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This paper discusses the conceptual and theoretical foundation upon which whole systems change interventions are based The paper first describes six methods of intervention that are currently being utilized to change whole systems: (1) future search, (2) search conferences/ participative design, (3) open space, (4) large scale interactive process methodology, (5) simu‐real, and (6) fast cycle full participation and the conference model. Next, six common values and assumptions underlying these large scale change interventions are identified: (1) organizations are seen as “whole systems,” (2) viewing organizations as whole systems requires the creation of dialogue among all organizational stakeholders, (3) organizations do not exist, but organizing processes and procedures do, (4) what we perceive as our collective organizational reality becomes the organization that is created, (5) individuals within organizations have the capacity to self‐organize and redefine their reality, and (6) humanity shares a set of universal values that are inherently “good” and these values will ultimately influence voluntary collective action. The paper concludes with an appeal for interventionists and users of large group techniques to be cognizant of the assumptions that drive their choice of intervention.

Top‐down or outside‐in change methodologies are increasingly seen to be ineffective. Systems thinking suggests that change in organizations is a much less straightforward and more subtle phenomenon than previous models allow. Since the late 1970s and as organic metaphors have become used more, the concept of organizational learning has emerged as central to the issue. However, an understanding of how this may take place is still undeveloped. Recently technologies for whole systems development have emerged based on Weisbord′s dictum that for change or learning to occur we need to “get everybody into improving the whole”. Whole systems development can offer a way to realizing the learning organization. Provides a case study of whole systems development in action within Walsall Metropolitan Borough Council in the UK. Begins with a brief account of the ideas on which whole systems development is based and concludes with a commentary on the case study.

New reforms in the public sector mean that many organisations are attempting to cope with turbulent environments. Traditional models of change have been found to be too static and unable to change the “whole system”. Explores processes for changing the whole system for public sector organisations operating in a turbulent environment. A case study is used to discuss the implications.

To share ten integrated OD practices that propels the entire enterprise to transform itself to a higher state of performance

We have distilled the evolutionary learning of 47 years with over 1,000 organizations the application of authentic organization development universal principles and methodology that can apply universally to most organizations regardless of industry, culture, country or issue.

We have the confidence that if these practices are competently applied, extraordinary results will occur. The key is having the process led by a competent internal change agent.

This is not disciplined qualitative or quantitative research. It is the boiling down of years of reflection by the authors on what needs to change our methodology in order to achieve organization development's original focus and that is of changing the entire system through engagement and action research.

We believe that all aspiring OD professionals would best consider bringing each and every one of these practices into their approach. We would welcome research artists to contact us and get involved in researching our on-going work.

Organization development is coming back to its original focus of the whole system. Whole system transformation is but one of many new organization wide change methodologies. It is of value to any student or seasoned practitioner of organization change who wishes to embellish their practice.

Recent democratic trends in Mexico as well as the opening of new economic markets and free trade relationships have made the management of change a major issue in Mexico. Most Mexican organizations need to transform their structures and processes, and to develop management and human resources in order to compete in the global marketplace. In addition, the need for change in Mexico includes such basic issues as uplifting whole classes of people out of poverty so that they can become productive members of society. We argue that change can be produced and facilitated through highly participative, egalitarian, and intensive large-group interventions. Even though existing cultural research might suggest that these approaches are inconsistent with the cultural orientation assumed to be predominant in most Mexican organizations, we offer two case studies employing whole-systems change approaches that provide evidence suggesting quite the opposite: large-scale and highly participative change interventions are very appropriate to facilitate change in Mexican society today.

This chapter analyzes the success factors, outcomes, and future viability of large-group methods. We have used an exploratory action research approach focusing on eight variously purposed large-group methods (AmericaSpeaks, Appreciative Inquiry, Conference Model®, Decision Accelerator, Future Search, Participative Design, Strategic Change Accelerator/ACT (IBM), and Whole-Scale™ Change). We interviewed nine leading practitioners and creators for each method, as well as six clients who had played key roles in most of these methods' execution at their organizations, asking them to reflect on the current practices and outcomes and the future of each respective large-group method, as well as the methods as a group of interventions. Based on our findings derived through theme and content analysis of interviews, we purport that both the Art (excellence in method execution) and the Artist (the right facilitator) are necessary for achieving desired outcomes of the large-group methods. We stipulate that critical elements of the Art include these five common elements (or five “I”s): having the right Individuals in the room; aiming the method at resolving the right Issue; having Intentional process (including pre-work, intra-method process, and follow-up); having the right Information in the meeting; and using the right Infrastructure (such as appropriate physical space, technology, etc.). We suggest that while these elements of Art are important, the simultaneous requisite role of the Artist is to manage the tension between the rigidity of the Art (the 5 “I”s) and the emerging human dynamics occurring between the large-group method process and the associated evolving client objectives. That is, to achieve desired outcomes, the execution of large-group method needs to be both highly premeditated and ingenious. We supplement our findings with client case descriptions and quotes from the practitioners and conclude that these large-group methods are particularly appropriate for resolving a variety of issues facing today's organizations operating under the conditions of high technology saturation, interdependence, globalization, economic downturn, and others – and that this, with some exceptions, will likely remain the case in the future. However, the future use of these methods will be challenged by the availability of Artists who can execute the methods so they lead to desired outcomes. We close with discussion of open questions and directions for future research.

Although high-quality comparative data from international assessments are now more widely available, to what extent is that data being used to trigger, inform, and direct educational change in non-Organization for Economic Co-Operation and Development (OECD) countries? The purpose of this paper is to develop a theoretical framework to guide a case analysis of Trinidad and Tobago's system response to international assessment data.

