A central debate in organizational theory concerns factors which bring about change. Nils Brunsson argues that reform can be regarded as part of organizational stability and routine rather than of change. One effective way of stopping reforms is to try to implement them, he writes. In this reply...

Summary Based on the merger of two Swedish university hospitals, this paper examines top management's work in implementing radical change initiatives. Our case confirms the limitations of the classic top-down approach to radical change in professional organizations. We also identify an important...