Accepted Change Management Framework - The Organization and the Change - Essay Example

Accepted Change Management Framework Accepted Change management framework In the modern world, leaders in health care organizationsas well as their employees are always dealing with changes such as dealing with new employees, and introduction of technology in the workplace. Effective management of these changes is imperative for it to achieve or attain the intended objectives. This paper uses an accepted change management framework to analyze a public health organization that has undergone transformational change. This paper offers a description of what the organization did to effect the change, what was successful and what was not successful, and describes leadership behaviors and actions that had an impact on the effort. Subsequently, this paper describes the degree to which the organization followed the change management framework. The organization and the change Ascension Health is an example of a health care organization or institution that has undergone transformational change. Ascension Health can be described as a nonprofit health institution with outlets in twenty states in the United States. According to the Commonwealth Fund (2006), "Ascension Health is the largest catholic and largest nonprofit health care system in the United States, includes sixty seven acute care facilities staffed by one hundred and six thousand associates in twenty states and the District of Columbia" (p. A1). At one time, this health organization recognized the main sources of unnecessary and avoidable injuries as well as fatalities within their health. Therefore, the organization instigated or initiated a process of transformational change that was geared towards reducing and subsequently eradicating these quandaries within a span of five years. The transformational change that was planned by Ascension Health involved the recognition and classification of practically each and every part of the health care delivery system within the institution that was the source or otherwise led to any fatalities or injuries to individuals seeking care. This was followed by methodical operations and activities geared towards identifying and as well widening or extending superlative plans of action in order to radically develop and advance patients safety within affected departments and units. Kotters eight step of change There are various theories that have been developed over the past to elucidate the process of change in organizations. One of the examples of the theories applicable in this case is Koters model. The initial steep of transformational change according to Kotter is the institution or creation of a sense of exigency or importance (Kotter, 1995). For any change to be implemented within an organization, there must be the involvement of all individuals in positions of leadership. These individuals are always involved in demanding activities and hence it is considered tough to convince them of the importance of change. It is important to posit that individuals in leadership and decision making positions are the people with the authority, integrity, and reliability to instill the proposed change. In Ascension Health organization, this sense of exigency was created through the identification of avoidable sources of fatalities and harm among patients. In any health care organization, any identifiable source of harm or cause of fatality ought to be addressed as soon expeditiously. The presence of a key quandary within the health organization is therefore enough reason to attract the involvement of all leaders within the organization. Secondly, there must be the creation of a partnership or alliance with the capacity to instill the change (Kotter, 1995). On the other hand, this alliance ought to have high profile managers with the necessary proficiency and multiplicity of skills and knowledge. This was achieved by Ascension Health in the process of transformational change through collaborating with key individuals in the Institute for Health Improvement. After this collaboration, a team comprising of thirty nine highly skilled and knowledgeable individuals was created to arrange and implement the change. This team was able to recognize and classify a number of areas of main concern that required immediate action. The third step in the Kotters model involves the development of an idea as well as a plan necessary to effect the change. The establishment of a tactical and well calculated plan is imperative in the process of change (Kotter, 1995). Subsequently, there ought to be the involvement of all stakeholders in the process of change. Leaders cannot instill or implement the proposed change devoid of the involvement of all employees. When there is a clearly defined plan or idea, all individuals involved in the process of change are able to comprehend their roles and hence they are able to make appropriate decisions without necessarily waiting for any affirmations from their bosses. According to the Commonwealth fund (2006), "A clinical team representing chief medical officers, chief nursing executives, chief executive officers, and a mission executive developed a clinical excellence statement to guide the pursuit of this goal" (p. A1). This statement created to direct the change aimed at patient safety, efficiency of services, provision of patient focused care, provision of professional and ethical services, as well as unbiased or impartiality of health care services. Fourthly, strategies ought to be put into place to communicate the proposed change, ideas, and opinions (Kotter, 1995). It is important to keep reminding all stakeholders involved in the change process of the importance of the change as this will enable them to apply the change in all available opportunities. Additionally, leaders driving the change ought to set good examples to other employees. The need to effect the change was regularly communicated and discussed in Ascension Health. In fact, alpha sites to create the change model were identified and all individuals involved met regularly to discuss and concur on ways to effect the change (The Commonwealth Fund, 2006). According to Kotter (1995), the fifth step in the change process according to the Kotters model involves the elimination of hindrances and barriers to change. Ascension Health identified a number of structures that had to be dealt with promptly as they could negatively affect the change process. The existing organizational culture had to be transformed in order to accommodate patient safety issues. It was also of significance for all employees in Ascension Health to comprehend all