Western Organizational Change Capacity Theory and Its Application in Chinese Public Health Organizations: A Multiple Case Analysis

Abstract

As public health reform becomes a crucial task for governments in both China and the United States, public health organizations are required to adopt changes based on reform policy. However, little research has focused on organizational change capacity and its application in Chinese organizations, especially public health organizations. Organizational Change Capacity theory (OCC), developed by Klarner and his colleagues (2007), is a Western theory that was employed in this study to understand Chinese public health organizational change. The OCC framework indicates the change capacities that organizations should possess when pursuing successful organizational change. The main purpose of this dissertation is to understand public health organizational change in China during the country’s national health reform by applying Western OCC theory to Chinese public health organizations that have already achieved success or have remained challenged in implementing organizational change during the health reform. This study seeks answer to these questions: Is the OCC theory applicable in Chinese public health organizations? How should the OCC framework be modified to best fit Chinese public health organizations? In this study, 72 participants from twelve Chinese public health organizations were recruited for in-depth interviews and follow-up questionnaires that asked questions about their experiences during their organizational changes. The participants included leaders, mid-level managers, employees, and clients/partners in public hospitals, community health centers, and district health bureaus in the cities of Beijing and Xi’an. During the comparison of common elements across the six successfully changed sites and the six remain challenged sites, a new Chinese Organizational Change Capacity theory (CNOCC) with nine main themes emerged. The themes consist of transformational leadership, implementation strategy, member’s positive character, communication and transparency, government support, member’s consensus on change, healthy internal system, member’s self-improvement, and cooperation with external parties during the change. The CNOCC framework developed from this study provides a guideline and a tool for Chinese public health organizations to evaluate their change capacity levels. Furthermore, it offers a theoretical foundation for researchers to design interventions that help Chinese public health organizations increase their change capacity and achieve successful change.