weakening their position, with implications on board cohesion. The board is thereby functioning as an agglomerate of individuals. However women are bringing resistance to a negotiation process of power struggle, the future outcomes of which are unknown. Ultimately, the data underscores the need for deeper organizational change management approaches to address ingrained inequalities and maximise women’s contributions in the board. We discuss implications for theory and practice.

Change is an inevitable fact of life from birth to death, affecting cultures, countries, and societies. Especially today, change is happening faster than in the past, and this causes societies and organizations to face much more change that they need to keep up with. Organizations can only survive if they change themselves by adapting to these rapid changes. In this study, definitions of organizational change were given, and the factors that cause organizational change were described. Then, the theories of change were mentioned depending on the reason for the change and the changes it brings about in the organization. Then, resistance to change, management of organizational change, and organizational change in educational organizations were examined.

Change is an inevitable fact of life from birth to death, affecting cultures, countries, and societies. Especially today, change is happening faster than in the past, and this causes societies and organizations to face much more change than they need to keep up with. Organizations can only survive if they change themselves by adapting to these rapid changes. In this study, definitions of organizational change were given, and the factors that cause organizational change were described. Then, the theories of change were mentioned depending on the reason for the change and the changes it brings about in the organization. Then, resistance to change, management of organizational change, organizational development and organizational behavior were examined.

Almost every professional sector has embarked on the move toward sustainability. European landscapes are facing rapid changes in land use, where understanding and management of this process is essential. Sustainability has become a widely acknowledged dimension of huma actions, but still little stress is put on education in sustainability. This paper identifies focus of education, gives suggestions for improvements and presents a new tool for education and training in sustainable land use – “Route Planner”. As results, it provides all users with new interesting facts on sustainability in the European Union and additional materials related to sustainable land use and Sustainability Impact Assessments (SIA). Users got the access to updated information regarding approximately 3000 courses on offer in this topic area throughout the European Union as well as case studies to compare sustainability practices in these countries in comparison to other parts of the world. Furthermore the end result of the information chain also leads the user to a collection of links such as interesting websites and further reading in the topic area

This article focuses on analyzing the core principles and approaches to strategic innovation changes in construction projects. It highlights the methodological foundations that define the effectiveness of construction project management in a changing market environment and the integration of innovations into the activities of key market participants, such as developers, contractors, investors, and end-users. Given that the construction industry is one of the most capital-intensive and complex sectors to manage, strategic innovations can provide significant competitive advantages and cost reduction. The article discusses key methodological approaches to implementing changes in construction project management, particularly the use of integrated management models, the application of digital technologies, and new approaches to project financing and implementation. It also emphasizes the importance of flexible strategies that enable adaptation to market changes, environmental requirements, and technological innovations. As a result, the article outlines the significance of strategic management and innovations for the development of construction projects and improving their efficiency. This paper also highlights the key challenges faced by construction market participants when implementing innovative strategies in construction project management. One of the main challenges is the need to adapt to rapid changes in the economic and technological environment, which requires flexibility in management and the ability to quickly respond to new market demands. Considering the high capital intensity of construction projects, enterprises must focus on effective resource and investment management, which is only possible through the introduction of innovative methods and technologies. Important aspects include the use of digital tools, such as Building Information Modeling (BIM), management automation systems, big data analytics (Big Data), and Internet of Things (IoT) technologies, which allow optimizing processes, reducing costs, and improving the quality of work execution. The article also examines the importance of integrating stakeholders into the project management process, which helps create more transparent and effective conditions for all market participants. Involving investors, contractors, and end-users in decision-making processes helps reduce risks and improve the efficiency of interaction among all parties. Considering their interests and integrating with the latest project management approaches are key elements for achieving long-term success in the construction market. As a result, the article provides recommendations for improving construction project management through the integration of innovative strategies, including the latest technologies and flexible management strategies that contribute to increased efficiency, cost reduction, and enhanced competitiveness of construction enterprises.

