Organizational Transformation Issues In A Health Care Clinic

CONTENTSPages ASSIGNMENT BRIEF 2 EXECUTIVE SUMMARY 3 GLOSSARY OF TERMS 4-5 1. 0. INTRODUCTION 6 1. 1. OBJECTIVES 7 1. 2. METHODOLOGY 8 2. 0. LITERATURE REVIEW 9-25 3. 0. ANALYSIS 26-30 4. 0 REFLECTION 31 REFERENCES BIBLIOGRAPHY ASSIGNMENT BRIEFORGANIZATIONAL vicissitude ISSUES IN A HEALTH CARE CLINIC (CASE STUDY). EXECUTIVE SUMMARY This paper is ground on the theme need Organizational Transformation in a Health C be Clinic w here direction, is the many ecesisal transformational emergences that bind space during an presidential termal victimisation and transformational reposition of the Health C atomic number 18 Clinic. fit to Anderson and Ackerman (200139-40 & 50), transformational adjustment is defined as a completely rude(a) way the physical composition and its great deal chitchat the world, their customers, their do work and themselves. For brass instrumental deepen to be successful the procedure would use up variety shows that would affect employees behavio ur, how they think and the musical arrangements culture thus education many transformational sequels much(prenominal) as forgetership issues, communication issues, formulation and tuition issues, and heathen issues. GLOSSARY demeanoursThe way in which plurality in the organization act in terms of what they do and say that brings the strategy and craved culture to life ControlsWhat gets measured and rewarded channelise To alter, modify or transform CultureThe congeries of tenderly transmitted behavior patterns, arts, beliefs of an institutions FacilitateTo make something easier to do GoalsThe objectives or bottoms that the organization is trying to get LeadershipThe ability to guide, direct and influence persons centeringPersons in cathexis of organizing and controlling the affairs of a business or a celestial sphere of a business MissionThe purpose of the organizationOrganizationA body of persons organized for some particular(prenominal) purpose Organization incre ase (OD)A primarily behavioural science border on to mean organizational turn that is composed of traditional OD and inject OD ( Krell 1981) Organizational Transformation (OT)Change that involves transformative transposes in the fundamental constitution of the organization and requires completely new ways of thinking, behaving and perceiving by members of the organization Realignment To readjust or permute something to fit assorted circumstances StrategyThe approach that the organization is adopting to get through the goals that support the strategy ValuesThe underlying principles and ethics that drive the organization passel A picture of a desired future state that is sufficiently appealing and compelling to drive compound forward 1. 0. INTRODUCTIONORGANISATIONAL TRANSFORMATION groundwork be defined as a fundamental shift key in the way business delivers clipping value to its customers and s plowholders resulting in dramatic sort strategy, goes, engineering scie nce and utilisation and management of human re computer addresss to meet the inevitably of the world(prenominal) economy. ORGANISATIONAL DEVELOPMENT is a system wide application and conveyancing of behavioural science knowledge to the planned increment, improvement and livelihood of the strategies, complex body parts and growthes that lead to governing bodyal effectiveness. Many organizations of today go done inter ex departs because of circumstances, wanting to be lessen more(prenominal) developed and/or advanced or simply because of wanting to give the axe with the time.Management of the health assist clinic initiated an organizational development programme because of problems originating from the application of new-made engineering science to the mull overs of health check technologists. It was discovered that employees of the bio alchemy department were greatly dissatisfied because of their odour of having their skills underutilized, having cultural differences with opposite rung members, having communication barriers and non having logical argument contests present. The organizational development staff and the manager agreed that craft re objective should take place to bring more autonomy, control, feedback and meaningfulness to the work for the employees of the clinic.Over a period of two years evaluation of the results by the organizational development staff build that line of work characteristics and satisf bodily process declined for both concourses that were involved in the transformational change process. changing surrounds of an organization has effect on the organization and the organizations environment thus creating many transformational issues. Transformational issues embarrass leading issues, cultural issues, communication issues, cultural issues and formulation and development issues. 1. 1. OBJECTIVES 1-To identify the organizational transformational issues that argon involved in the change in the health fore boding clinic 2-To evaluate change executing and intervention strategies at a health care clinic. 1. 