monetary dynamics that are necessary to effect the change in order to gain the capacity to support the change. All obstructive variants were subsequently eliminated within the health care institution (Amalberti et-al, 2005). The sixth step of Kotters model is establishment of activities that have immediate but temporary successes (Kotter, 1995). This is important as it helps motivate all individuals involved in the process of change. Less expensive targets or objectives adapted by Ascension in the process of change such as reduction of avoidable fatalities, infections, and reduction of injuries from falls led to "a decline of the overall mortality rate for patients not admitted for end-of-life care by 21 percent across the system from mid 2004 to mid 2005" (p. A1). The seventh stage involves building on the change (Kotter, 1995). In Ascension Health, a total of eight key areas requiring immediate measures were identified to effect the change. These included "preventable deaths, adverse drug events, Accreditation core measures, pressure ulcers, nosocomial infections, perioperative complications, perinatal safety, and fall and falls injury". There were considerable changes witnessed after strategies were put into place to reduce avoidable deaths and injuries. The eighth stage involves attaching or affixing the changes permanently into the organizational culture (Proctor and Thibault, 2001). All the components of the change ought to be incorporated in all activities within the health care organization. The effects of the change in Ascension Health led to a total transformation of the organizational culture. In fact, each and every employees in this health organization has something to offer and subsequently to receive from colleagues. It is important to elucidate the fact that these changes were successful as they attained their intended purpose. For instance, according to The Commonwealth Fund (2006), there was an "85 percent decrease in the birth injury rate at Seton Healthcare Network, a 62 percent reduction in patient falls at St. John Macomb Hospital, and 50 percent drop in bloodstream infections at St. John Hospital and Medical Center" (p. A1). Pryor et-al (2011) posits that approximately five thousand preventable deaths were averted in 2010. Leadership behavior and actions that had an impact on this change There are identifiable leadership behaviors and actions that contributed to the change in Ascension Health. Leaders were able to effect the proposed change due to their ability to comprehend the existing problems. The change in Ascension Health was driven by the need to reduce and prevent avoidable deaths and injuries among patients. Leaders were able to effectively understand and comprehend this issue. The mysticism and dedication of the leaders in their work also facilitated success in this change. Leaders were able to incorporate the culture of teamwork and involvement of all stakeholders in the change process. The ability to organization and manage the change process is also one of the behaviors or actions that facilitated the change process. Leaders were also able to propagate or communicate appropriate information in an organized and timely manner hence the success of the change (Rose et-al, 2006). Degree to which the change management framework was followed It is worth noting that all the stages of Kotters model off change were followed by Ascension Health in its process of change. However, there is one problem linked to the seventh stage of the model that can be pointed out. It is imperative to conduct change in an systematic and organized manner. The management in Ascension envisaged the fact that change would commence from the alpha sites created and then spread to other departments methodically. However, the changes were felt in all departments in all the states and hence all of them wanted to adapt the changes at once (The Commonwealth Fund, 2006). Conclusion The process of change ought to be implemented in a systematic or methodical manner for it to attain maximum benefits. Theorists have developed models that can be followed by organizations or individuals as they effect on specific changes. One of the most effective model is the Kotters model which comprises of eight stage. These stages include creation of exigency, establishment of appropriate partnerships, establishment of the idea for change, setting strategies to communicate the idea for change, eradication of impeding barriers for the change, identification and implementation of goals with immediate success, adapting the change in all organizational activities, and finally, affixing the change permanently into the organizations culture. Ascension Health, in its process of change to eradicate preventable fatalities and injuries to patients, employed these stages in their process of change. This led to a significant change or reduction in the number of avoidable deaths and injuries within the health care organization. Behaviors that were adopted by the leaders in effecting this change included collaboration, effective management and organizational skills, total dedication to effecting the change, and also effectively communicating all information relating to the change process. References Amalberti, R., Auroy, Y., Berwick, D., & Barach, P. (2005). Five System Barriers to Achieving Ultrasafe Health Care: An Intern Med, 142(9): 756-764. Kotter, J. P. (1995). Leading Change: Why Transformation Efforts Fail: Harvard Business Review. Retrieved from http://www.sykehusapoteket.no/Upload/Topplederprogrammet/Litteratur/2.1%20Lead ing%20Change%20- %20Why%20Transformation%20Efforts%20Fail%20by%20JP%20Kotter.pdf Proctor, D., & Thibault, T. (2001). The Making of Ascension Health: The Bringing Together of the Two Catholic Health Care Cultures Was a Complex Effort. Retrieved from http://www.chausa.org/docs/default-source/health-progress/the-making-of-ascension- health-pdf.pdf?sfvrsn=0 Pryor, D., Hendrrich, A., Henkel, R. J., Beckmann, J. K., & Tersigni, A. R. (2011). The Quality Journey at Ascension Heealth: How weve Prevented at least 1500 Avoidable Deaths a Year-And Aim to do Even Better: Health Affairs, 30(4): 604-611 Rose, J. S., Thomas, C. S., Tersigni, A., Sexton, J. B., & Pryor, D. (2006). A Leadership Framework for Culture Change in Health Care: Journal on Quality and Patient Safety, 32(8): 433-442. The Commonwealth Fund. (2006). Case Study: A Transformational Change Process to Improve Patient Safety at Ascension Health. Retrieved from http://www.commonwealthfund.org/Innovations/Case-Studies/2006/Jan/Case-Study-- A-Transformational-Change-Process-to-Improve-Patient-Safety-at-Ascension- Health.aspx Read More