Nursing Organizational change - Essay Example

That is until the recent economic down turn. Comanche has a couple of major problems at this time, that will require major change. They are running in the red like many hospitals but this has not happened to them before and they have a very traditional history and the Senior team is older and very traditional in their approaches. This is also true of the second layer or Senior Directors. They have had one lay off this year and the new fiscal year began in July. The end o July figures showed that they were in the black by $134,000.

Some of the middle level directors and managers have been replaced by attrition by more forward thinking staff. However, most of them have been there a year and there has been little change and these new leaders are becoming very frustrated. This paper will discuss the change needed at Comanche Regional Hospital Kotter (1996) tells us that there are eight stages of change. Those stages are establishing a sense of urgency, creating the guiding coalition, developing a vision and strategy, communicating the change vision, empowering a broad base of people to take action, generating short-term wins, consolidating gains, and producing even more change and institutionalizing the new approaches in the culture.

The change initiative that will need to go through these stages is a reduction of length of stay which will improve hospital throughput. There are many issues related to length of stay so for the sake of a shorter paper, discharging patients by noon will be chosen. Establishing a sense of urgency is the first of the eight stages of change that are proposed by Kotter (1996). For Comanche Memorial Hospital, this will not be a simple task. This is a group of senior leaders that just does not get riled up about most things. . This has filtered down through the rest of the organization and has created a sense of complacency.

The CFO in this case understands the need for the change so the initial plan here would be to illicit his help in putting together some realistic but important numbers together to show what can be gained by improving this process. Convincing of the whole administrative group is crucial (Kotter, 2008). only then can we proceed. This same process will then need to go to the director level and an incentive program here will work very well to establish urgency. Creating a guiding coalition in this case should be happening with the creation of the first sense of urgency.

Many times, according to Kotter (1996), the guiding coalition is given credit to one person but in the case of this hospital, that guiding coalition must be the C suite and the Senior Directors. They must be convinced and added to this group are the informal leaders of patient care. This group must be credible though and must contain people who are movers because to have a stagnant committee will only teach the lesson that complacency is OK after all when the lesson needs to be, the train in moving on, get aboard.

This coalition must have four kinds of power to be successful. Those include position power which means that there are enough of the key players on board to make a difference (pg. 57), and expertise which is that there are people in the group that have experience relevant to the problem. Credibility is high only if the