2. METHODOLOGYThe police detective in the context of this case study has opted to use the phenomenological approach as unlike to a positivistic approach (Collis and Hussy 2003). Triangulation-the use of more than one mode or source of selective education in the study of a phenomenon so that findings washbasin be cross checked Bryman (2008 pg. 700) Triangulation method of entropy collection provide be used stack away soft and quantitative data from both primary and secondary sources for example utilise unstructured questions and interviews. A variety or books, theoretical and analytical tools and techniques leave behind be used. The research conducted being a case study the data collection pass on be consequence on the evidence as purposeed in the case study. Random sampling s pop the questioned by Saunders et al fecal matter non be validated, in that for quantitative research the sample size essential be of at to the lowest degree 95% in order to notice realistic or quantifiable data and it whitethorn be atrocious and slight accurate to do otherwise. 2. 0. LITERATURE REVIEW The core issues which result guide the facilitation of policy development, plans and programs for the organisational result include the under mentioned factors Lewins(1951) force land analysis demonstrates the two key external forces that push organisations into change topographic prognosticates save counteracting, resisting forces are often arisen from inside organisations when the changes are attempted and that change occurs when the crusade forces out number resisting forces.This force field is propagated on the idea that social situations crumb be agnizen as equilibria that are periodically disturbed when changes to the situation are attempted. The concept of change as modification of these forces keeping a systems behaviour stable. The two groups of forces are those striving to state the status quo and those pushing for change. A state of quasi-stationary equilibrium as coined by Lewin(1951) is achieved when both sets of forces are almost equal and current behaviours and attitudes are maintained. FIG. 1 BELOW REFERS. Kurt Lewin (1951) set collar stages of behaviour modification in a simplistic change management ensample is seen in the table 1 below. LEWIN(1951)THREE STAGE focal point TABLE. (TAB. ) UnfreezingIs concerned mainly with selling the change and provides a motive for groups and separates to change their attitudes, systems, behaviours values and structures. The unfreezing stage will be greatly accelerated if it is recognised that the need for change is immediate, clear and the survival of the organisation depends upon it. MovingIs concerned with recognising what the new attitudes and desirable practise, norms and behaviours should be and communicating it and advance others in the organisation to embrace and own it as new play needfuls. This reflection rear occur through assimilation and exposure to new concepts or from idiosyncratics with dissimilar perspectives. RefreezingThis stage is the final and stabilising stage of the change implying reinforcement of the new behaviours.Evoking cocksure reinforcements such(prenominal)(prenominal)(prenominal) as rewards and praise. For negative reinforcement such as sanctions for indiscipline or deviant attitudes. SourceMullins,Laurie J. (1997) Management and Organisational Behaviour 9th. Edition. FT/ learner Hall . Again, Lewin(1951) suggested that for change to be successful on that point must(prenominal) be group activity. Unless group norms are transformed at that place will be no sustenance to exclusive proceedings and without reinforcements change washbasin be short-lived. Employees are beginning to accept that the time has come for change and the changes must be made so that the organisation can lie viable. Schein (1988) clay sculptur e of change outlined the pivotal role of the change agent.Schein (1988) represented each stage of Lewins (1951) model by expressing the dynamics of individual change and how imperative it is for change agent to manage these changes (see table 2 below) the change agent can be seen as the coach, facilitator and motivator assisting individuals through the change can be seen as the coach, facilitator and motivator assisting individuals through the change. agree to Scheins(1988) model the first stage the change agent assists with motivating the individual by disconfirming their behaviours, attitudes and executeance. Stage two emphasises the need to get employees to perform tasks differently and in reality engaging belief that changing norms and working habits can effectively improve their performance.At Stage trine the change agent dish outs the employee to change his thought patterns by integrating new and easily defined behaviours. self conceptualisation and reinforced performa nce standards are confirmed. Schein (1988) believes that none of these stages are nonresistant to self management unless need the intervention of change agents. In stillance, cummings and Worley (2005) planned change concept outlined how change can be implemented in organisations. This action research model places difficult emphasis on gathering and diagnosing data prior to action planning and implementation and on assessment of results after action is taken. The action research model describes change as a cyclical process involving joint activities amid employees and organisational ractitioners. Figure 2 below compares Lewin (1951) change model to other models of planned change such as the positive model and the action research model all of which describes the phases by which planned change occurs in organisations. Initiation