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Application of Change Models to Healthcare Organizations

Name of the Model: John Kotter’s Eight Steps to Change Model

Description of the Model

John Kotter’s model of change outlines eight steps that managers can take to bring about change in their organizations. The first step involves creating a sense of urgency. Kotter argues that urgency is a necessity for bringing about change. Without urgency, people are not likely to change. The second step involves creating a guiding team. This is a team of people who are enthusiastic about the change and who lead others in the change process. The third step is the creation of vision and strategies. The vision and strategies help to steer the change process. They also help the organization to stay focused on the change process.

The fourth step involves communicating the change for the change to remain in the minds of the members of the organization. The “fifth step involves empowering people to drive the change process and to act on the vision” (Rock & Page, 2009, p. 169). The sixth step involves generating short-term gains which are crucial for the change process and which bring reality to the change. They also provide credibility, momentum, and confidence. The seventh step involves building momentum to further enhance confidence. The last step involves nurturing a culture of change. This step ensures that the change is permanent (Rock & Page, 2009).

Type of Healthcare Change Situation where Model is best applied

John Kotter’s model of change can be applied to the healthcare sector to introduce a quality improvement tool such as the Plan-Do-Check-Act (PDCA) cycle. The organization would first of all need to create the urgency for the tool, for instance, by informing its members that the organization would be closed if the tool is not

implemented. Next, a quality improvement team would be formed to steer the program. The team together with managers of the organization would then create a vision and the strategies to be used to implement the program. These would then be communicated to the members of the organization who would then be empowered through education and training to adopt and implement the program. The QI team and the managers of the organization would then be forced to build the momentum for the implementation of the program, for instance, by communicating to the members the benefits they will gain from the program. Lastly, the team and managers of the organization would need to create a culture of quality improvement in the organization to make the change long-lasting.

Name of the Model: McGregor’s Theory X

Description of the Model

McGregor’s Theory X and Theory Y are an expansion of Maslow’s hierarchy of needs theory which was used to describe the actions of managers in their associations with their employees. In Theory X model, McGregor asserts that managers view their employees as lazy and disinterested in their jobs. As a result, employees require constant guidance and direction to enable them execute their work duties (Bogardus, 2009).

The theory also asserts that managers are of the opinion that employees lack the ambition and drive to take the initiative and responsibilities of their work. They are only interested in job security more than anything else. Managers who comply with the Theory X are autocratic leaders who adopt the top-down management style. This style of leadership entails making decisions at the management level and then passing them down to the employees without questioning. The employees lack the chance and opportunity to take part in the decision making process.

The Theory X thus has three propositions. The first proposition is that management is accountable for the organization of money, material and people for economic gains. The second proposition is that people have to be controlled and motivated so as to meet the needs of the organization. The third proposition is that the conformity to organization and achievement of organizational goals are not possible without the intervention and direction of people (Miller, 2008). According to Theory X therefore, employees act the way they do not because they want to but because the organization forces them to do so. The demerit of this approach is that organizations fail to discover the great potential their employees have (Marriner-Tomey, 2004).

Type of Healthcare Change Situation where Model is best applied

McGregor’s Theory X of management is not a highly recommended management approach because it undermines the potential of employees. However, it is effective and successful in certain situations. In the healthcare setting, Theory X model of change is applicable in emergency situations such as during a traumatic event like a deadly accident or a terrorist attack. In such situations, most often the employees are at a loss of what to do. They may also be traumatized by the event thus limiting their capability to take the best course of action. Applying the theory to an emergency situation would entail three major steps.

First, the organization needs to organize its resources both material and human resources to address the given situation. This would entail arranging for the medical equipments and professionals that would be in charge of the victims. Second, the theory advocates for the control and motivation of people to achieve the organizational goals. In healthcare organizations, saving lives is one of the most essential objectives. In order to save lives in an emergency situation, the leaders should direct and supervise the healthcare professionals. Lastly, the theory argues that the achievement of organizational goals requires conformity of the employees.

Thus, in such emergency scenarios, the leaders should step in and make all the decisions that serve the best interests of the victims. The employees should only take the decisions passed by the leaders and act on them. In such scenarios, this model is the most appropriate because it saves lives that would otherwise have been lost as the employees in charge waste time in trying to find out what they need to do.

Name of the Model: Edgar Schein’s Model

Description of the Model

Edgar Schein’s model of change is referred to as the model of quasi-stationary equilibrium. This model has three stages namely: unfreezing, changing and refreezing. The unfreezing stage of change is the most crucial yet the most challenging stage.

The stage involves creating the motivation to change. This is achieved by altering the forces that act on the system by disconfirming the current situation, arousing anxiety or guilt if some goals are not met, and providing adequate psychological safety that prevents the targets from defending themselves from the change process. In order for the freezing stage to be successful, the organization must create a balance such that the disconfirmation is enough to arouse maximum anxiety or guilt level without causing denial or a defense strategy (Miner, 2007).

The second stage is the changing stage which entails the learning of new concepts, new understandings and new standards. It also entails creation of role models who members of the organization can imitate and identify with. It also entails looking for solutions and learning through trial and error (Mariner-Tomey, 2004). The third stage is the refreezing stage. This stage entails making the new set of meanings and concepts to fit into the personality of the members of the organization or the organizational culture. This ensures that the change is permanent rather than temporary (Schein, 2002).

Type of Healthcare Change Situation where Model is best applied

The Edgar Schein’s model of change can be applied to the healthcare system through a program meant to train healthcare professionals on the use of electronic medical records. The process would first entail disconfirming the use of manual medical records by, for instance, creating awareness in the employees about the benefits of EMRs and the demerits of manual records. This stage would then be followed by the changing stage in which the professionals would be trained on how to use the EMRs. In this stage, the professionals would learn about the new concepts and meanings pertaining to EMRs as well as the techniques involved.

Once the training program is over, the professionals would be required to go back to their organization and make use of the EMRs. For the training to be effective and successful, the organization must have a culture in place that supports and embraces the new technological device. If the professionals do not find such a culture and instead are met with opposition and unwillingness from the rest of the members, they are likely to unlearn and disconfirm what they learned during the training.

Reference List

Bogardus, A. (2009). PHR/SPHR Professional in Human Resources Certification Study Guide. New York: John Wiley and Sons.

Mariner-Tomey, A. (2004). Guide to nursing management and leadership. New York: Elsevier Health Services.

Miller, K. (2008). Organizational communication: approaches and processes. Thousand Oaks, CA: Cengage Learning.

Miner, J. (2007). Organizational behavior: From theory to practice. London: M.E. Sharpe.

Rock, D., & Page, L. (2009). Coaching with the brain in mind: Foundations for practice. New York: John Wiley and Sons.

Schein, E. (2002). Models and tools for stability and change in human systems. Reflections, 4(2), 34-46.

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