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helped bring about successful outcomes
se to the change; the nurses
the change offered them. Their participation in the
right , what went wrong.
Evaluations of change initiatives offer a clear framework for examining what went
assess the process should
swer who, what, where, when, why, and how questions. Who introduced the change ideas?
in the organization? Why was the change needed at this time? How long did the process
take? What was the timeline for implementation? How does the change fit in with orga-
nizational mission? What, if anything, should have been done differently?
troduce the change plan by meeting with the stakeholders (the three clinic officer
Alfred has a problem. His efficiency plan is failing. To effectively address his prob-
lem, he should ask the questions of who, what, where, when, why, and how. He could
During this meeting, he could ask for their input, their participation, and their assessment
of efficiency needs at the clinics
. With that meeting and with continued, consistent sup-
portive efforts, Alfred may be able to get Mariana to build a commitment to change, giv-
ing the change a better chance to succeed.
Evaluate the statement that the role of the stakeholder is important for successful
change implementation. Give an example from your own experience that illustrates this
Alfred’s problem implementing his efficiency plan had to do with what he did not do. As-
sess his performance by determining the questions of who, what, when, where, why,
and how he should have addressed with the staff at the WPHC when he first started his
new job and then answering them.
With reference to Kanter’s (2001) ten classic reasons people resist change, how would
you recommend a manager should introduce a new work schedule that includes week-
end work for staff used to working only on weekdays?
Essential Techniques for Healthcare Managers
Once Alfred had set up office, he personally met with the three clinic office man-
agers. He told them he was there to improve the clinics and would be informing them of
changes that would bring this about. He was surprised that the managers had asked few
questions, but he assumed that they were on board and in agreement with him. He followed
up with them via e-mail, instructing the managers to meet as a group every two weeks to
move forward with his assignments. Alfred had not attended any of these meetings.
To date, none of his recommendations had been implemented. He knew that one of
the office managers, Mariana Buchanan, had been negative about his ideas. In fact, she
had often called the other two office managers to complain about him and his efficiency
plan. One of these office managers had met with Alfred to express her concern about the sit-
uation. The office manager explained, “Mariana is starting to get on my nerves. Every time
talking with her.”
we office managers get together, she just complains all the time. I am beginning to dread
Mariana had earned an associate’s degree in medical assisting 15 years ago, and
she had been a clinic office manager for over 20 years. She liked to run the office the way
she had been taught at the local university. “If it isn’t broken, don’t fix it” was her motto. She
knew that Alfred’s plan was designed to make the offices more efficient, but she did not un-
derstand why he wanted to change everything she had been doing for many years. He had
never asked for her opinion, even though she had a lot of experience and on-the-job train-
ing. Furthermore, she knew what worked. She was exasperated by his decision that the
clinic needed a central patient database. What was wrong with the current system, in which
each clinic followed its own protocol regarding patient files? Why change what works?
CHANGE IS CONSTANT
Alfred Lockhart needed to get Mariana Buchanan on board. But how could he convince this “old-
timer” it was time to change? Alfred had been the business manager at the Wasatch Primary
Healthcare Clinics (WPHC), a consortium of three clinics that serve five counties in Utah, for nine
months. WPHC had hired him as soon as he had earned his MBA with an emphasis in healthcare
management, and the clinic physicians had encouraged him to introduce efficient office man-
agement protocols to their three clinics. Changing reimbursement schedules of insurance con-
tracts and rising operation costs had sent them in search of ways to cut costs without a negative
effect on current operations. Some of the physicians advocated purchasing new equipment; oth-
ers wanted to raise the clinic staff’s salaries. All of the physicians agreed that Alfred’s efficiency
measures should align with their clinic mission: Be responsible to the patient, be responsible to
the staff, and provide excellent primary care for the people of Utah. Alfred had started his job with
enthusiasm and confidence that he could help create efficiencies that achieved the physicians’
vision of keeping pace with technology and raising staff salaries.
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