of successful organisational change modified restructuring strategies and organisational efficiencies can be envisaged through these theories. In this mo del many misuses overlap and act in practise. This simple model has been used to analyse and manage change and can be useful at times. However, it tends to treat mass as the objects of manipulation and does not involve them in the change process at all.All three approaches emphasises the application of behavioural science knowledge, involve organisation members in the change process to varying degrees and recognise that the interaction between an organisation and a consultant constitutes an intervention that affects the organisation. Lewins(1951) change model approach differs from the other two models in that it deals with the general process of planned change whereas the others target specific organisational development(OD) activities. To manage strategical change effectively, it is important to understand its causes. deuce main classifications of the causes of change are outlined by the following theorists 1) Tichys(1983) four main causes of strategic change 2) Kanter, Stein and Jicks(1992) three dynamics for strategic change. According to Tichy (1983) four main triggers for changeTICHY(1983) TRIGGERS FOR CHANGE Environment- shift in the economy, competitive pressures and legislative changes can lead to demands for strategic change. Business relationships-alliances, acquisitions, value chain linkages or core competencies. Technology People-new entrants whitethorn feature different educational or cultural backgrounds or expectations that require change. SourceMullins, Laurie,J. (1997) Management and Organisational Behaviour 9th. Edition FT/ apprentice Hall. (TABLE 3) Tichy(1983) suggests that change is not and needed in such circumstances scarcely can be managed to produce effective results. Kanter, Stein and Jick(1992)identified three causes of strategic change Environment-changes here compared with the situation in the organisation can lead to demands for strategic change.Life musical rhythm differences-changes in one partitioning or part of the organisation as it moves into a phase of its life cycle that is different from another division may necessitate change. Typically, change issues related to the size, shape and influence of such parts and involve coordination and resource allocation issues between them. Political fountain changes inside the organisation-individuals, groups and other stakeholders may struggle for force-out to make decisions or enjoy the benefits associated with the organisation. For example, shifts in strategy from production oriented to customer oriented would be accompanied by a shift in the power balance between those two functions.The researcher suggested that the causes were constantly shifting, sometimes late and at other times faster. Kanter, Stein and Jicks(1992) theory can be directly related to the Health care clinic as the organisation go through the process of change as it relates to the external environment changes so too must the organisation, as one part of the organisation change s o too must other parts of the organisation change to catch up. Internal and external factors influence changes. Kanter, Stein and Jick (1992) identified three major forms taken by the change process. They linked these three categories of people involved in the change process, to produce a three stage process for managing change.These three forms were 1)The changing identity of the organisation. 2)Coordination and transition issues as an organisation moves through its life cycle. 3)Controlling the political aspects of the organisation. The three major categories of people involved in the change process I. Change strategists-those responsible for star strategic change in the organisation. They may not only be responsible for implementation. II. Change implementers those who hold direct obligation for change management. III. Change recipients- those who receive the change programme with varying degrees of anxiety depending on the nature of the change and how it is presented.Kanter, Stein and Jick(1992) offer one way of structuring and managing aspects of the change process. However, these categories of people only give limited indicators of how to manage the process. Kanter, Stein and Jicks(1992) model may be suited to major changes than the more common ongoing process. According to Cummings and Worley (2005) there are five major activities involved in order to lead and manage change and they are done in the order in which they are performed. These in order of priority are ? Motivating change. ?Creating a vision. ?Developing political support. ?Managing the transition. ?Sustaining momentum. A major point to note is that in this model, overcoming opposite to change is required early in the change.The change process in the organisation can be sternly affected by subway to change. People tend to very unwilling to move from their perceived comfort zone to some unforeseen place as it relates to change thereby begging the questions of whether their contri simp lyions will mean anything for them in the future. Albrecht (1983) provided an interesting model of change in which organisations undergo the change cycle. Individuals in any case experience symptoms of change response cycle. This cycle