The Four Frames for Change Management in Health Services

The delivery of health services is complex, and this complexity is exacerbated by embedded wicked problems requiring solving through change management initiatives. To create sustainable solutions and improvement healthcare leaders and managers are required to have a well-developed understanding of their complex organisation from several perspectives. The Bolman and Deal framework postulates that organisations can be viewed through four frames: structural, human resource, political and symbolic. This paper presents four real life case studies to show the four frames from the perspective of assessment and intervention, demonstrating ways in which the Frames can be applied to healthcare organisations. A retrospective analysis of the case studies demonstrates that the application of the Frames can lead to identifying areas for improvement and innovation and that they can play a role in creating strategies for evaluating health service improvement initiatives. The full potential of the Frames is only realised when a comprehensive approach is taken by utilising all four frames. Only then a better understanding of complex organisations takes place, helping healthcare organisations to improve and innovate.