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).