Theoretical Models of Change

There
are various theoretical models that have been developed over the years regarding
organizational change processes, and these have been applied differently
depending on the specifics of the organization in need of change. Theoretical
models of change include among others; The action research model, Lewin’s three
step model, Schein’s extension of Lewin change model, Kotter’s strategic eight
step models, and Shield’s five step model. Given that each of these highlighted
theories have specific contexts in which they can work, Shield’s model and Action
research will be the appropriate model in this organizational change context
collectively as these models work best when the change is aimed at enhancing
and improving process and human aspects of the organization as well as
innovation, in which case this applies to technological changes here. Action
research will focus on the possible challenges to the intended change in the
case of Xanda Hospital, while Shields five step model focuses on the human and
cultural aspects of organization.  

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Shield’s theory of change builds on the
idea that change fails because of insufficient attention to the human and
cultural aspects of organizations as well as innovations Pryor, et al. (2008).
Shield submits that there are serious components that are necessary for leaders
to change an organization. They posit that, if a change occurs in one component
and one does not align the other components, this leads to inefficient work
processes. Essentially, the model system combines human resources management
with business process innovations. Shield further suggests that leaders who are
considering change should clearly understand what they want to change and
define significant features to know the degree to which the anticipated change
is 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 unrelated
change activities. Lastly, Pryor,
et al. (2008) observed that to identify the degree of alignment in
support of the organizational strategy, organizational leaders must assess each
of the work elements involved. Hence, he suggested five steps to accomplish
change: 1) Define the desired business results and change plans; 2) Create
capability as well as capability to change; 3) Design innovative solutions; 4) Develop
and deploy solutions; and 5) Reinforce and sustain business benefits.

Action
research is a change process based on the systematic collection of data and
selection of a change action based on what the analyzed data indicate (Robbins,
Judge & Vohra, 2012). This method provides a scientific methodology for
managing planned change and consists of five steps (that closely match the
scientific method): diagnosis, analysis, feedback, action, and evaluation. The
change agent begins by gathering information about problems, concerns, and
needed changes from members of the organization, like physicians, and asks
questions, reviews records, and interviews employees and listens to their
concerns. This is followed by analysis which looks at problems people have and
the patterns they take. The agent summarizes information into key concerns,
problem areas, and possible actions. In this model, people who participate in the
change program help to identify the problem and determine the solution (Robbins,
Judge & Vohra, 2012). Hence, feedback stage requires sharing with employees
what has been found from the initial steps. The employees then develop action
plans for bringing about the needed change, aided by the change agent. The
employees and the change agent carry out the specific actions they have
identified to correct the problem. The final step is evaluation of the action
plan’s effectiveness, using the initial data gathered as a benchmark. The best
part of action research is that it is problem focused, that is, the agent
objectively looks for problems, which then determine the action taken to solve
it, and that the model also engages employees in the process which greatly
helps reduce resistance to change

While
the highlighted theories serve as the selected model for the intended change at
Xanda hospital, other models though applicable may not help adequately and
effectively achieve the desired change given the initial unwillingness by the
hospital stuff in the past few months to reluctantly adopt and implement the
new technological change. For instance, despite being a good model, Kotter’s
models is designed to be used at the strategic level of an organization to
change its vision and subsequently transform the organization, where as our intended
changed is not intended to change the vision but the processes of operations. Suffice
to state that the chosen models do not necessarily imply they are the only
correct ones but primarily intended to ease the process of implementing change
in Xanda hospital and to highlight their relevance in the current situation.

To
extensively comprehend organizational change process to be addressed in this
organization, it is worth learning from various organizations that have gone
through similar changes as well as those involving technology changes, that
maybe of interest as we anticipate the changes to occur at Xanda Hospital. In a
research conducted by Gerdin, et al. (2010), they studied the change to implement
a new a technology called Visual Planning (VP) in one of the units of a leading
construction company in the Nordic region called Construction Sweden. Visual
Planning is a new project management tool in which activities and question are
posted on a virtual wall enabling higher visibility where all the involved
workers can know when and where their contribution fits the over-all plan, and
are updated on current focus in the project. The purpose was to enable a high
sense of commitment and morale and increase effectiveness through the new
technology which was aimed at providing a leaner and effective operation of the
company. overtime, they observed improvements in the process though not without
challenges.  

In
a study by Bates, et al. (1998) on the impact of computerized physician order
entry (CPOE) on medication error prevention in hospitals in the US in Boston
city, they demonstrated that CPOE reduced human error rates by 55% from 10.7 to
4.9 per 1000 patient days when the technological changed was implemented
compared human performance. Computerized physician order entry (CPOE) systems
are electronic prescribing systems that intercept errors when they most
commonly occur at the time medications are ordered. With CPOE, physicians enter
orders into a computer rather than on paper. Orders are integrated with patient
information, including laboratory and prescription data, and the order is then
automatically checked for potential errors or problem (Bates, et al., 1999). In
another research on the same technology being implemented, Tierney, Miller,
Overhage & McDonald (1993) also identified substantial reductions in
pharmacy, radiology and laboratory turn-around times, and there was a reduction
in length of stay in one of the hospitals studied. This has also helped reduce
the duration of stay at the hospital after the implementation of CPOE at Ohio
State University.  

Another
study conducted by Aldosari, Sadik & Al Kadi, (2017), they wanted to
measure the level of Picture Archiving and Communication System’s (PACS) impact
on its users in a hospital facility in Saudi Arabia at the KAMC-National Guard
radiology department in Riyadh. PACS is the technology system that has replaced
x-ray film with digital images. The study showed that PACS has a positive
impact on its users. PACS resolves many of the problems that were associated
with film. Film could only be available in one place at a time and would
frequently result in delayed patient care if it was not immediately available
to the referring physician (Aldosari, Sadik & Al Kadi, 2017). However, with
the PACS changes, patient results could be viewed from any computer at any of the
hospital facilities or from a referring physician’s office. PACS also allows
the radiologists to read results performed at any of the facilities making them
much more efficient and greatly reducing the turn-around time for report
dictation.

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