ABSTRACT
What can we do about health care? Nations around the world are searching for eff ective solutions to ensure that people can access high quality services and that these services can be somehow aff ordable. Th is is proving to be a diffi cult task. Many change initiatives have been designed, but it is during implementation that our lack of knowledge about organizational change in health-care settings becomes obvious. So far, organization theory has not been particularly helpful. However, as a recent editorial in Health Aff airs clearly points out, when you take time to look, there are important examples of innovation taking place and there is much to learn from them (Dentzer, 2011). Th e preceding Chapters 12-15, in Part IV, contribute valuable insights into how change initiatives can help improve health-care. Th e authors of these chapters do so by purposely taking a positive lens to focus on the ways in which meaningful changes can occur. In this commentary, I fi rst summarize the ways in which each of the four previous chapters employ a positive lens to improve our understanding of eff ective change in health-care, and then I provide my overall views of their collective insights.
Golden-Biddle and Correia (Chapter 12) investigate how leaders and clinicians in a community-owned health system brought in a new model of care (Collaborative Care) that eff ectively turned providers’ focus onto getting patients well instead of treating medical conditions. To readers outside the world of health-care, this may sound like a minor change. To those
inside health-care, the signifi cance of this new focus will not be lost. What Golden-Biddle and Correia found is that the creation of hope-hope that the system could, in fact, be changed-was a critical precursor to change. Furthermore, they propose that as a generative dynamic of change, the development of hope relies upon: (1) activating belief that action can make a diff erence, and (2) acting on belief to realize the desired change. In other words, belief is at the heart of the matter, but it must be ignited or activated before change initiatives can be eff ective.
