Changing the culture of a hospital: From hierarchy to networked community

This article is a case study of a large-scale change programme within an NHS hospital. Drawing upon ethnographic data collected over a two-year period of intensive research involvement, it tells how the hospital struggled to transform itself from a rigid and divided 'hierarchy' into a more flexible and collaborative 'networked community.' The paper describes the model of change devised for this purpose, and seeks to capture the lessons learned on the rocky road to network organizing. It concludes that the full potential of networks will only be realized if there are correspondingly dramatic changes in culture, relationships and skills, all of which have to be addressed as part of an overall organization development effort. Networks are more than just a new organizational form; they are also a new paradigm for the professional organization, which is encapsulated in the notion of the 'network culture.'