This article describes experiences during, and outcomes of, an OD intervention conducted by an internal consultant in an outpatient health centre. It focuses on how the “multiple realities” associated with the medical and administrative hierarchies of the health centre affected the course of...

Organizational development and design are focused on bringing about a coherence between decision areas, and the reasoning that either development or design is right or wrong is postulated. Both can be seen as complementing approaches to organizational improvement.

Third‐order change in organizations refers to attempts to help organizational members to transcend their shared schemata. It has not previously been explored in depth. Uses mystical experience as a model of how the third‐order change process may occur. Discusses several characteristics of...