Organizational Change Implementation

Implementation is the moving stage of the change process. It is here that plans, which are theoretical in nature, are executed so that they become reality. It requires action in order for the organization to fulfill each step in the plan and reach the goals that were set. Yet, how can we ensure that implementation is successful and proceeding within the prescribed timeframe? How can we determine if problems develop and require troubleshooting? The answer lies in effective monitoring.  

Monitoring is defined as “the systematic measurement of variables and processes over time”. During the planning stage, mechanisms to determine the success of planned activities aimed at reaching goals and objectives have been identified. Consequently, these mechanisms are applied in defined intervals throughout the moving stage. The purpose of monitoring is to regulate change implementation, identify weaknesses and impending problems, and respond by making the necessary decisions in a timely manner. As in all stages of the change process, using a participatory approach in monitoring is a key principle.

By participation, this means that all people affected by the change should have a voice in decision making from planning to implementation. Through collaboration, inclusion and openness in the workplace, the participatory approach results in successful change for several reasons. By giving participants a role in the process, and thereby an opportunity for them to invest their time and effort in it, they develop a sense of ownership over the outcome of the plan.  Further, because they feel that they can help shape the outcome and that they have a degree of control over it, they commit to the change.

There are several methods consistent with the participatory approach which can be used in monitoring. Foremost is individual reporting. Planned activities have corresponding time frames and persons who are in charge of them. Obtaining an individual report, for example from the person who is trying out the new protocol during pilot study, and discussing the contents with the source face-to-face rather than employing a one-way upward communication process will provide information not only on the viability of the protocol but also the difficulties that need to be overcome and the person’s thoughts on ways to overcome them. By engaging the person in a dialogue, he/she does not feel like a passive means to an end but a principal actor in change.

Another method for monitoring is holding staff meetings. At the onset, these are invaluable venues for communicating the change plan and the vision where this plan aims to lead the organization. Further down the road, staff meetings become opportunities for sharing updates on what has been accomplished so far, thus building a common knowledge of how far or how near the organization is to the set goals.  Further, it is an ideal time to obtain feedback from those who tried the new protocol in the pilot study which can convince the rest of the team to buy it. During full-scale implementation, staff meetings are also opportunities to check up on their adjustment to the new protocol. Using the participatory approach in monitoring through staff meetings communicates the message that employees’ opinions matter and that they can meaningfully contribute to change.

Further, staff meetings provide a change manager’s perspective on what else needs to be done and what challenges need to be addressed in terms of employee behavior, the primary target of change.  For example, since an established way of dealing with missing patient chart data is being changed, a staff meeting is an opportunity to assess what aspects of individual behavior and group norms still need attention. Eventually, the aim is to make behavior and norms fully compatible with the change being introduced (Spector, 2010). Some of the important questions to answer are the following: Is there still evidence of resistance? Who are involved and how can they become convinced further? The monitoring process then becomes an avenue for gaining full support for the change while it offers insight on possible adjustments along the way.

It is worthwhile to note that several organizational systems and processes positively affect the proposed change. For one, teamwork is the predominant culture in our department. As such, the members themselves are resources when it comes to difficulties encountered during the review. Work becomes an individual and collective effort. The team-based approach has helped our department to be always above the consistency score in terms of job quality and performance.  The hiring process is also consistent with our department culture since HR ensures that every nurse hired for the job is also a team player. These conditions are very conducive to participatory management of change.

Being open, communication systems in the organization are also favorable to implementing change. Whether among members of the team, between the team and the manager, and between the department and the medical director, lateral and upward communication has not been a problem. As a result, the team as well as upper levels of management is accessible if we have concerns. Again, this system supports participatory change management. In addition to the openness of communication, the manner of doing it is also an important point to consider. I take as an example the way our department manager communicates with us. Her style of communication gives us the impression that she is honest, fair and trustworthy and this has contributed to her credibility. This communication style, which fosters an effective leadership, benefits the change process since employees would tend to be receptive when the change agent communicates a change plan and the vision associated with it.

Other systems that would facilitate the adoption of the new protocol as proposed change include quality assurance mechanisms in the department.  The monthly approval rating system, the presence of an approval committee, and job consistency scoring all emphasize quality, a value that has become innate in our department. The definition of quality is dependent upon external and internal regulations and policies. Therefore, packaging the proposed change as an undertaking that further contributes to quality consistent with the organization’s vision and goals would be one way of selling it. This makes it easier to buy since quality is something that employees in the utilization review department strive to attain every day.   

Lastly, the process of human resources development is such that it is nurturing. Employees are provided the necessary resources and training for them to be able to do their job well. Moreover, there are times when some members of the team, for whatever reasons, perform less than their best. The department manager has always been proactive in these situations by providing the tools and resources that would assist the individual to get back on track. These practices develop a feeling of security that employees would not be assigned responsibilities they are not deemed capable or ready for, and during the change process itself, the team will not be left hanging in the air if problems arise.

For example, in evaluating the old protocol, team members assigned to engage in research should be given adequate training in research and report writing in order to do the job well. This is also true with team members participating in trying out the new protocol (pilot study), and those tasked to draft the standard tool or form. However, if the team’s capabilities cannot meet the demands of these tasks then persons from other departments or external to the organization, such as consultants, may have to be called in to perform them. By dispelling employee fears which are one of the causes of resistance to organizational change, systems pertaining to human resources in the organization makes it easier for change to take place.

However, though processes and systems as they apply to the utilization review department are conducive to implementing the proposed change, the same cannot be said for the medical services or physicians’ department. It is highly probably that their group norms, communication systems, management styles and work environment differ from those in our department based on the fact that physicians have a different professional role and a distinct subculture.  This will require a modification or change in approach in order to address such nuances. The most important thing is to overcome the division between the two departments since the goals set for the proposed change cannot be met without interdisciplinary collaboration (Borkowski, 2005). For this, higher levels of management need to be involved.

Despite our best efforts, plan implementation may not go as smoothly as we expect them to proceed since there are many factors that cannot be adequately controlled. In the face of change, resistance among team members is a major barrier to implementation which can be dealt with by employing appropriate communication techniques. Communication then is not just about generating information for others. This is just half of the task. The manner of communicating should also be considered if we are to accomplish our purpose in communication. Especially in conflict situations, methods of communication which guarantee resolution must be used.

Conveying openness to communication is a prerequisite for employees’ raising their issues to the attention of the change agent since the former feel that their concerns matter to management and they will be heard. Undivided attention and sufficient time should also be given to issues as they arise to avoid escalation. Only through active listening can the change manager truly understand what the employee wants to communicate in its entirety, as opposed to half-hearted listening where most of communicated information does not enter into consciousness and are therefore missed (Borkowski, 2005). Knowing what the employee is intending to get across facilitates a speedier resolution. Empathy should also be injected in communication since the ability to see an issue from the perspective of the employee yields an objective view of the problem.  Hence, a fair, timely and appropriate resolution would be expected.

In summary, being able to manage change is crucial especially during plan implementation. Monitoring helps by working like a barometer in gauging the emotional climate of the proposed change. This way, the change agent can better perceive how employees are coping with the change and whether efforts are still needed to gain full backing of the plan. This can be achieved either through individual reports or staff meetings. Not only employee behavior but also organizational processes and systems must be modified to be compatible with the goals of change. When problems do arise, using openness, giving full attention and empathy help in settling employee concerns.

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