Quantitative Data Case-Assignment

Quantitative Data Case-Assignment

Quantitative Data Case-Assignment

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This is the time to make people uncomfortable with the status quo. Plant the seeds of dis- content by introducing information that may make people feel dissatisfied with the present and interested in something new. This information comes from the data collected (e.g., research findings, quantitative data, and patient satisfaction questionnaires or staff surveys). Couch the proposed change in comfortable terms as far as possible, and minimize anxiety about the new change.

Managers need to plan the resources required to make the change and establish feedback mechanisms to evaluate its progress and success. Establish control points with people who will provide the feedback and work with these people to set specific goals with time frames. Develop operational indicators that signal success or failure in terms of performance and satisfaction.

Three surgery center nurses designed a flow chart of how the process could be improved. They took it to their administration and were put in charge of its implementation.

Implementation The plans are put into motion (Lewin’s moving stage). Interventions are designed to gain the nec- essary compliance. The change agent creates a supportive climate, acts as an energizer, obtains and provides feedback, and overcomes resistance. Managers are the key change-process actors. Some methods are directed toward changing individuals in an organization, whereas others are directed toward changing the group.

Methods to Change Individuals The most common method used to change individuals’ perceptions, attitudes, and values is information giving. Providing information is prerequisite to change implementation, but it is inadequate unless a lack of information is the only obstacle to effecting change. Providing infor- mation does not address the motivation to change.

Training is often considered a method to change individuals. Training combines information-giving with skill practice. Training typically shows people how they are to perform in a system, not how to change it. Therefore, it is a strategy to help make the transition to a planned change rather than a mechanism to initiate change.

Selecting and placing personnel or terminating key people often is used to alter the forces for or against change. When key supporters of the planned change are given the authority and

accountability to make the change, their enthusiasm and legitimacy can be effective in leading others to support the change. Conversely, if those opposed to the change are transferred or leave the organization, the change is more likely to succeed.

Methods to Change Groups Some implementation tactics use groups rather than individuals to attain compliance to change. The power of an organizational group to influence its members depends on its authority to act on an issue and the significance of the issue itself. The greatest influence is achieved when group members discuss issues that are perceived as important and make relevant, binding de- cisions based on those discussions. Effectiveness in implementing organizational change is most likely when groups are composed of members who occupy closely related positions in the organization.

Individual and group implementation tactics can be combined. Whatever methods are used, participants should feel their input is valued and should be rewarded for their efforts. Some people are not always persuaded before a beneficial change is implemented. Sometimes behav- ior changes first, and attitudes are modified later to fit the behavior. In this case, the change agent should be aware of participants’ conflicts and reward the desired behaviors. It may take some time for attitudes to catch up.

The surgery center nurses worked with physician offices, insurance companies, and other hospital departments to implement the new process for preoperative services.

Evaluation Evaluate Effectiveness At each control point, the operational indicators established are monitored. The change agent determines whether presumed benefits were achieved from a financial as well as a qualitative perspective, explaining the extent of success or failure. Unintended consequences and undesir- able outcomes may have occurred.

Stabilize the Change The change is extended past the pilot stage, and the target system is refrozen. The change agent terminates the helping relationship by delegating responsibilities to target system members. The energizer role is still needed to reinforce new behaviors through positive feedback.

Over the next three months, the preoperative services department was able to show a 90 percent decrease in duplicate test orders, a 50 percent decrease in patient waiting time, and an 80 percent increase in physician satisfaction with the process.

Change Strategies Regardless of the setting or proposed change, the four-step change process should be followed. However, specific strategies can be used, depending on the amount of resistance anticipated and the degree of power the change agent possesses.

Power-Coercive Strategies Power-coercive strategies are based on the application of power by legitimate authority, economic sanctions, or political clout. Changes are made through law, policy, or financial appropriations. Those in control enforce changes by restricting budgets or creating policies. Those who are not in power may not even be aware of what is happening. Even if they are aware, they have little power to stop it. Health care reform legislation, is an example of power-coercive strategy by the federal government.

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