Health care delivery in the United States is currently undergoing substantial changes to address issues of cost, quality, and access. I developed the first version of this slide in 2012 and have been updating it as new trends are identified. I’m curious to see how many of the “Future State” items will become “Current State” over the next 5 years.
How Can Leaders Facilitate Organizational Learning?
Organizational learning is vital to surviving (and thriving) in a rapidly changing business environment. Thus, business leaders should strive to create conditions that facilitate organizational learning. Yukl (2009) provides several examples of approaches leaders can undertake to encourage organizational learning, including (p. 50):
- Encourage people to question traditional methods and look for innovative new approaches that will be more effective.
- Articulate an inspiring vision to gain support for innovative changes from members of the organization.
- Encourage and facilitate the acquisition of skills needed for collective learning by individuals and teams.
- Strengthen values consistent with learning from experience and openness to new knowledge, thereby helping to create a learning culture in the organization.
- Help people develop shared mental models about cause-effect relationships and the determinants of performance for the team or organization.
- Encourage social networks that will facilitate knowledge sharing, collaborative development of creative ideas, and the acquisition of political support for innovations.
- Help people recognize when important learning has occurred and to understand the implications for the team or organization.
- Gain external support and financing for major initiatives involving the acquisition or application of new knowledge (e.g., acquisitions or joint ventures).
- Encourage experiments to gain more knowledge about the likely effects of changes before implementing them on a large scale in a way that cannot easily be aborted.
- Encourage teams to conduct after-activity reviews to identify effective and ineffective processes.
- Develop measures of collective learning and knowledge diffusion to assess how well it is accomplished and identify ways to improve it (learning how to learn).
- Encourage people to acknowledge when a new initiative is failing and should be aborted rather than continuing to waste resources on it.
- Create decentralized subunits with considerable authority to pursue learning and entrepreneurial activities in a responsible way.
- Develop, implement, and support programs and systems that will encourage and reward the discovery of new knowledge and its diffusion and application in the organization.
References
Yukl, G. (2009). Leading organizational learning: Reflections on theory and research. The Leadership Quarterly, 20, 49-53.
Goals of Successful Change Management
Holden, et. al. (2008) provides one of the more comprehensive lists of goals for successful change management. They include (p. 461):
- Develop a change that fits the organization and its needs, and implement it in a fitting way
- Be able to anticipate future problems/barriers and deal with them effectively
- Build a shared, agreed-upon understanding of the change
- Create an awareness of the change such that all key stakeholders are accurately informed
- Reduce fear and uncertainty
- Plan and implement a high-quality change that will be useful, ‘‘user-friendly,’’ and compatible with the current state of affairs—and promote it as such
- Ensure justice in all that is done
- Manage employees and management reactions including receptivity, resistance, commitment, cynicism, stress, buy-in, and trust
- Ensure that workers are satisfied and make (effective/efficient) use of the change
- Ensure that the change has a positive net benefit for individuals and the organization
- Institutionalize change and secure lasting commitment
- Learn from successes and failures, and adapt as needed
- Demonstrate to stakeholders that change was worthwhile
References
Holden, R.J., Or, C.K.L., Alper, S.J., Rivera, A.J., & Karsh, B.T. (2008). A change management framework for macroergonomic field research. Applied Ergonomics, 38, 459-474.
30 Principles of Successful Change Management
Holden, et al. (2008) synthesized the literature on organization-level change to develop 30 principles of success change management efforts. They include:
Principle 1. Successful organization-level change requires a holistic, systems approach. This means paying attention to all levels of the system including macro-level elements such as culture, management, and the environment, as well as to the interaction-rich system as a whole.
Principle 2. Change is dynamic, and thus change management will occur over time, either in spurts and episodes or continuously. There is a need for sustained effort, repetition, and iteration.
Principle 3. Efforts must be made to consider the existing politics and culture of the organization and its units. Change agents must know of and partake in the dominant customs and rituals of the culture in order to fit in and to please key political players.
