Organizational Change Part I

The Center for Health Affairs, n. . , Para. 1). The program consists of nine modules: heart-head-heart communication, the power of presence, acknowledging feelings, showing caring nonverbally, explaining positive intent, the blameless apology, the gift of positive regards, the caring broken record, and the skills combined (The Center for Health Affairs, n.

D. ). The Centers for Medicare and Medicaid Services (SMS) made a decision in 2013 to biblically report patient experience of care scores (Oregon Health Authority, n. .

). Value based purchasing paved the way for mandated reporting through the introduction of the physician compare web site, and patient centered medical homes, as a response to the Accountable Care Act mandates. Pay for performance is the reimbursement structure supported by the accountable care organizations in which the state of Oregon supports robustly. The organization I work for requires a 90th percentile rating for CHAPS scores as reported by an independent vendor.The organization is presently ranked in the 70 to 80th percentile, and they expect that implementation of the Language of Caring program will enable them to reach their desired goal.

Barriers to Change Barriers to change include lack of motivation by employees, lack of skills and knowledge necessary to carry out the change, and personal belief in the benefit of he change. External motivation provided by the organization was the decision to attach a two percent compensation to providers if they obtained the desired goal, and a two percent deduction if they did not.The external motivation was met with mixed feelings from the staff, and was actually a barrier. The staff resented their compensation being linked to their CHAPS scores, and felt as if they did not have control. The tools for supporting improvement should have been presented first, and establishing that employees understood the need for change.

If an employee does to see the benefit to implementing the change, or if the change is inconsistent with an individual's beliefs or values, they will not engage.According to Rosenberg and Masc. (201 1), an organization's history can serve as a barrier. If employees have experienced failed change attempts, they will be less likely to engage in another. Employees who have been tainted by a history of unsuccessful change implementation may think that they do not have to engage because the efforts will soon end. Factors that Might Influence the Proposed Change Factors that might influence the proposed change include the quality of the execution of the implementation plan (Rosenberg & Masc.

, 2011).An excellent implementation plan will include knowledge sharing with staff, and solicitation of staff input. Employees need to know what changes to expect and when they will be implemented. Employees also need to feel empowered to participate in the change efforts. Effective and appropriate communication with staff can reduce the resistance to change by staff. Appropriate communication to staff may decrease the fear and anxiety staff may have about the unknowns anticipated with the change implementation.

Management should address the personal reasons staff have to resist change, such as the disruption of their routine workflow, or loss of security (Rosenberg & Masc., 2011). The single most critical factor that may influence the proposed change are the people involved with the change implementation. If the staff are not engaged and do not support the change effort, the implementation will not be successful. Readiness to Change Readiness to change can be explained as the opposite of resistance to change.Readiness to change would include an organizational awareness of the staffs beliefs, ND attitudes regarding the change implementation.

"Readiness, which is similar to Linen's (1951) concept of unfreezing, is reflected in organizational members' beliefs, attitudes, and intentions regarding the extent to which changes are needed and the organization's capacity to successfully make those changes" (Ramekins, Harris, & Monkshoods, 1993, p. 1).Readiness to change would require an understanding by staff of what is being changed, how the changes will be implemented, and the ability to connect that understanding with something they care about. Theoretical Model Related to the Change The theoretical model that relates to the proposed change of implementing the Language of Caring, is Linen's model of change implementation.

"Lenin is best known for his three stages of change implementation: unfreezing, moving, and refreezing" (Specter, 2010, p. 29).Unfreezing pertains to changing group norms and standards. Moving is the second stage in Linen's model and refers to group members alter their patterns of behavior through the redesign of organizational roles, relationships and accountabilities (Specter, 2010). The organization referred to n this paper is providing mandatory education forums in three phases which address all nine modules in the Language of Caring program.

Refreezing is the final stage in this model where the new behaviors and norms are institutionalized (Specter, 2010).This stage addresses sustainability and aligns control systems and rewards with performance. The organization referred to in this paper has identified a two percent compensation package associated with provider CHAPS performance. Resources Needed to Support the Change Initiative In order to support the change initiative, various subject matter experts are needed o participate.

A program manager would be desired to help keep the project on task. A change management team would be nice to have to coordinate and schedule trainings, and communication to leadership and staff.Credentialed educators would be helpful to deploy to departments to support the prescribed rolls. Leadership support is necessary to provide the messaging which includes the present status of the organization, the reason that change is needed, what the effects would be if change is not implemented, and the capability of the organization to implement the change. Leadership also needs to provide the resources necessary to implement the change, such as allowances in the budget for non-productive education time for staff, and the necessary educators to support the training sessions.

Conclusion In conclusion, successful change implementation is challenging, but necessary to meet the changing demands of health care. The case outlining the need for change is very important to identify for staff. Barriers to the intended change should be identified and addressed, communication to staff should be clear, and staff should be active participants. Linen's model for change implementation would be a good model to follow for implementing Language of Caring into the organization described in this paper.