Organizational Change Plan Part II Change Methods

The modern world demands for organizational change. Hospitals in particular need change to handle the growing problem of elopement or, intended leaving of a medical facility after person is aware of not having permission to do so. Organizational change to solve such a problem can come from several areas. Some of which may involve new leadership or new ways to assess any changes throughout the day. New leadership could bring in, an organizational change through plans that involve changing the way staff behave and think in regards to certain activities like elopement and how to manage such potential incidents.

The first towards implementing any kind of organizational changes in regards to reducing elopement is to understand the type of patients most likely to elope from the hospital. Patients with Alzheimer's or Dementia or most likely to elope. If staff are informed from the beginning of a patient's stay that this patient may run risk of elopement, better monitoring and other precautions like locking the door at night time, may prevent or at least lessen chances of elopement.

In an exploratory, qualitative study by Aud, the author describes the conditions, environmental perils, and injuries experienced in 62 elopements. These elopements happened in long-term care facilities where elderly with dementia resided in. Content examination of the information of the elopements recognized patterns that encompassed:

1) a lack of effective precautions to prevent elopement when residents had indicated an intent to elope, had repeatedly attempted to elope, or had a history of elopement; 2) a lack of awareness by the staff of resident location; and 3) ineffective use of alarm devices intended to alert staff to elopement attempts (Aud, 2004, p. 361).

So for there to be a reduction of elopement, working alarm devices must be put in and tested periodically to see if they function properly and effective implementation of precautions and raised awareness of staff of the occurrence of elopement and which group is most likely to elope. Implementation and monitoring of an organizational change can be a critical and often difficult task. Sometimes it is difficult because of the inherent need of some to not want to accept change and belief the old way is a stable and suitable one. Other times it comes from lacking enough motivation or communication to carry out objectives. However there are tools available to make change in a medical or hospital setting less difficult.

Dr. Kilian Bennebroek Gravenhorst in an interview, discussed a measurement tool called the Change Monitor. The Change Monitor is an organizational intermediation tool aimed for use by businesses with well-formed organization teams and a consciousness of organizational matters. The purpose of the Change Monitor is "to help you assess your organization's capacity for the changes being implemented and what action to take as a result. Unlike other change management measurement tools, the Change Monitor ™ takes a more integrative approach" (Savage, 2012, p. 1).

Consequently, the change monitor software eradicates the struggle of determining the problematic regions to correct and staff a part of the organization can then perform their job duties instead of focusing on duties normally performed without the change monitor software. This instrument examines the workflow data, defines complications, and alerts the employees of any new changes or issues. The employees then communicate problematic information to the organization team. The entire process hurries the corrective action time promoting better handling and communication within the organization. If staff were to attempt to adapt to a new method of handling patients or in the case of long-term care facilities, residents, without use of any tools or methods, there may be some confusion. Confusion often leads to anger, miscommunication, and even a disruption in nursing care. Use of the Change Monitor may help the confusion and alleviate any negative ramifications brought on by the new implementation process.

Another model, named the Kurt Lewin Change Management Theory model can be used in conjunction with the Change Monitor. Kurt Lewin's Change Management Theory, is a "time-tested, easily applied field theory that is often considered the epitome of change models, suitable for personal, group and organizational change" (Kaminski, 2011, p. 1). A brief background on Kurt Lewin, reveals he was a Gestalt social psychologist and has been recognized as the "forefather of social change theories" since numerous modern models are at minimum roughly founded on Lewin's work. This theory along with the Change Monitor gives the Burn Unit staff tools to better handle the changes faced. As previously mentioned, people often find it hard to handle change and prefer things remain the same. These tools offer an easier transition.

To understand the...

"The first stage involves finding a method of making it possible for people to let go of an old pattern that was counterproductive in some way. This is the stage where the desire to change occurs, or at least the recognition that change is needed" (Kaminski, 2011, p. 1). Many examples of the first stage involve transforming a paper-based system into an electronics-based system since computers are faster and easier to store information in than using paper documents and records. The second stage involves a progression of modification.
This process includes changes in opinions, approaches, comportment, or all three, that allows for a sensation of liberation and a chance at more productivity than doing things the like previously. Throughout this stage, the people a part of the change are persuaded to believe the new way is better and the old way is obsolete. The third and final stage consists of "establishing the change as a new habit or process, so that it now becomes the "standard operating procedure" or status quo. Without some process of refreezing, it is easy to backslide into the old ways of doing things" (Kaminski, 2011, p. 1). In this stage it is very important to give rewards and offer support to those not handling the changes well.

Good leadership becomes a significant part of this stage. Any changes made must remain "frozen" to provide a sense of stability to the people witnessing the change(s). Establishing rewards, new policies, continual support, and a concrete direction will not only help the staff undergoing the change, but also help with any new personnel that come in. Leadership may consist of developing certain methods that will provide satisfaction and stability for the staff. A characteristic method might contain "increased resource allocation to both research and development and marketing, a shift in the reward system to encourage the extra attention needed by new activities, and a change in the way activities are grouped as well as in reporting relationships" (Gupta, 2013, p. 12).

These kinds of activities amidst organizational change is essential and often necessary to keep people from feeling awkward or powerless during implementation. Communication has always been seen as an important means to achieving any objective. Effective communication comes from realizing the need for structure and operating along that structure. As Gupta discussed in an article, "Organization structure refers to the network of organizational arrangements and relationships formally established on a durable basis. It consists, among other-things, of mechanisms to ensure that parts are linked and work together effectively" (Gupta, 2013, p. 14).

Several theories have been used to deliver organizational change: "Systems theory, organisational development, social world's theory, and complexity theory each has a practical contribution to make to our understanding of how indicators work in prompting quality improvements and why they sometimes don't" (Rhydderch, Elwyn, Marshall, & Grol, 2004, p. 213). One theory from the list, organizational development, sets out to improve the effectiveness and knowledge of the people within the organization. If people within an organization are knowledgeable of the not only the changes needed to implement, but also of ways to cope with the new changes, there will be less resistance to the change and better success in carrying out the change. If people for instance, are informed in meetings of what to do, how to do it, and if they have any questions, ask, this keeps people from second guessing and it provides them with a greater sense of confidence to carry out their responsibilities. Developing an organization's knowledge pool not only gives people better ways to communicate but also relieves fear of the unknown and things that may otherwise seem foreign.

References

Aud, M.A. (2004). Dangerous wandering: Elopements of older adults with dementia from long-term care facilities. American Journal of Alzheimer's Disease and Other Dementias, 19(6), 361. Doi: 10.1177/153331750401900602

Gupta, A. (2013). Business strategy implementation and strategic management: An analytical study. INTERNATIONAL JOURNAL OF Management AND DEVELOPMENT STUDIES, 2(6), 11-16. Retrieved from http://www.ijmds.com/admin1/adminsettings/upload/AbhishekGupta2.pdf

Kaminski, J. (2011). Theory applied to informatics -- Lewin's Change Theory. Canadian Journal of Nursing Informatics, 6(1), 1. Retrieved from http://cjni.net/journal/?p=1210

Rhydderch, M., Elwyn, G., Marshall, M.N., & Grol, R.P. (2004). Organisational change theory and the use of indicators in general practice. Quality & Safety in Health Care, 13(3), 213. doi:10.1136/qshc.2003.006536

Savage, D. (2012). The Change Monitor | Think Transition. Retrieved May 30, 2014, from http://www.thinktransition.com/articles/the-change-monitor/