This is a single-nation explanatory case study using data from policy documents and elite interviews. Findings are generated through inductive thematic analysis.

The four emerging themes were: first, weaknesses in the national evaluation system; second, policy-making practices not attuned to data; third, lack of collaboration and stakeholder involvement; and fourth, challenges in accessing and using data. Findings suggested that data rarely acted alone to trigger system change. Critical to initiating and sustaining effective data use for system reform were policy-making contexts and mental maps of system leaders, which in this context acted as barriers. Respondents believed that greater strategic leadership from politicians and technocrats could ensure data-informed systemic change.

The study focuses upon data use and data-driven decision making for whole system reform within a single country context. However, it advances theory that might be applied to other non-OECD cases.

The findings contribute to the refinement of a conceptual model explaining data-driven system reform applicable to non-OECD contexts. The role of system leaders when using international assessment data is clarified.

The purpose of this paper is to examine a bold and ambitious scheme known as the North East transformation system (NETS). The principal aim of the NETS is the achievement of a step-change in the quality of health services delivered to people living in the North East region of England. The paper charts the origins of the NETS and its early journey before describing what happened to it when the UK coalition government published its proposals for unexpected major structural change in the NHS. This had a profound impact on the leadership and direction of the NETS and resulted in it taking a different direction from that intended.

The research design took the form of a mixed methods, longitudinal 3.5-year study aimed at exploring transformational change in terms of content, context, process and outcomes. The sample of study sites comprised 14 NHS trusts in the North East region chosen to provide geographical coverage of the area and to reflect the scale, scope and variety of the bodies that formed part of the NETS programme. The qualitative component of the research, which the paper draws upon, included 68 semi-structured interviews, observational studies and focus groups. Data analysis made use of both deductive and inductive frameworks. The deductive framework adopted was Pettigrew et al.’s “receptive contexts for change” and four of the eight factors stood out as especially important and form the basis of the paper.

The fate of the NETS was shaped and influenced by the eight factors comprising the Pettigrew et al. receptive contexts for change framework but four factors in particular stood out as being especially significant: environmental pressure, quality and coherence of policy, key people leading change, supportive organisational culture. Perhaps the most significant lesson from the NETS is that achieving whole systems change is particularly vulnerable to the vicissitudes of politics especially where that system, like the UK NHS, is itself subject to those very same pressures. Yet, despite having an enormous influence on health policy, the political context is frequently avoided in research or not regarded as instrumental in determining the outcomes in respect of transformational change.

The chief limitation is the credibility and authenticity of the interviews captured at particular points in time. These formed the datebase for subsequent analysis. The authors sought to guard against possible bias by supplementing interviews with observational studies and focus groups as well as running two dissemination events at which emerging findings from the study were subjected to independent external scrutiny and comment. These events provided a form of validation for the key study findings.

The research findings demonstrate the importance of context for the likely outcome and success of complex transformational change initiatives. These require time to become embedded and demonstrate results especially when focused on changing culture and behaviour. But, in practice, allowing sufficient time during which the organisation may remain sufficiently stable to allow the change intervention to run its course and become embedded and sustainable is highly problematic. The consequence is that bold and ambitious efforts like the NETS are not given the space and stability to prove themselves. Too often, politics and external environmental pressures intrude in ways that may prove dysfunctional and negative.

Unless a different approach to transformational change and its leadership and management is adopted, then changing the NHS to enable it to appear more responsive to changing health care needs and expectations will remain a cause for concern. Ultimately the public will be the losers if the NHS remains insensitive to changing needs and expectations. The patient experience was at the centre of the NETS programme.

The study is original insofar as no other has sought to evaluate the NETS independently and over a reasonable time period. The research design, based on a mixed-methods approach, is unusual in evaluations of this nature. The study’s conclusions are not so original but their value lies in largely confirming and reinforcing the findings from other studies. It perhaps goes further in stressing the impact of politics on health policy and the negative consequences of constant organisational change on attempts to achieve deep change in the way the NHS is organised and led.

Rhetoric and reality lead separate lives when it comes to integrating health and social services in Scotland, and it is making planning and implementation difficult for practitioners of integration. This paper is a collaboration between a practitioner and two academics who teach, research and write about integration. It explores the views of other integration practitioners about the policy, language and nature of integration, and the issues practitioners are currently grappling with, especially how the policy language of ‘integration’ fails to connect with integration in practice. It appears that ‘integration’ has less to do with broad policy aspirations and principles of service (re)organisation, than with the specific aims, objectives and outcomes of individual projects delivered in very specific circumstances. Acknowledging the localisation of integration, and allowing the time for productive problem solving which can generate a new language, ought to be essential elements of integration.

In this chapter, we identify three distinct transformational performance improvement (TPI) approaches commonly used to redesign work processes in health care organizations. We describe the unique components or tools that each approach uses to improve the delivery of health services. We also summarize what is empirically known about the effectiveness of each TPI approach according to systematic reviews and recent studies published in the peer-reviewed literature. Based on examination of this research, we discuss what knowledge is still needed to strengthen the evidence for whole system transformation. This involves the use of conceptual frameworks to assess and guide implementation efforts, and facilitators and barriers to change as revealed in a recent evaluation of one major initiative, the Lean Enterprise Transformation (LET) at the Veterans Health Administration. The analysis suggests ways in which TPI facilitators can be developed and barriers reduced to improve the effectiveness and sustainability of quality initiatives. Finally, we discuss appropriate study designs to evaluate TPI interventions that may strengthen the evidence for their effectiveness in real world practice settings.