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Journals / Ege Akademik Bakış Dergisi / 2026 / Cilt: 26 Sayı: 4

ORGANIZATIONAL CHANGE MANAGEMENT AND WORK FLEXIBILITY IN TURKISH HEALTHCARE: COMPARATIVE EVIDENCE FROM PUBLIC AND PRIVATE HOSPITALS

Türkiye Sağlık Sisteminde Örgütsel Değişim Yönetimi ve İş Esnekliği: Kamu ve Özel Hastanelerden Karşılaştırmalı Kanıtlar

Delal Aydın(FIRAT UNIVERSITY)0000-0002-1135-5128
Özcan Demir(FIRAT ÜNİVERSİTESİ)0000-0001-9382-6781
Ömer Karakoyun(DİCLE ÜNİVERSİTESİ)0009-0008-8196-7470
Pages
727–748
Publication Date
2026-09-23
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

These findings reveal a hierarchy among Kotter's steps: structural enablers (empowerment, institutionalization) show substantially stronger relationships with flexibility adoption than rhetorical strategies (vision, communication).

📌 3 Key Takeaways

🎯
Objective & Hypothesis:The COVID-19 pandemic accelerated organizational transformations in healthcare globally, particularly regarding work arrangements, yet systematic evidence on change management effectiveness remains limited in emerging market contexts.
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Key Findings & Data:We surveyed 652 healthcare professionals across 24 hospitals in three provinces , employing hierarchical regression and multi-group analyses.
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Conclusion & Impact:These findings reveal a hierarchy among Kotter's steps: structural enablers (empowerment, institutionalization) show substantially stronger relationships with flexibility adoption than rhetorical strategies (vision, communication).
🔬Design:Survey & Empirical Study
📍Scope:Comprehensive Sample
⚙️Variables:Değişim yönetimi · Kotter modeli · İş esnekliği

Abstract

The COVID-19 pandemic accelerated organizational transformations in healthcare globally, particularly regarding work arrangements, yet systematic evidence on change management effectiveness remains limited in emerging market contexts. Drawing on Kotter's eight-step change model, this study examines relationships between change management practices and work flexibility adoption in Turkish healthcare organizations. We surveyed 652 healthcare professionals across 24 hospitals in three provinces , employing hierarchical regression and multi-group analyses. Results reveal significant positive associations between change management effectiveness and flexibility adoption (β=0.54, p<0.001, ΔR²=0.28). Supplementary analyses with organizational agility as an additional outcome confirmed similar patterns (β=0.51, p<0.001). Among Kotter's eight steps, employee empowerment (β=0.32, p<0.001) and institutionalization (β=0.24, p<0.001) emerged as strongest predictors, while vision (β=0.14, p<0.01) showed modest effects and communication was non-significant. Private hospitals demonstrated substantially higher change management effectiveness (M=67.5 vs. M=58.2, Cohen's d=0.81), with largest gaps in coalition building (d=0.83), empowerment (d=0.89), and institutionalization (d=0.88). The association between change management and flexibility adoption was stronger in private (β=.61) versus public hospitals (β=.48; interaction β=.09, p=.011). These findings reveal a hierarchy among Kotter's steps: structural enablers (empowerment, institutionalization) show substantially stronger relationships with flexibility adoption than rhetorical strategies (vision, communication). Public sector organizations require targeted policy interventions addressing bureaucratic and cultural barriers constraining change implementation.

Özet

COVID-19 pandemisi, özellikle çalışma düzenleri açısından, küresel ölçekte sağlık sektöründeki örgütsel dönüşümleri hızlandırmış; ancak değişim yönetimi uygulamalarının etkinliğine ilişkin sistematik kanıtlar, özellikle gelişmekte olan ülke bağlamlarında sınırlı kalmıştır. Bu çalışma, Kotter’ın sekiz adımlı değişim modeli çerçevesinde, değişim yönetimi uygulamaları ile iş esnekliği benimsenmesi arasındaki ilişkileri Türkiye’deki sağlık kurumları örnekleminde incelemektedir. Üç ilde yer alan 24 hastaneden 652 sağlık çalışanıyla gerçekleştirilen anket verileri, hiyerarşik regresyon ve çoklu grup analizleri ile değerlendirilmiştir. Bulgular, değişim yönetimi etkinliği ile iş esnekliği benimsenmesi arasında anlamlı ve güçlü ilişkiler olduğunu göstermektedir (β=0.54, p<0.001, ΔR²=0.28). Ek analizlerde örgütsel çevikliğin ek bir çıktı değişkeni olarak modele dâhil edilmesi benzer sonuçlar ortaya koymuştur (β=0.51, p<0.001). Kotter’ın sekiz adımı arasında çalışanların güçlendirilmesi (β=0.32, p<0.001) ve kurumsallaştırma (β=0.24, p<0.001) en güçlü yordayıcılar olarak öne çıkarken; vizyon adımı daha sınırlı bir etki göstermiş (β=0.14, p<0.01), iletişim ise anlamlı bulunmamıştır. Özel hastaneler, kamu hastanelerine kıyasla toplam değişim yönetimi etkinliğinde belirgin biçimde daha yüksek skorlar elde etmiştir (M=67.5 vs. M=58.2, Cohen’s d=0.81). En büyük farklar ise koalisyon oluşturma (d=0.83), güçlendirme (d=0.89) ve kurumsallaştırma (d=0.88) adımlarında görülmüştür. Ayrıca değişim yönetimi ile iş esnekliği arasındaki ilişki özel hastanelerde (β=.61) kamu hastanelerine göre (β=.48) daha güçlüdür (etkileşim β=.09, p=.011). Bulgular, Kotter modelindeki adımlar arasında belirgin bir hiyerarşi olduğunu göstermektedir: Yapısal kolaylaştırıcı adımlar (güçlendirme, kurumsallaştırma), söylemsel stratejilere (vizyon, iletişim) kıyasla iş esnekliği benimsenmesiyle çok daha güçlü ilişkiler sergilemektedir. Kamu hastanelerinde bürokratik ve kültürel engellerin değişim uygulamalarını sınırladığı görülmekte olup, bu alanlarda hedeflenmiş politika müdahalelerine ihtiyaç vardır.

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Cite This Article

Aydın, D., Demir, Ö., Karakoyun, Ö. (2026). ORGANIZATIONAL CHANGE MANAGEMENT AND WORK FLEXIBILITY IN TURKISH HEALTHCARE: COMPARATIVE EVIDENCE FROM PUBLIC AND PRIVATE HOSPITALS. Ege Akademik Bakış Dergisi, Cilt: 26 Sayı: 4, 727–748. https://doi.org/10.21121/eab.202600245

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