Changing perspectives on change

This conclusion presents some closing thoughts on the key concepts discussed in the preceding chapters of this book. The book presents myriad theoretical ideas concerning organizational change. In order to investigate and assess their relevance and effectiveness within the broadly defined health care domain, the book has extensively utilized research, with the empirically based chapters depicting initiatives leading to more and less positive outcomes. It identifies a pressing need to investigate the appropriate balance between, and form of, system and organizational support for planned and emergent change processes. A particular challenge is identifying and ensuring the availability of internal generators of organizational change, from within health care. One powerful source of change from within the system has been the advent of evidence-based medicine (EBM). The EBM movement has led to the consolidation and updating of the latest scientific evidence on a range of conditions.