Table 1 Definitions of approaches to... | Emerald Publishing

Table 1

Definitions of approaches to change and their operationalisations used in the analysis

Approach	Definition	Operationalisation in this study
Absorbing	Strategies that aim at restoring a broader system or its activities to its original state without remarkably changing the structures of a system (Blanchet et al., 2017; Foroughi et al., 2022) by adding or removing something that already exists and doing familiar things at a different pace or intensity Quick responses to external stimuli, which are typically non-reflexive by nature (Roux-Dufort, 2000)	For example: shifting focus, scale or intensity of existing professional activities to ensure fulfilment of previously defined core functions of the (whole or a part of the) health system during a shock
Adapting	Strategies that aim at modifying present activities to better fit a shock at hand (Blanchet et al., 2017) while aiming at restoring as much of the old procedures as possible Via adaptation, an organisation aims to change its characteristics to better match the requirements of its surroundings (Sarta et al., 2021) Adaptation is more reflexive and intentional than absorption thus requiring a higher level of consciousness (Sarta et al., 2021). Often, it is more structured and offers answers to more intensive challenges than does absorption (Foroughi et al., 2022)	For example: modifying existing preparedness plans to better fit a challenge or rearranging existing collaborative practices to reach a more appropriate platform for information sharing for a network
Transforming	Can be characterised as fundamentally new ways of thinking or acting that produce novel types of practices (e.g. ways of acting, operational models and processes), structures or systemic components (i.e. in addition to system-wide transformations thus also including, by definition, smaller parts of a system or taking place only at a particular systemic level) (Blanchet et al., 2017) Reflexively thinking about or organising an issue in a novel way, which often includes processes that force an organisation to redefine its core assumptions or value system (Roux-Dufort, 2000)	For example: redefining professional roles, expertise and skills or “high-quality care”, reorganising networking processes, interactions or the collecting of information, rethinking and reorganising multiprofessional boundaries and work practices or seeing services and their delivery more holistically
Resisting	Abstaining from action while being under pressure to change This can represent active rebellion, hesitation or stagnation (freeze mode) in the face of a challenge, and, therefore, can represent reflexive, rational, non-reflexive or emotional responses	For example: deciding not to act because of conflicting values, tensions between groups of actors, insufficient means or unclear mandates

Approach	Definition	Operationalisation in this study
Absorbing	Strategies that aim at restoring a broader system or its activities to its original state without remarkably changing the structures of a system (Blanchet et al., 2017; Foroughi et al., 2022) by adding or removing something that already exists and doing familiar things at a different pace or intensityQuick responses to external stimuli, which are typically non-reflexive by nature (Roux-Dufort, 2000)	For example: shifting focus, scale or intensity of existing professional activities to ensure fulfilment of previously defined core functions of the (whole or a part of the) health system during a shock
Adapting	Strategies that aim at modifying present activities to better fit a shock at hand (Blanchet et al., 2017) while aiming at restoring as much of the old procedures as possibleVia adaptation, an organisation aims to change its characteristics to better match the requirements of its surroundings (Sarta et al., 2021)Adaptation is more reflexive and intentional than absorption thus requiring a higher level of consciousness (Sarta et al., 2021). Often, it is more structured and offers answers to more intensive challenges than does absorption (Foroughi et al., 2022)	For example: modifying existing preparedness plans to better fit a challenge or rearranging existing collaborative practices to reach a more appropriate platform for information sharing for a network
Transforming	Can be characterised as fundamentally new ways of thinking or acting that produce novel types of practices (e.g. ways of acting, operational models and processes), structures or systemic components (i.e. in addition to system-wide transformations thus also including, by definition, smaller parts of a system or taking place only at a particular systemic level) (Blanchet et al., 2017)Reflexively thinking about or organising an issue in a novel way, which often includes processes that force an organisation to redefine its core assumptions or value system (Roux-Dufort, 2000)	For example: redefining professional roles, expertise and skills or “high-quality care”, reorganising networking processes, interactions or the collecting of information, rethinking and reorganising multiprofessional boundaries and work practices or seeing services and their delivery more holistically
Resisting	Abstaining from action while being under pressure to changeThis can represent active rebellion, hesitation or stagnation (freeze mode) in the face of a challenge, and, therefore, can represent reflexive, rational, non-reflexive or emotional responses	For example: deciding not to act because of conflicting values, tensions between groups of actors, insufficient means or unclear mandates

Source(s): Authors' own work