Principle 4. Change agents must scan the system internally to gain an understanding of the organization’s structure, culture, workflow, policies, procedures, internal stakeholder demands, and intra- and extra-organizational boundaries.
Principle 5. Internal system scans will identify differences between units within the organization that need to be considered in the implementation; if differences are great, separate implementation plans may need to be tailored to individual units.
Principle 6. Change agents must scan the external environment to identify the external (e.g., market, legislative, public opinion) forces and stakeholders who will affect and be affected by the change. Stakeholder demands must be identified.
Principle 7. Benchmark the successful changes of other organizations to identify how one’s own change process can be improved.
Principle 8. Gauge the organization’s readiness for change, focusing on individuals’ early beliefs, attitudes, and intentions vis-a` -vis change. Every effort should be taken to select organizations or units that are ready, or else to ready them.
Principle 9. Form a powerful team that includes individuals who have power in terms of titles, reputations, relationships, knowledge, and interpersonal skills. Education and encouragement should be aimed at securing a shared vision, commitment, and appropriate teamwork.
Principle 10. A competent, dynamic change leader will serve as the face of the change and will play many roles. The individual chosen for this must have the highest possible technical and interpersonal skills in order to lead the change, manage the change, or consult the change team.
Principle 11. Identify and make contact with informal employee leaders who can champion the change, lead fellow employees, and generally act as a bridge between change agents and internal stakeholders.
Principle 12. Identify opinion leaders and their attitudes toward the change; promote these individuals’ positive feelings toward the change and address their concerns before they spread throughout the organization.
Principle 13. Whenever possible, involve employees in the design and implementation of change, being careful to train employees appropriately on the competencies needed for successful participation (e.g., teamwork, information on how to design and implement changes).
Principle 14. Follow-through on all of the planning done ahead of time, while keeping in mind that unanticipated predicaments will require problem solving and improvisation.
Principle 15. Develop structured plans, including timelines, planned outcomes, contingency plans, and an explicit purpose and vision statement.
Principle 16. Establish specific, achievable, and measurable desired outcomes.
Principle 17. Create an agreed-upon vision statement that is clear, concise, and specific enough to guide the entire change process.
Principle 18. Make a positive initial impression and continue to reinforce it throughout.
Principle 19. Participating in the change must be perceived to maximize the benefits that are relatively important to individuals and to minimize costs unless the costs are relatively unimportant. The key cost-benefit perceptions may be related to the usefulness and ease of participating in the change.
Principle 20. Participating in the change must be perceived as encouraged by individuals who matter, be they coworkers, managers, clients, regulatory agencies, or any other important groups or people.
Principle 21. Participating in the change must be perceived as being under volitional control and individuals must be convinced that they have the ability to participate successfully.
Principle 22. Make the individuals who are deciding whether to adopt the change aware of the positive characteristics of the change, including relative advantage, compatibility, trialability, low complexity, and many others.
Principle 23. Openly and persuasively communicate all positive and negative aspects of the change through all possible channels.
Principle 24. The design and implementation of the change must actually have the positive characteristics associated with acceptance.
Principle 25. Design all interactions within the organization to convey fairness in how the change process was conducted.
Principle 26. Manage individuals’ stress responses by being open and honest, providing adequate and relevant information, showing gratitude, and generally conveying an impression of psychological safety.
Principle 27. Provide the skills, training, freedom, information, financial support, and tools, which are all necessary for individuals to be able to successfully take part in the change.
Principle 28. Secure and maintain management support throughout the change effort.
Principle 29. Although short-term wins are important, change must be sustained over the long term.
Principle 30. Evaluate and continuously refine the change effort.
References
Holden, R.J., Or, C.K.L., Alper, S.J., Rivera, A.J., & Karsh, B.T. (2008). A change management framework for macroergonomic field research. Applied Ergonomics, 38, 459-474.