is prevalent when change is set(p) or imposed by management and internal and external forces. ( put off 4 below refers. ) (TABLE4) SourceCummings, Thomas G. nd Christohper G. Worley,(2005) Organisation Development and Change 8th. Edition-,Thomson Southwestern. The six box model of change was introduced by Weisbord (1978) as a diagnostics tool to measure organisational effectiveness and looks at the inter-related elements at bottom the organisation. Purpose. Is the representation of the organisation and an understanding of the employees agreement and commitment to it. Leadership.. Includes the behavior and integrity of the employee and their ability to be goal oriented. Structure . -Displays the organisational chart, reporting styles and systems, suppose responsibility and delegation of authority Relationship. Are those of the employees in the organisation unneurotic with their norms, behavioural patterns, conflict management and their degrees of inter dependence Rewards. -Represent what the organisation inescapably to rewards both in real and psychological terms and include incentives for doing the near thing Helpful Mechanisms. -Are the different and varied formal procedures and management systems that monitor lizard and coordinate the organisations work. . According to Kotter(1995) there are eightsome steps to transforming an organisation. SourceCummings, Thomas G. and Christohper G. Worley,(2005) Organisation Development and Change 8th. Edition-,Thomson Southwestern.Kotter(1995) suggests that for change to be successful 75% of the companys management needs to buy into the change and really work hard at step and spend significant time and energy building urgency in the lead moving into the other steps. Dont panic and jump in too fast because you dont want to risk further short term losses, if you act without being properly prepared, you could be in for a bumpy ride As a result of change many times there is the issue of conflict arising. Conflict is inevitable just as change and assuming that organisational goals are broadly dersiable , there are two aspects of conflict that are relevant and leadinghip must take cogniscance of. According to Hunt (1986) conflict can be extremely desirable, it can energise relationships and clarify issues. Conflict can be plastic as well as destructive. the constructive effects of conflict are hat it can introduce different solutions to problems, power relationships can be defined more clearly,it can encouragecreativity and testing of ideas,it focuses attention on individual contributions, it brings emotions out in the open and it provides opportunities for the release of hostile feelings that may have been, or may be, repressed otherwise. Conflict can have negative effects as it may distract attention from the task, it can polorise views and fall away the group, odjectives may be subverted in favour of secondary goals,it encourages defensive or spoiling behaviour,it may result in the disintegration of the group and it can foster emotional, win-lose within the group. duty design involves the planning of the job. This includes its contents, the methods of performing the job and how it relates to other jobs in the organization (Rahim 2001).Job design and redesign main focus is to put together the needs of the employees that are involved in the different jobs with the production necessitate of the organization in mind. One of the main aims of job redesign is to supply the organizations workers with significant work that fit effectively into the period of the organization. Enriching, enlarging or simplifying are as well as goals of job redesign. For the improvement of performance job redesign theory focuses on, job rotation and job en largement. As in the case it was shown that the general feeling of the employees of the clinic was that there was an absence of job challenge and that technology had alter the work to be done.According to Herzbergs theory of motivating, workers motivation to work depends on the nature of the work and how challenging it is. Lack of this challenge will allow employees to become disenchanted with their job thus having a negative pretend on organizational transformation. Having job challenges will help in motivating the employee to work. Adair (2004) believes that motivation comes from within a person but is fuelled by external factors eg. having work challenges to be able to align themselves to achieve a specific goal, (the goal being a challenge but yet it is attainable by the employee). Job rotation where the employees will be allowed to work on different tasks or in different departments.This will increase job satisfaction and would have helped the employees as they would have ha d the opportunity to perform different tasks, thus inhibiting boredom on the job. Learning will to a fault take place as employees also learn new tasks and have different responsibilities with job rotation. Job enlargement whether horizontal or vertical would also lead to a more successful organizational transformation as it would also help in giving the employees a challenge as they will have more to do. Time is also drawn-out so that the challenge of doing more is realistic. Self esteem will be contributed to as the employee would be entrusted with exercising judgement thus having added responsibility for tasks.Job design and redesign is mainly done by the management of the organization who are responsible for making decisions about how to design those jobs ( Mintzberg 1973) as they see fit. Although managers would have more influence and control over job design than they do over structure, technology, culture, relationships and people ( Hackman & Oldham 1980), the time and atte ntion of managers would still be greatly needed (Dutton & Ashford, 1993). Pfeffer(1994) believed that the depending on how managers make decisions about job design, it can be a liability or a potential source of competitive advantage for organizations however, many managers often use simplified work as the default approach to designing jobs (Campion & Stevens, 1991). 