Breaking a Path by Creating a New One: How Organizational Change Boosts Children’s Cancer Care
通过俄罗斯儿童医院的纵向案例，揭示了在锁定于集中化路径的医疗系统中，如何通过创造新路径实现组织变革，从而显著提升儿童癌症护理水平。
The theory of organizational path dependence helps us to understand why organizational change is sometimes extremely difficult, if not impossible. Although recent conceptualizations of path dependence allow for strategic agency, the theory is still underspecified regarding how to break an organizational path. In an attempt to develop the theory in this regard, we make use of a case in the sphere of global health with an undisputed life-saving impact. More precisely, we trace a significant improvement in the field of pediatric cancer care back to path-breaking organizational change: the successful introduction of multicenter cooperation within a healthcare system that is arguably locked into a centralization path. Drawing on longitudinal research conducted within Russian children’s hospitals, we conclude that path-breaking change is an intricate process based upon distinct activities, and supported by mechanisms, directed towards the creation of a new organizational path.