Verified
Four Stages of Change:
Transformation is a very complex issue, regardless of the industry and it is extremely difficult to plan too far ahead. There is always the fear of the unexpected as well as the fact there never seems to be enough of either time and/or resources. In Healthcare or organizations there are additional challenges to be faced such as:-
• Varied Groups of Stakeholders
• Healthcare Organizations have a multi-plank approach (provision of healthcare, financial solvency, community employer etc)
• Doctors and nurses are individuals who value their freedom and hence the decisions they make impact the top and bottom lines of the organization.
• The non-availability of data which could help in the spearheading transformation in a healthcare organization.
Keeping the similarities and differences between healthcare and other organizations in mind, the author started work on the development of what he refers to as the four-stage healthcare change framework. This was helped through a review of similar processes in other industries (cf., Kotter 1996; Tushman and O’Reilly 1997). The idea was to make progress on the earlier studies by keeping what was relevant in the case of healthcare organizations in perspective. It was necessary for elaborate customization of the previous studies to be done so that this particular model would be of greater value to healthcare managers. One could describe this particular process as a “do-it-yourself” manual for people who spearhead transformation.
Determine Desired End State:
The author assumes that the people spearheading transformation in healthcare organizations would have some initial thoughts about it and that these thoughts would generally stem from an initial estimation of the gap between perceived performance and actual performance. Generally this gap could exist due to the creation of opportunities or lack thereof in the actual and real world when compared to planned performance. The author found this to be the case with MOE/MAR which presented UHN with the opportunity to improve on the patient safety records while reducing medication errors. This particular opportunity was recognized by UHN’s Chief Information Officer.
Strategically in an effort to have MOE/MAR be looked at as a safety requirement/necessity instead of just some interesting Information Technology Project, this particular initiative was also supported by UHN’s CEO and Chairman of the Board who were structured in their thinking. For years together both these people had been voicing their displeasure with the failure of the healthcare sector to employ Information Technology in an effort to improve the performance of the industry.
Reaching a new desired end state generally reflects a long journey and in the case of large organizations, the journey is filled with roadblocks, diversions and other challenges. The leaders who possess maturity are ready for such challenges and realize that they need to think “out of the box”, while keeping the overall vision very clear and action-oriented.
In the case of UHN, it was imperative to specify goals that could be measured so that progress could be looked at in an effort to determine its success or failure. The initial supporters of MOE/MAR did have a very clear idea of the type of goals that were required. Further their thought process was very much in tune with the entire concept of how to measure these goals through various tools. There was also a need to consider other components which formed a part of the of the thought process.