Implementing and translating change in health care and public organizations - what researchers know and what to do about it

In Denmark as well in other countries, new innovative ideas are continuously introduced in order to change health care and other public organizations. As a consequence health care and other professionals are often asking themselves how to introduce these ideas effectively. When asking such questions professionals often turn their attention toward science in their search for answers.  As a consequence the research of three different communities of researchers doing research related to health care and public organizations are analyzed. It is concluded that each of these communities base their research on different metaphorical understandings of organizational change - a metaphorical understanding of change as intervention, implementation and translation. It is also concluded that some evidence about the nature of organizational change exists but that it has turned out to be difficult to reach clear conclusions about the nature of and the cause and effect relationships related to organizational change in all of these communities. The difficulties are related to the study of organizational change as being realism and becoming realism and to the status of the knowledge claims that are the results of these two approaches. It is shown how these two approaches may result in the type of inconclusive research results that have been identified in all of the three research communities in relation to organizational change. Finally an alternative pragmatic approach to knowledge claims is proposed that suggests that the problem of inconclusiveness may be solved if knowledge and truth claims are put to the test by actors trying to solve problems in organizational practice.