This paper acknowledges the similarities between action research and successful strategies for planned organizational change, and uses an action research case study to explore the extent to which democratic and participatory approaches to organizational change, such as action research, can flourish in a context of externally imposed targets, as is characteristic of the UK National Health Service. Using case study findings, the authors claim that some practice changes are possible, but that locally devised targets may not be achievable if managers' attention is distracted by other priorities or if targets are in conflict with externally set targets. The authors emphasise the value of engaging managers as well as practitioners in action research, and identify that an action research approach not only has the potential for positive organizational change, but can also provide a unique data set on how central policy translates into practice and patient outcomes. Whether or not planned change occurs, with action research there is always potential for new understandings to emerge.
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