3. 0. ANALYSIS/FINDINGSThe researcher in her analysis of the case study of the particular health care clinic desire to ascertain where the problems were and attempts to ascribe the requisite solutions. There were certain strengths as well as considerable weaknesses associated with the case study. It was found that Lewins(1951) models were followed to the letter in the structure of this health care clinic and that factors outside these frameworks were not used thereby creating straightforward gaps. TECHNOLOGY Tichys(1983) four main triggers of successful strategic change identifies technology as an important driver in the change. As is the situation in the case study it was found that with the advent of new modern technology strengths as well as weaknesses are abound.The medical technologists in the bio chemistry department were either inept with the new technology or were not prepared for the imposition of the new technology thereby dissatisfaction was wide spread, which can be seen as another weakness. Technological shifts can substantially impact on the quality or content of the work and may finally influence the factors that affect survivability of the organisation. SOURCES OF DISSATISFACTION Paragraph 2 of the case study identifies some(prenominal) sources of dissatisfaction among the technologists that were of concern. The under mention identifies the concerns together with the possible cause and effect and in all probability solutions. Under utilisation in their work-this can be seen as a weakness in the organisation and could have been possible as the OD staff failed and or neglected t o take into consideration issues such as job design and redesign RAHIM (2001), job rotation, job enrichment, job enlargement and job evaluation on employees at the health care clinic. Communication within the laboratories was insufficient-it is apparent that the communication channels between laboratories were severed or perhaps were insufficient. As such the OD experts should have embarked on team building workshops and organisational development seminars and sufficient enough training and development exercises. Work wasnt evenly distributed- this would suggest that there was a certain lack of supervision in the laboratories and there was a also-ran to have equity distribution in assignment and management of tasks. The issues of expertness management and production planning are areas that OD experts should have looked at. medical exam staff didnt treat them with the respect that they deserve-this clearly suggests that the medical staff felt that the technologists were their subo rdinates and felt that way because the technologists may be less remunerated as compared to the medical staff. As such OD staff should take into consideration issues such as reward management systems, chastity recognition eg. Employee of the month, performance pays system, team based pay and a broad performance related merit system of remuneration. The advent of technology had had simplified the work to the point that it no longer seemed to require the level of training common among medical technologists-this would suggest that technologists should have had enhanced training in other skill sets or multi skill training which would give them the extended capacity to build manpower capacity. Studies in personnel management publications-there is no such evidence in the case study to suggest that there were any studies in the personnel management literature carried out. Job challenge was a primary cause of job turnover-this is an issue really of job retention as opposed to job attriti on. By looking at performance appraisal strengths and weakness can be determined.In looking at job turnover OD require job retention, job security and career and talent management. LEADERSHIP The art of leadership is saying no, not yes. It is very easy to say yes. (TONY BLAIR, 1994) Are leaders born or made? Trait (1950) theory seems to suggest that leaders are born and not made, yet Stodgill(1949) and Mann (1959) suggests that there are some relationship between the traits possessed by leaders and their performance. The Trait (1950) theory that leaders are born failed under scrutiny (Zaccaro, 2007). Kirkpatrick and Locke (1991) having examined existing literature on leadership suggests that there are six leadership traits.They are 1-Drive 2-Leadership motivation 3-Honesty and integrity 4-Self confidence 5-Cognitive ability 6-Knowledge of the business As in the case study there is no clear reading material as to the leader (Weisbord 1978) of the change process as it is reputed tha t the OD staff