Inception: Where the idea began

The seed for this research was sown during my doctoral journey in Organizational Behavior, where I was studying person–environment fit and self-management in organizations. Around the same time, I began observing India’s healthcare system closely — especially how the COVID-19 pandemic exposed its structural fragilities and human costs. The contrast between overburdened hospitals and the growing need for dignified, home-based care led to a critical question:
Could the principles of self-managed organizations offer a sustainable model for homecare in India?

Discovering global models of decentralized, nurse-led care in the literature was an eye-opening moment. These systems thrived on autonomy, trust, and collaboration — the very principles I was exploring theoretically. The possibility of applying such ideas to India’s healthcare context felt both bold and necessary.

Conceptual grounding and research direction

The next step was to find an Indian context where self-management principles were being applied in healthcare. Observing such a system in practice provided a living example of how decentralized structures operate without rigid hierarchies, allowing frontline professionals the freedom to make real-time decisions. This became an ideal setting to study how organizational design influences care outcomes and employee engagement.

To frame the research theoretically, we linked self-management to Peter Senge’s learning organization framework, finding deep resonance with its emphasis on continuous learning, shared vision, and systems thinking — all vital to adaptive healthcare systems.

The research process: entering the field

The empirical journey was both intellectually stimulating and logistically demanding. We conducted in-depth semi-structured interviews with twelve management members over a two-year period. These conversations offered rich insights into autonomy, teamwork, conflict resolution, and the cultural adaptations required for self-management in the Indian context.

Following Constructivist Grounded Theory (CGT), we allowed findings to emerge organically. Each round of analysis revealed new layers — from trust and empowerment to communication and coordination. The iterative process of coding, comparing, and refining themes was as humbling as it was enlightening.

Challenges and learning moments

One of the biggest challenges was gaining access and building trust within a self-managed system. With no single gatekeeper, establishing rapport required patience, empathy, and respect for participants’ professional rhythms.

Another challenge lay in maintaining reflexivity. Coming from management and psychology backgrounds, we had to ensure our interpretations reflected participants’ lived realities rather than academic assumptions. Translating these nuanced experiences into theoretical insights demanded both rigor and humility.

Insights that stayed with us

Two key themes emerged:

1. Creating a nurturing work environment built on trust, collaboration, and empowerment.

2. Enhancing communication and coordination through both technology and human connection.

These are not merely organizational traits — they are human foundations for sustainable care. When professionals are trusted and supported, patient satisfaction and care quality naturally improve.

Reflections and looking forward

Writing this paper deepened our belief that organizational structures are moral systems — shaping how people relate, decide, and care. In India’s largely hierarchical healthcare landscape, self-management offers a humane and adaptive alternative that balances autonomy with accountability.

This journey reaffirmed that research is not only about discovering models but also about re-discovering human potential within them. We hope this work inspires healthcare leaders and policymakers to view self-management not as a borrowed concept, but as a universal principle rooted in trust, respect, and shared purpose.