Exam 3 content: Planned Change (Ch. 8) Flashcards
what forces are driving change in HCS?
Rising health care costs Declining reimbursements Workforce shortages Increasing technology Dynamic nature of knowledge Growing elderly populations
why do HCO change?
Upgrade their structure
Promote greater quality
Keep their workers
what is the continual change in health care?
Organizational Restructuring
Quality Improvement
Employee Retention
what is the definition of planned change?
- Deliberate application of knowledge & skills by a leader to bring about change
- Well thought out effort to make something occur.
what is a “change agent”?
Person skilled in theory and implementation of planned change
what are change agent challenges?
Organizations tend to reject outside change agents.
~ Perceived as lacking information.
~ Motives are not trusted
Inside agents are influenced by personal bias.
Change agents must have sensitivity to needs of the organization
what are L&M functions in planned change?
- Well developed organizational skills
- Vision & expert planning skills
- Ongoing evaluation of organization goals
- Changes implemented based on evaluation organization needs
- Appropriate use fiscal & human resources
- Be visionary & flexible in adapting to change
what is change theory?
- Classic Change Theory by Kurt Lewin (1951)
- He stated change should be implemented for good reason
- It should be gradual
- Should be planned, and not sporadic or sudden
- All individuals who would be affected by the change, should be involved in the planning.
- Lewin identified three phases
- Change agent must be involved in the entire process
- Unfreezing, Movement, and Refreezing
what is “unfreezing stage”?
Unfreeze the forces that maintain the status quo
People become discontented and aware of a need for change. People may feel anger.
Convince members of the group to change when guilt, anxiety, or concern can be elicited and most importantly anger!
Make a through and accurate assessment of the extent and interest of the change
Implement change for good reason
Coerce members of the group to change, or when guilt, anxiety, or concern can be elicited
what is movement?
Identify, plans, and implements appropriate strategies
Ensures that driving forces exceeds restraining forces
Implement gradually and for good reason
Allow time change to be fully assimilated
what is refreezing?
Assist in stabilizing the system so that it becomes integrated into the status quo
Be supportive
Reinforce
Takes 3 – 6 months to be accepted
Make a commitment to be available until the change is complete
Refreezing does not eliminate the possibility of further improvements to the change
what are Lewin’s Driving and Restraining Forces?
Driving forces (facilitate) - The forces that push the system towards change - desire to please your boss, eliminate a problem, pay raises, and receiving recognition, healthcare (private health insurance program premiums are above what consumers can afford)
Restraining forces (barriers)-The forces that pull the system away from change - resistance, bad timing, lack of power
what is necessary for practice changes to occur?
Must feel a need for change (unfreezing)
A helping relationship between the change agent and his patient (Movement)
Problem is identified and clarified
Alternatives for change are examined
Resources are assessed
Active modification occurs
Movement is complete
Refreezing occurs; change is stabilized
The helping relationship ends
what should you know about resistance?
Expected Response to Change
Level of resistance is based on type of change
~ Technological changes involve less resistance
Changing IV pump
~ Perceived social changes that are contrary to customs or norms involve more resistance.
` Change in who is able to administer certain types of IV therapy.
It is easier to change knowledge levels than attitudes
Values, education, culture, experiences & social background affect level of resistance to change
what should you know about resistance to change?
Because change disrupts the homeostasis or balance of the group, resistance should always be expected
It’s a natural and expected response to change
Encourage subordinates to speak openly so that options can be identified to overcome objections
Change should be planned and implemented GRADUALLY!
what are some strategies to minimize resistance to change?
Established trust & rapport with workers
Encourage subordinates to speak openly
Encourage workers to share their perceptions of the forces driving changes
Then, assess the need for support & resources
See & share the vision of what the future state will be after the change is implemented
Experienced change agent & project champion
what is the needed change to impact 21st century organization dynamics?
21st Century organizations are contemporary
- Change is unforeseeable & ever present - HCS’s long term outcomes are unpredictable - This unpredictability can not be managed with traditional linear theories (Lewin)
Nonlinear theories are needed to managed change in this unpredictable society
what is Complex Adaptive Systems (CAS)?
a Nonlinear Change Theory
The relationship btwn elements & agents within a system is nonlinear & are constantly in motion for change
Change agents must examine the focus of the relationships & interactions involved in change
what is Chaos Theory (Butterfly Effect)?
Nonlinear Change Theory
Determine the underlying order in the random information in a changing system
Hidden variables must be explored before change is considered
This chaos makes it difficult to determine the future
what should you know about organization aging? what is it?
Organizational Aging: Change as a Means of Renewal
Organizations progress through developmental phases.
As organizations age, they become more stable
Young organizations: High energy & fluid
Aged organizations: Established turf, control & change is limited.
Organizations must have balance
Without change; organizations stagnate/die
how should you integrate leadership and management in planned change?
Understand plan of action & implement.
Be aware of restraining/driving forces.
Provide tools/resources needed for change.
Be productive in a chaotic changing system.
Know the trends & changes facing your system.
Big picture focus.
Integrate vision, adapt to change & know when change is needed.
Model professional skills.
