How to embed paradox solutions – a process perspective on establishing reflective routines during an organizational change in a nursing department

Based on a longitudinal case study of a change initiative in a nursing department, we explore the question of how to embed paradox solutions. Drawing on routine dynamics our study shows the emergence of reflective routines as both a medium and part of the outcome to handle a paradox. The establishment of reflective routines moves from individual observing, through repeated interaction, resonance with both poles of the paradox, towards embedding reflective routines formally while differentiating them in terms of topics, participants and temporal rhythm. Thereby, reflective routines overcome the separation between designers and implementers of paradox solutions and become an integral part to daily organizing within the studied organizational unit.