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This chapter describes two change efforts involving participatory action research within the pharmacy operations division of Kaiser Permanente. Focus is on a parallel learning mechanism that has been used to support communications and change during two large-scale information technology interventions. It begins with basic background information on participatory action research in organizations. Since the case setting is Kaiser Permanente, the chapter provides some information on the U.S. healthcare industry context and then shifts to Kaiser’s communication forum, a learning mechanism that has been in place for 35 years. Cognitive, structural, and procedural aspects of the learning mechanism are explored, and the chapter features interviews with some of the key forum players. Both in the forum’s infancy and in its current more institutionalized state, the pharmacy organization has been in crisis. Implications for the use of parallel learning structures on a long-term basis to support long-term participatory action research are explored along with contributions to theory on insider/outsider action research.

Since 1973, the pharmacy operations division of the Kaiser Permanente Medical Care Program (KPMCP) has used long-term action research programs as the principal method for orchestrating change. This chapter covers the evolution of action research theory within large, complex organizations, with particular attention to health care organizations. Four case examples from KPMCP are discussed in depth and mapped to the recently advanced Roth model of insider action research. This model considers external and internal business context, the perceived need to create new organizational capabilities, as well as insider action research theory and learning mechanisms used in change programs. Issues posed by the Roth model are explored, and new theory is advanced regarding the need for a long-term perspective, the advantages and difficulties posed when managers act as insider action researchers, and the quality of data gathering that takes place during insider action research change programs.

The goal of boosting creativity and productivity in knowledge‐based teams is shared by managers in technology‐oriented companies and industries. In this paper, we assess the nature of team performance and creativity in the context of computer‐supported technology. A field study of a Seagate Software project team provided the basis for the examination of four sub‐ teams’ overall functioning and creativity. Factors considered included technology support, team member relationships, decision making, performance and meeting deadlines, attention to quality, and innovation and creativity. Results varied, revealing less reliance on computer‐aided support and more on social support. Creativity was recognized and supported, but at times hampered.

The article explores the use of a communication forum intervention in the Pharmacy Division of a large health maintenance organisation. An initial discussion of communication forum interventions as a sub‐set of parallel learning structure interventions is followed by a descriptive case study. The article concludes with an assessment of the intervention over a ten‐year period and a discussion of implications.

The field of organization design is changing rapidly, reflecting contributions from managers and diverse organizational consultants. One of the most recent developments is in the design of non‐routine systems. Explores non‐routine systems design from a socio‐technical systems (STS) perspective. Includes a brief discussion of non‐routine systems and an examination of alternative methods for diagnosing and redesigning organizations composed of knowledge workers. The results of two STS case studies provide new learnings and point to special design principles for non‐routine systems. Concludes with implications for both managers and STS consultants interested in management of knowledge workers.

In order to implement business process reengineering successfully, organizations find that they need to combine a variety of change initiatives. Yet, most of the empirical literature dwells on a single change initiative. Integrating multiple change initiatives requires a structural learning mechanism. The learning mechanism is created to lead, design, and implement the overall change effort. This paper reports on BPR at Blue Shield of California. The theoretical implications of system‐wide transformation and learning mechanisms ‐ based on the integration of BPR with other change initiatives ‐ within the rapidly changing health care competitive context are discussed.

In recent years, organisations around the world have been seriously affected by a range of economic, political and social upheavals that have gathered momentum in most parts of the globe. The viability of the conventional (pyramidal) organisational structures is being challenged in conjunction with major shifts in the roles of mid and top managers. In many countries, the pace of the above socio‐economic events and uncertainties is happening at an unprecedented pace. Some markets are showing signs of potential gigantic expansions while others (historically prosperous) are on the verge of complete collapse (Dent, 1991). In responding to the socio‐economic challenges of the nineties, organisations (across the board) have resorted to dismantling the conventional pyramidal structure and adopting so‐called “leaner” structures (see Zeffane, 1992). The most common struggle has been to maintain market share in an economic environment increasingly characterised by excess labour supply (Bamber, 1990; Green & Macdonald, 1991). As organisations shifted their strategies from “mass production” to “post‐fordism” (see, for example Kern and Schumann, 1987), there has been a significant tendency to emphasise flexibility of both capital and labour in order to cater for the niche markets which are claimed to be rapidly emerging, world‐wide. This has resulted in massive organisational restructuring world‐wide.