had discussions with the managers. clear no one took charge of the change process from the onset of the planned change. There is no evidence to suggest whether the OD staffs were adequately fitted to conduct such a change process or whether the interviews were conducted professionally. discourse Communication is a key component in the facilitation of any change process.For this reason communication is heightened importance when change is needed. Bordia et al (2004) suggests that communication during change is vital to manage employee uncertainty and feelings of loss of control. As was the case in this case study there is hardly any evidence to suggest that there was a proper reporting structure so that information on the change initiatives were being communicated to the technologists by the OD experts. To this end came the issue of the readiness for change as this is an important indicator to coping with resistance to change so suggests Armenakis, Harris and Mossho lde(1993). Communication strategies need to emphasize two messages.They are 1- The need for the change, that is, indicating what the organisation is doing as opposed to what it should be doing and 2- The ability to change successfully, that is, it is important that the employees believe that the change could be done thereby encouraging them to make the extra effort. TIMEFRAME Apart from using volunteers to assist in the analysing of the data which is in itself questionable as there is evidence that they are overworked and not properly remunerated. The OD staff administered questionnaires which asked for confidential opinion as opposed to change or job analysis questions and there is no indication of its contents. These questionnaires sought only quantitative data.Whether the truth will be create verbally on those questionnaires is anybodys guess as there is no constitution of the data. There is no clear definition as to the timeline for the project and no implementation plan. The random sampling data collecting took two months seems to be incredibly long for such an exercise. To suggest that two years subsequently the OD staff evaluated the results of the change program was incredulous to say the least as this was certainly not an effort in organisational transformation but rather an incremental change plan. This was an exercise that was limited in scope, time and cost thereby failing to meet its objectives. RESISTENCE TO CHANGEResistance to change is a astray used term that generally gives a bad or a negative connotation. It us usually asked of employees to change something in the organisation that they may have been comfortable with for their entire life. That change will not come easy at all, there will be some misgiving and fight and may even be the source of collective group action like strikes and industrial action by employees. This is not needfully a bad thing. Ford and Ford(2009) suggests that resistors to change should not be unmarked but that resistance should be taken in a positive light and accepted as a form of feedback that can actually build and encourage the change process.Pockets of resistance can also be found with the Lewin (1951) model of unfreezing, moving and refreezing. As the activity of unfreezing comes to an end resistance is usually found as employees attempt to move. This is quite natural as without proper communicating many are unsure of their future especially the employees who have fallen into their comfort zone. As with the case study there was a definite feature of resistance to change. 4. 0. REFLECTION This change process was a failure from its inception because the very basic of protocols were not adopted. The OD staff sought to enlist volunteers who do not have the requisite educational capacity to carry out that vital function of collecting and analysing data.The human resources department should have been the ones directly involved in the change process. The change agent should have been enga ged who is a highly dexterous professional in organisational development to lead the drive towards organisational transformation. In this case study the data collected would at best be unscientific and unrealistic to say the least. Change, whether planned or emergent can take a number of forms, each of which requires a different type of action. Utilising collective methods of action research together with capacity building and the will to include people in the change process will go a long way in achieving successful change.In conclusion it must be said that there are unprecedented opportunities and challenges in the health care industry for which organisational development (OD) practitioners must be aware of and as such there can be significant positive growth and development by linking strategic activities of the organisation towards the direction of organisational transformation. Organisational transformation can also be achieved by being able to facilitate integration of people and processes across traditional department and organisational boundaries and by acknowledging competencies and integrity. REFERENCES ATKINSON, P. E. (1990) CREATING CULTURAL CHANGE MANAGEMENT SERVICES VOL. 34 NO. 7, PP. 6-10.BPP PROFESSIONAL EDUCATION- ORGANISATIONS AND BEHAVIOUR SUPPORTIND FOUNDATION DEGREES, mandatory UNIT 3 P. 185.. 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