Background
The theoretical framework of this research is grounded in the concept of
organizational transformation in the context of a hospital. This
framework employs a sociological perspective that utilizes structuration
theory as its guiding lens.
2.1. Organizational transformations as a processual and
contextual phenomenon
The need for organizational
transformation has been widely recognized due to the various aspects,
approaches, and theories highlighted in extensive
research9,10,11,12,13. This process involves
significant changes in an organization’s structure, culture, processes,
systems, and strategies to adapt to internal and external changes and
enhance long-term performance9. Researchers have
explored organizational transformation from various angles, such as the
process of transformation14 and the environmental
factors that motivate them15. These different
perspectives reveal the complexity of the phenomenon and its
interdependent themes, which include the initiative, the organizational
context, the transformation process, and the results of
transformation3.
The process of transformation can be viewed as an ongoing, natural
change driven by professionals within the field and influenced by the
structural characteristics of the organization16, or
as a deliberate process initiated and managed by the
organization17. The organizational context may refer
to a structural rigidity that is a source of resistance to
change18,12,19,20. The context defines the need and
urgency for transformation21,22. Context and actions
appear to be interdependent23,13,24. The
transformation process can be understood through several distinct
streams of thought25,26, which converge on the notion
of periodization and succession of phases leading to transformation. For
example, Lewin’s25 work outlines three phases
(unfreeze, move, refreeze). Time is an integral part of the
transformation process, and it is essential to consider the context and
the sequencing of the phenomenon12,27,28. Therefore,
when examining the transformation process, it is crucial to consider the
initiative, its sequencing, and interdependence with the context (figure
1).