"Sub-Cutane Change" as a practice for protective interrupting : Handling stability and change in a pluralistic organization

Taking a process perspective, we explore stabilizing and changing. Building on insights of routines, improvising and changing scripts, we on the relationship between a change initiative and the daily organizing and explore the question: how is stabilizing of a change initiative accomplished while it attempts to alter daily organizing in which it is embedded? Within a single longitudinal case of introducing a new surgical treatment practitioners explained their conducting change as "sub-cutane change". We interpret sub-cutane change as an emergent process pattern to conduct a change initiative within an organizational setting like surgery that requires a high degree of stable practice. Sub-cutane change addresses the topic of simultaneously stabilizing a change initiative while changing the daily organizing in which it was embedded. An important insight of the presented case is that both require mutual protection from each other. Changing is precarious because it means to interrupt ongoing daily practice. But as the organization continues operating, it enacts that which is to change. Continued operating provides functional legitimacy that can block the change initiative. As a conclusion, stabilizing in change is understood as an ongoing accomplishment.