ABSTRACT
What does this research tell us about how to manage the sustainability and spread of new working practices? To answer this question, it is necessary first to consider the context in which changes were taking place, as context both influences and is in turn affected by management actions. The properties of that context thus have implications for practice. Four aspects appear to be important, concerning the organizational setting, the nature of systemic change, the role of ‘best practice’, and the professional nature of healthcare organizations.
