The increasing pace of healthcare transformation places emphasis on how to enact it. However, there is a difference between healthcare commentators and policymakers regarding preferred change management practice; policy guidance is rooted in diagnostic practices, whereas commentators suggest that dialogic is a more appropriate practice for ensuring success. What is missing from this debate is evidence to inform whether commentators’ suggestions will increase the likelihood of successful transformation outcomes. This study presents a systematic review of change management practices and outcomes, identifying 10 papers that report on 292 cases of transformation. It finds broad support that dialogic increases the likelihood of successful transformation, providing supporting evidence for updating healthcare policy and practice. JEL Classification: I18

As a practitioner recently turned scholar, my view is that organization development practices too often prioritize the organizational outcomes of change and, in doing so, overlook human outcomes. Using a personal experience from a round-the-world yacht race as a template, I explain how change practices can influence the lives of those involved. Halfway through the race, I switched boats from one managed with diagnostic practices to one managed dialogically. It was the dialogic boat that precipitated a more enriching human outcome. Here, I deconstruct the effect of these contrasting change practices on my experience.

Woiceshyn et al provided an explanation for how—when the current pandemic was in its early phases—a group of concerned physicians came together to radically redesign the workforce model for acute care.1 Motivated by early data showing how quickly emergency departments would be overrun, the physicians built a shared vision of how increased demand could be met, redesigned existing processes, then brought junior physicians and executive leadership on board with a change programme. Social identity theory explains how an individual’s self-esteem derives from the social groups they identify and, as a consequence, within-group members accomplish positive social identity by comparing themselves favourably to other groups.11 In healthcare, the current functional approach to training staff—by separating physicians from nurses—results in well-inculcated group identities that limits intergroup communication and, as such, can adversely affect quality of care.12 13 Where crisis situations provide a sense of urgency that provokes groups to come together and establish common ground, in non-crisis times consideration of how groups are structured offers a means to achieve this same aim. Research has found that designating individuals from differing groups to coperform the leadership responsibility, such as a physician and a nurse or a physician and an executive leader, promotes better communication, reduces conflict and enhances perceptions of leadership effectiveness.15 16 This coleadership structure provides a platform for ideas and visions for the future to be shared naturally at the same time as resolving intergroup tensions. [...]the cue provided by establishing a coperforming leadership structure provides a stimulus that resolves intergroup differences and, in doing so, strengthens shared visions of the future. [...]their developed model doubled-up on key decision-making roles—providing redundancy in the case of one physician being required to isolate or falling ill—at the same time as providing flexibility for rapid decision making when required. [...]the cue provided by autonomy, achieved through explaining to teams that they have the latitude to alter key processes, provides a stimulus for challenging leadership capabilities.

Change processes, the activities that enable change, and change leadership, meaning how to lead change processes, both influence the success of change. However, a surprising omission from this knowledge is: how do leaders choose between change processes? This article explores leaders’ choices between two orientations of change processes—illustrated by dialogic and diagnostic organizational development—in 79 cases of organizational change. It identifies that change is successful when leaders choose to oscillate between these two processes as change unfolds. Developing a model that explains this evolution, the article describes how the change leadership practice of concurrent inquiry interacts with the two representations of knowledge described by diagnostic and dialogic theories to inform a choice to oscillate. For scholars, this model further integrates the theoretical perspectives of dialogic and diagnostic theories. For practitioners, it provides a means to navigate between extant theories and, as such, ameliorate outcomes.

This piece reflects on my recent transition from practitioner to academic. Drawing from my experience, I highlight a case that explains what I see as a gap in organization development theory. Illustrating an as yet untheorized aspect of how dialogic and diagnostic theories come together, I propose a future focus of integrating the virtues of these two perspectives.

