Theoretical Models of Change Thereare various theoretical models that have been developed over the years regardingorganizational change processes, and these have been applied differentlydepending on the specifics of the organization in need of change. Theoreticalmodels of change include among others; The action research model, Lewin’s threestep model, Schein’s extension of Lewin change model, Kotter’s strategic eightstep models, and Shield’s five step model. Given that each of these highlightedtheories have specific contexts in which they can work, Shield’s model and Actionresearch will be the appropriate model in this organizational change contextcollectively as these models work best when the change is aimed at enhancingand improving process and human aspects of the organization as well asinnovation, in which case this applies to technological changes here.

Actionresearch will focus on the possible challenges to the intended change in thecase of Xanda Hospital, while Shields five step model focuses on the human andcultural aspects of organization.  Shield’s theory of change builds on theidea that change fails because of insufficient attention to the human andcultural aspects of organizations as well as innovations Pryor, et al. (2008).Shield submits that there are serious components that are necessary for leadersto change an organization. They posit that, if a change occurs in one componentand one does not align the other components, this leads to inefficient workprocesses. Essentially, the model system combines human resources managementwith business process innovations. Shield further suggests that leaders who areconsidering change should clearly understand what they want to change anddefine significant features to know the degree to which the anticipated changeis possible.

This is very significant in organizational change process. Additionally,organizations must make efforts to communicate the strategic objectives to the employees.Otherwise, without doing this, the change effort will be simply a series of unrelatedchange activities.

Lastly, Pryor,et al. (2008) observed that to identify the degree of alignment insupport of the organizational strategy, organizational leaders must assess eachof the work elements involved. Hence, he suggested five steps to accomplishchange: 1) Define the desired business results and change plans; 2) Createcapability as well as capability to change; 3) Design innovative solutions; 4) Developand deploy solutions; and 5) Reinforce and sustain business benefits.Actionresearch is a change process based on the systematic collection of data andselection of a change action based on what the analyzed data indicate (Robbins,Judge & Vohra, 2012). This method provides a scientific methodology formanaging planned change and consists of five steps (that closely match thescientific method): diagnosis, analysis, feedback, action, and evaluation.

Thechange agent begins by gathering information about problems, concerns, andneeded changes from members of the organization, like physicians, and asksquestions, reviews records, and interviews employees and listens to theirconcerns. This is followed by analysis which looks at problems people have andthe patterns they take. The agent summarizes information into key concerns,problem areas, and possible actions. In this model, people who participate in thechange program help to identify the problem and determine the solution (Robbins,Judge & Vohra, 2012).

Hence, feedback stage requires sharing with employeeswhat has been found from the initial steps. The employees then develop actionplans for bringing about the needed change, aided by the change agent. Theemployees and the change agent carry out the specific actions they haveidentified to correct the problem. The final step is evaluation of the actionplan’s effectiveness, using the initial data gathered as a benchmark. The bestpart of action research is that it is problem focused, that is, the agentobjectively looks for problems, which then determine the action taken to solveit, and that the model also engages employees in the process which greatlyhelps reduce resistance to changeWhilethe highlighted theories serve as the selected model for the intended change atXanda hospital, other models though applicable may not help adequately andeffectively achieve the desired change given the initial unwillingness by thehospital stuff in the past few months to reluctantly adopt and implement thenew technological change. For instance, despite being a good model, Kotter’smodels is designed to be used at the strategic level of an organization tochange its vision and subsequently transform the organization, where as our intendedchanged is not intended to change the vision but the processes of operations.

Sufficeto state that the chosen models do not necessarily imply they are the onlycorrect ones but primarily intended to ease the process of implementing changein Xanda hospital and to highlight their relevance in the current situation. Toextensively comprehend organizational change process to be addressed in thisorganization, it is worth learning from various organizations that have gonethrough similar changes as well as those involving technology changes, thatmaybe of interest as we anticipate the changes to occur at Xanda Hospital. In aresearch conducted by Gerdin, et al. (2010), they studied the change to implementa new a technology called Visual Planning (VP) in one of the units of a leadingconstruction company in the Nordic region called Construction Sweden.

VisualPlanning is a new project management tool in which activities and question areposted on a virtual wall enabling higher visibility where all the involvedworkers can know when and where their contribution fits the over-all plan, andare updated on current focus in the project. The purpose was to enable a highsense of commitment and morale and increase effectiveness through the newtechnology which was aimed at providing a leaner and effective operation of thecompany. overtime, they observed improvements in the process though not withoutchallenges.  Ina study by Bates, et al. (1998) on the impact of computerized physician orderentry (CPOE) on medication error prevention in hospitals in the US in Bostoncity, they demonstrated that CPOE reduced human error rates by 55% from 10.7 to4.9 per 1000 patient days when the technological changed was implementedcompared human performance.

Computerized physician order entry (CPOE) systemsare electronic prescribing systems that intercept errors when they mostcommonly occur at the time medications are ordered. With CPOE, physicians enterorders into a computer rather than on paper. Orders are integrated with patientinformation, including laboratory and prescription data, and the order is thenautomatically checked for potential errors or problem (Bates, et al., 1999). Inanother research on the same technology being implemented, Tierney, Miller,Overhage & McDonald (1993) also identified substantial reductions inpharmacy, radiology and laboratory turn-around times, and there was a reductionin length of stay in one of the hospitals studied. This has also helped reducethe duration of stay at the hospital after the implementation of CPOE at OhioState University.  Anotherstudy conducted by Aldosari, Sadik & Al Kadi, (2017), they wanted tomeasure the level of Picture Archiving and Communication System’s (PACS) impacton its users in a hospital facility in Saudi Arabia at the KAMC-National Guardradiology department in Riyadh. PACS is the technology system that has replacedx-ray film with digital images.

The study showed that PACS has a positiveimpact on its users. PACS resolves many of the problems that were associatedwith film. Film could only be available in one place at a time and wouldfrequently result in delayed patient care if it was not immediately availableto the referring physician (Aldosari, Sadik & Al Kadi, 2017). However, withthe PACS changes, patient results could be viewed from any computer at any of thehospital facilities or from a referring physician’s office. PACS also allowsthe radiologists to read results performed at any of the facilities making themmuch more efficient and greatly reducing the turn-around time for reportdictation.


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