Impact of mining on vegetation cover: A case study of Prestea Huni-Valley municipality

Foreword by Elinor Ostrom Introduction Part I: Health and Adaptation Approaches 1. A Half-Century Portrait: Health Transition in the Xavante Indians from Central Brazil 2. Balancing People, Politics, and Resources in Rural Tibet 3. Human-Wildlife Contact and Emerging Infectious Diseases Part II: Land Change and Landscape Management Approaches 4. Change in Natural Resource Management: An Experiment with 'Participatory GIS' 5. Peopled Parks: Forest Change in India's Protected Landscapes 6. Public-Private Interactions in the Conservation of Private Forests in the United States 7. The Monitoring of Land-Cover Change and Management across Gradient Landscapes in Africa Part III: Institutional and Political Ecology Approaches 8. Between Cooperation and Conflict: The Implementation of Agro-Extractive Settlements in the Lower Amazonian Floodplain 9. Conservation of Natural Resources: Which Matters -Having a Regulation or the Size of the Penalty Imposed? 10. Small-Scale Farmers and the Challenges of Environmental Conservation and Rural Development: Case Studies from the State of Sao Paulo and the Amazon Region 11. Institutional Evolution, Forest Conservation, and Rapid Change in Rural Honduras 12. Land-Use Institutions and Natural Resources in Fast-Growing Communities at the Urban-Rural Fringe Part IV: Historical and Archeological Approaches 13. Agroforestry in Tome-Acu-An Alternative to Pasture in the Amazon 14. Changing Driving Forces, Imposed Tenure Regimes, and Tree-Cover Change on Village Landscapes in the West Mengo Region of Uganda, 1890 to 2002 15. Was Agriculture a Key Productive Activity in Precolonial Amazonia? The Stable Productive Basis for Social Equality in the Central Amazon Part V. Future Directions 16. Human-Environment Research: Past Trends, Current Challenges and Future Directions Index

BackgroundEvidence from the 2009 A/H1N1 influenza pandemic demonstrated that pregnant women are particularly vulnerable to infection and at an increased risk of death. Active data collection through the UK Obstetric Surveillance System (UKOSS) about women admitted to hospital during the 2009 A/H1N1 pandemic was used to inform ongoing clinical guidance regarding the use of antiviral treatment for pregnant women and demonstrated that, in addition to an increased risk of maternal morbidity, influenza infection in pregnancy is associated with poor perinatal outcomes, including an increased risk of stillbirth and preterm birth. This evidence influenced the decision to offer routine influenza immunisation to pregnant women. Even in a non-epidemic period, pregnant women continue to die from influenza.ObjectiveTo establish, and then to put into hibernation, the study mechanisms needed to mount a rapid investigation of the impact of pandemic influenza in pregnancy in the event of a newly emerging pandemic strain.DesignA new UKOSS cohort study was designed, based on the 2009–10 study, and following consultation with the Pandemic Flu Planning Group at the Royal College of Obstetricians and Gynaecologists and the UKOSS Steering Committee, to identify potential previously unanswered questions.SettingUK maternity units.ParticipantsAll pregnant women admitted to hospital with influenza in a future pandemic.Main outcome measuresManagement of pregnant women with influenza infection, intervention rates, treatment and pregnancy outcome for both the mother and fetus.ResultsThe study was designed and approved by the UKOSS Steering Committee and then placed into hibernation for activation in the event of an influenza pandemic.ConclusionsPregnant women, as a result of their changed immunological status, appear to be particularly susceptible to infection, including from influenza. The existence of the UKOSS enabled us to rapidly mount a study of pregnant women who were hospitalised with 2009 A/H1N1 influenza. Minor modifications to incorporate previously unanswered questions and our previous study enabled us to design, and then put into hibernation, a new study ready to investigate the impact and management of influenza in pregnancy, which is poised for activation in the event of a newly emerging pandemic strain. This will enable real-time data to be available on which to base rapid changes in clinical management as the as-yet-unforeseen pandemic unfolds. In the event of an influenza pandemic the study will be available to be immediately activated following expedited regulatory approvals.Trial registrationCurrent Controlled Trials ISRCTN44137563.FundingThe National Institute for Health Research Health Services and Delivery Research programme.