Purpose The aim was to describe hospitals’ approaches to use change agents and visualmanagement tools, and examine change agents and visual management tools as job resourcesfor operative managers, during care process redesign. Design A longitudinal three year (T0, T1, T2) mixed method design was used. Qualitativedata from semi-structured interviews was collected at five hospitals (T0, T2). Quantitativedata from questionnaires (T1, T2) was collected to examine the use and support from changeagents and visual management tools among operative managers at the hospitals. Operativemanagers’ support and associations with their working conditions were further examined inrelation to the Job Demands and Resources model. Analyses of differences between groups ofoperative managers were performed with Wilcoxon tests. Findings Change agents as emotional job resources supported operative managers whenintroducing care process redesign. Higher change agent support was associated to positiveresults regarding burnout and organizational outcomes. Visual management tools as cognitivejob resources supported operative managers when used daily, and were associated to positiveresults regarding burnout, and organizational outcomes. Combined support from both changeagents and visual management tools was associated to beneficial organizational outcomes(collaboration between operative managers as well as between operative managers andhealthcare professionals during care process redesign, and possibilities to fulfill managerialduties) and thus were considered as important job resources for operative managers to drivechange.