Natalie Wilson, Anne Hogden, David Greenfield, Kathy Eljiz
Introduction Organization-wide culture change programs (OWCCP) implement initiatives across multiple sites, services, and work groups. Yet, there is considerable variability in sustaining OWCCP in healthcare. This study aimed to identify the factors that organizational leaders perceive as influencing the embedding of OWCCP across clinical and non-clinical services and settings in healthcare.Method Data was collected through semi-structured interviews with 21 organizational healthcare leaders in clinical and non-clinical settings. Reflexive thematic analysis was employed to analyze data and identify key themes from the interview transcripts.Results This study demonstrated the unique application of Normalization Process Theory (NPT) in a non-clinical setting and defined 12 key factors that influence the embedding of OWCCP in healthcare. The influencing factors included (1) Program governance – measurement and reporting; leadership; defined roles and accountability; process and systems; (2) People factors – resources; training; perceived benefits; and (3) Contextual factors – external environment; communications; stakeholder engagement; adaptive program; and alignment with organizational culture.Conclusion This study demonstrated the unique application of NPT in a non-clinical setting and defined key factors that influence the embedding of OWCCP in clinical and non-clinical settings in healthcare.