HEALTHCARE

Organizational change: A reflective report

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Organizational Change (Reflective Report)

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Introduction

            The term organizational change refers to any change that affects the system of performing work within an organization. This change is feasible when there is a difference between the actual work performed by the employees and what is expected of them to ensure organizational growth and success. Change in the organization is similar to the change in human life; new things replace the old ones. If an organization does not change with the changing competiveness in the business enviroment, then it is likely to be unable to survive in the long run (Smith, 1997).

From the experince of a manager at Prince Sultan Cardiac Centre, a hospital with multiple facilities and one of the leading institutes in Saudi Arabia, change is inevitable and vital. The manager joined Prince Sultan Cardiac Centre in 2005 where he served as the head of the Operating Theatre Department before becoming a manager. The transtion from a department head to a manager is itself an aspect of organizational change.  Chnage in this context involves acquisation of more knowledge while facing new challenges as regards to work responsibilities.

Organizational Change Theories

Lewin’s Model of Organizational Change

According to Lewin, social organizations are the balance of forces, with some people ready for change and others not (Lewin, 1890 – 1947). This model consists of 3 steps: Unfreezing, movement and refreezing.

Unfreezing disturbs the balance maintaining the firmness of the organization. Lewin argues that deterioration of current patterns of behaviour works to prevail over conflict to dissimilarity. Therefore, benefitting from an existing strain is one of the plans to originate unfreezing in an organization.

The movement step is a convincing movement to establish a direction in the current breakable system. It continues until a new constancy is obtained between driving forces and limiting forces.

Eventually, refreezing occurs when the pattern of behaviour becomes stable. An example of the refreezing strategy may include development of new hiring policies. It ensures that all fresh recruits comprehend and become part of the organizational culture;  performing their jobs accurately within the new structure.

Schein’s Psychological Safety

            Edgar Schein’s theory regarding psychological safety has contributed greately in understanding the process of change. The end of an existing system and the establishment of a new one implies a significant organizational change. In contrast, if the organization unfreezes accroding to Lewin, two types of nervousness wolud be prevalent in the organization: (i) lacking the ability to learn new things because they seem challenging, involves the fear of embracing change; and (ii) involves the encouragement of nervousness while continuing to perform something which will ultimately lead to failure (Hatch, 1997). Fear of not changing at all. Psychological safety is essential in switching on the latest course of action (Hersey et al. 2001).

Robinson Forces of Changes

According to Robbins (1997), there are six forces that stimulante change and they include workforce nature, economic shocks, competition, technology, world politics and social trends.

Workforce nature involves the mixture of culture, increament in professionals and a lot of new participants having insufficient skills.

Economic shock involves crashes in the security markets, fluctuations in interest rates and risk of change in the rate of currency.

Competition involves the growth of specialized retailers and global competitors.

Technology involves the introduction of new equipments, machines and programs while world politics can be viewed in the context of terrorism activities such as September 11’s invasion of America.

Social trends encompasses the increasing rates of divorces, young people delaying marriages and increase in attendance of college.

Types of Change

            Ackerman (1997), notes that change can be categorized into 3 types: developmental, transitional, and transformational. Developmental change is either emergent or planned. Its adjustments increase the aspects or corrects the current aspects, regularly focusing on skill enhancement. Transitional change emphasizes on a recognized, preferred state which differs from the current one. It is intended and can be drastic. Transformational change includes shift from routine to innovative systems. Shift in the beliefs within an organization is necessary for these changes to occur.

Level of Change

There are 4 levels of change which include: change in knowledge, change in attitude, change in individual behaviour and change in group (Hersey et al. 2001: 389).

Resistance to Change

According to Robbins (1997),           one of the important issues affecting change is resistance to change. These resistances are based on individual and organizational views. Individual resistance to change is mostly associated with human nature as is observed in  resistance to issues of awareness, requirement and personalities. These resistances are based on habit, protection, selected information processing, economic factors and fear of strangers. Organizational resistance is asociated with six main aspects including limited focus of change, threat to experts, structural inertia, group inertia, threat to established resource allocation and threat to established power relationships.

Change from the  Hospital  Perspective

Personal Change

The first significant change invoved the switch from unadulterated practices of healthcare to managerial work and office work. Robbins (1997), relates this shift to personal change in the organization. Lack of managerial experience prompted the manager to search for fresh knowledge, learn new managerial skills and adjust from routines. Maintaining a strong and positive relation with colleagues was driven by the aim to adjust. As a manager, relating with the surbondinates in a more polite and positive approach helped set the stage for change. New responsibilities triggered the change in his attitude, given that he was answerabel for the performance and behaviour of the group.

Organizational Change

In the last 10 years, there have been a centralized management system in the Operating Theatre Department at Prince Sultan Cardiac Centre. As an extremely busy division, there has been a shortage of staff in this department and this has derailed change in this period. An important task addressing change thus involves expanding the department through various initiatives that match the current hospital systems.

