Introduction

Since the 1990s, French hospitals have undergone extensive reforms aimed at addressing financial concerns, enhancing coordination among professionals, and improving the quality of care1. However, the restructuring process has been challenging due to the unique structural and cultural characteristics of hospitals, which comprise various types of professionals and compartmentalized activities2. The social aspect is a crucial component of the organizational transformation process 3. Recently, the French National Audit Office reported that the reforms aimed at modernizing and transforming the healthcare system have struggled to overcome the compartmentalization of organizations, particularly between sectors of activity and the prerogatives of each profession. Moreover, during the recent health crisis, the obstacles to intra- and inter-organizational collaboration and transformation were removed in favor of adapting the organization and operating methods of the hospital4,5,6. It appears that hospital strategies have been developed in the field rather than in regulatory institutions through ongoing interactions between professionals and the environment7.
Given these circumstances, it is essential to draw lessons from the recent health crisis and view it as an opportunity for organizational learning8. Therefore, the primary focus of our research is to examine the internal and external interactional mechanisms involved in the dynamics of organizational transformations within hospitals. Our central research question is: What are the internal and external interactional mechanisms involved in the dynamics of organizational transformations in hospitals?
In this article, we commence by delving into the theoretical underpinnings of our research, centering on the notion of organizational transformation through the lens of structuration theory. Subsequently, the research methodology is explicated in the second section, followed by an exposition of the findings in the third section. Lastly, we conclude with a critical reflection on the implications, limitations, and future avenues for this study.