Mindsets have entered the discussion on organizational change and its leadership, illustrated as different orientations by which change leaders see and engage with change efforts. Common conceptualizations illustrate two mindsets, aligned with different change processes. The planned mindset for when change is a planned, managed and controlled process, and the emergent mindset when futures are unknown, outcomes are adaptive, and leaders foster environments where new possibilities evolve. A limitation of this bifurcation is that modern, complex, change contexts require concurrent application of both perspectives; for example, planned processes for strategic decision-making and emergent processes for discovering new solutions. This convergence suggests the possibility of an underlying, single, mindset guiding a change leader when choosing between these two perspectives. Separately, well-established knowledge presented by organizational psychologists presents the fixed and growth mindsets. Testing the influence of these two mindsets on change outcomes, we observe 63 cases of organizational change, finding that leaders who singly exhibit a growth mindset lead exponentially more successful change outcomes. Further, these same leaders were far more likely to concurrently apply planned and emergent change processes. As such, we propose the growth mindset as a better conceptualization of the desired mindset for change leaders. Further, we propose a new leadership development approach for change leaders – mindset priming.

The scholarship of both organizational change and leadership is extensive. However, there have been few attempts to systematically integrate these fields of research in terms of theory or empirical examination. As a result, our understanding of the role and impact of leadership on organizational change outcomes is incomplete. This symposium is designed to generate a dialogue about what constitutes effective change leadership. It is comprised of four papers (two empirical and two theoretical), which explore factors that influence the effectiveness of change leadership in terms of strategic choices, behaviors, and the demands and resources related to the change leader role. Authors of the two most comprehensive reviews of change leadership scholarship – Jeffrey Ford and Shaul Oreg – will introduce and conclude the symposium. In introductory comments, Dr. Ford will comment on the state of change leadership research to date and remaining questions. Shaul Oreg will offer discussant comments that integrate the insights from the papers and propose directions for further research. A Process Model of Organizational Change and Leadership Presenter: Myeong-gu Seo; U. of Maryland Leaders’ Choice of Change Processes: The Option of Dynamic Application to Improve Change Outcomes Presenter: Bradley J. Hastings; UNSW Sydney Presenter: Gavin M. Schwarz; UNSW Sydney The Motivation of Leader Change Messages: An Examination of Regulatory Fit & Follower Responses Presenter: Jill Waymire Paine; IE Business School Presenter: Myeong-gu Seo; U. of Maryland Presenter: Sirkwoo Jin; Merrimack College The Demands and Resources Underlying Change Leader Effectiveness Presenter: Art Uprety; IE Business School, IE U. Presenter: Jill Waymire Paine; IE Business School

It is well documented that most organizational change initiatives following prescriptive or planned practices are unsuccessful. Although less discussed, there is evidence that the adoption of emergent practices correlates with far higher rates of successful change. While organization development (OD) has a long tradition of deconstructing change practices, a problem with OD literature is that it predominantly suggests either prescriptive practices (specifically diagnostic OD) or emergent practices (specifically dialogic OD). With the former, the focus of inquiry is the organization, e.g. 'what facts can we understand?' and with the later, the focus of inquiry is narrative, e.g. 'what are people saying is possible?' This paper responds to recent suggestions that both practices can be applied together. We ask whether the application of both focusses of inquiry concurrently improves the probability of implementing successful change? We present the initial findings of an ongoing study of 43 cases of change, illustrating that when change was observed to be initiated with diagnostic practices, the concurrent adoption of a dialogic practice improved success rates from 6% to 84%. These findings suggest that both dialogic and diagnostic practices can be utilized successfully as collaborative forms of inquiry.

Mindsets predispose us to see the world in a particular way, provide explanations for why things are the way they are, and at the same time, establish guidance for ways in which we behave. The term mindset has entered the fields of organizational and leadership development as a means of characterizing changing assumptions, and of thinking, and as an approach to aid organizational change. Organizational development has defined the dialogic mindset which is based on the key premise that change outcomes are a product of the mindset of the practitioner, however, currently there is no consensus on the specific elements of such a mindset. In response to this gap, synthesizing the properties of twenty-eight already established mindsets, this paper develops a set of five change-mindsets. Through this set, we articulate how these mindsets enable organizational change, and provide refreshing commentary on the benefits of a mindset-led approach for leaders of change.