Change in the management systems is therefore a core objective in restructuring the current approaches to change. For instance, inclussion of staff in decisions and procedures concerning management helps resolve the resistance due to manager-surbodinate relations. Hersey (2001), describes this as a threat for establishing the relationship of power. Ammedning other systems such as performance evaluation, scheduling, night shifts, and the leave booking systems is also an essential platfom for change. According to Ackerman (1997), this aproach encompasses developmental change.

Technological change is necessary in all organizations. At the hospital, technology acts as a force for faciliatating change. The fear to change is also refered to as the the fear of the unknown (Robbins, 1997; Ackerman, 1997).

From a cultural change perspective, the hospital manager accomplished the expansion of the number of national Saudi employees within 5 years as well as making the department a centre of attention for Saudi female staff. This came in handy as there was a sharp decrease in the numbers of international employees in the department due to the safety issues.

Analysis

Experiencing change in the organization is the best part of the manager’s five year tunure. The change from pure practices of healthcare to office and managerial work set the stage for other change initiatives. According to Robbins (1997), change is initiated by the nature of work to be done. Gain in knowledge helps in adopting decisions easily. This knolwledge can be obtained through research, studying relevant materials and other possible ways of gathering information (Hersey et al. 2001). It is much easier to adopt knowledge than attitudes especially when these attitudes revolve araound emotions.

Four key factors of Robbin’s theory match the manager’s experince. In regards to  the nature of work, the manager experience all nature of changes. For instance, he initiated the departments aim of providing the best services to patients through use of cutting edge technologies. Increase in salary helped change the attitude and the perfomance culture of Saudi Arabian staff positively following the resignation of international employees.

Lewin’s 3-step theory of change is one of the best in adrressing such changes. According to Lewin, subversion of current patterns of behaviour works to prevail over resistance to change. Searching and then taking advantage of current pressures within the present system is an important consideration for an unfreezing situation (Hatch 1997: 353). However, the manager might fear that this approach violates the code of ethical conduct and trust; which should otherwise be stable especially between managers and surbodinates. A manager is responsible for maintaining equilibrium within the organization by avoiding any change related stress. The manager thus may feel unsaied with the Lewin’s model since it fails to explore ethical aspects.

Evaluation

A change of the manager’s attitude following the change in responsibility is the most inspiring accomplishment towards efective organizational change. A changed atttitude means being able to maintain a strong relationship with the surbodintes. Additonally, the support by higher management and colleagues too is an essential basis for change (Hatch, 1890 – 1947). This would act as a platform for fresh and dynamic cultural change in the organization such as the increase in staff diversification. This is a very positive and stable change in the organization.

Unfortunately, conflicts arise among staff due to the new distribution of responsibilities. In the hospital, conflicts were triggred by the deviation from the authority although this disappeared over time once the new management structure was implemented.

Change brought great strengths in the department. A committee set up to monitor development and change made the department the most modernized in the country. However, weaknesses were prevalent too. More time and money was required to meet new requirements such as implementation of new processes and conflicts resolution decreasing the level of work stability. To maintain these changes, the manager made a plan for employee behaviour, to re-adapt the changes as described by Lewin’s refreezing theory. This was the weakest part in regards to the managerial and change process.

Conclusion

The mangaer-surbodinate relationship should be based on understanding and trust. Implementation of new ideas is a critical aspect of change and these ought to be learnt from research and consultation with senior staff (Smith, 1997). Employees follow a leader once they become comfortable with the new modifications in place. It is then important that every manager be aware of the difficulties likely to emerge following an organizational change. Lack of this awareness is the reason why some leaders have difficulties dealing with change.

Incase of another opportunity to serve as a manager in a similar enviroment, the manager should focus on facilitating positive change in the context of both the organization and employees, that is, change to improve the performance culture as well as the organization’s competitiveness. This would entail sharing intended plans and ideas with colleagues to keep them updated regarding the upcoming issues and problems. Staff involvement in the change process through decision making would be paramount for effective results. Athough many poeple might express fear and hesitation towards the change process, the manager’s skills and abilities, including past experinces would be very vital in enhacing a change in attitude.

References

Ackerman, L 1997, Development, transition or transformation: The question of change in

organization, Jossey Bass, San Francisco.

Adams, C 2008, What is a Habit – What is Habit Forming? Retrieved August 23, 2010

from http://ergonomics.about.com/od/ergonomicbasics/f/what_is_a_habit.htm.

Hatch, M, 1997, Organization theory: Modern symbolic and post-modern perspective, 1st

edn, Oxford University Press, New York.

Hersey, P, Blanchare, K, & Johnson, D 2001, Management of Organizational Behaviour:

Leading human resources, 8th edn, Prentice-Hall, New Jersey.

Lewin, K 1890 – 1947, International Encyclopaedia of the Social & Behavioural

Sciences, pp. 8737-8740.

Robbins, S 1997, Essentials of Organizational Behaviour, 5th edn, Prentice-Hall, New

Jersey.

Smith, R 1997, The 7 levels of change: Different thinking for different results, 3rd edn,

Tapestry Press Reading, Pennsylvania.

 

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