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This study aims to discuss the usefulness of free-text comments to gain insights into participants' opinions about an organizational change project.

A secondary analysis of 152 free-text answers to an open question in a questionnaire evaluating the implementation of lean facility design was conducted.

The authors identified three categories of responses to change: (1) dismissive – lean unrelated, (2) dismissive – lean related and (3) supporting – lean related. Notably, the large majority of the comments were dismissive by nature and unrelated to lean. Furthermore, critical responses also emanate from the most supportive group (critical friends).

Quintessential to change management is understanding how those involved perceive the changes. Free-text comments offer an opportunity to gain a view on these perceptions, particularly perceptions that often stay covert whilst having the potential to undermine change initiatives. At the same time, the comments may also be used to capitalize on constructive criticisms.

This study delivers a unique view on how free comments allow developing a broader understanding of hospital staff's responses to an organizational change initiative and particularly its “undercurrent” that may potentially have significant implications to change processes.