Table 9.

Organizational actions undertaken.

Dimension	Organisational Goal	Organisational challenge	Actions
Intersubjective	Sensemaking in order to avoid fragmentation and opportunistic behavours	Establishing purpose and need	Review participatory organisational mission of service in order to promote: intrinsic dignity, well-being and personal autonomy
			Review organisational culture values; to build by consensus a shared values code and behaviour framework according to the new proposed paradigm: positive attitude, recognition of diversity, fluid and open communication, trust and collaboration
			Develop new leadership programmes according to above mission of service and cooperative culture
Subjective	Learning in order to innovate	Engaging and involving participants enabling them to contribute with their experience, knowledge and skills	Promote programs for empowerment and training for team work; mainly face-to-face; listening, assertiveness and empathy
			Work to see human diversity as a source of innovation
			Facilitate outside support for teams to learn to manage conflict, diversity and ambiguity
Objective	Results (outcomes) in order to be cost-effective	Working with processes and systems to adapt them to the proposed change	The implementation of small and stable teams is essential; no rotation at all
			Establish three teamwork spaces for: care provision, learning and sensemaking
			Review HR policies according to new values; establish the organisational performance indicators according to the new values
			Establish new professional roles; mainly, the dual role of operational managers and case manager “new power”
			Open IT systems for information flow; remove protocols, establish good practice guidelines
			Team meetings are a powerful tool for information flow and learning; participation should be mandatory in team work; establish a guide and training for effective meetings.