HLTH4100 Walden Organizational Change And Behavior Management Help It has been said that the only constant is change itself. That is especially true of org

HLTH4100 Walden Organizational Change And Behavior Management Help It has been said that the only constant is change itself. That is especially true of organizations. While some organizational changes are minor—only affecting a work group—others are department- and organization-wide.

The employees of an organization have varied reactions to changes. A leader needs to apply effective strategies for making the change successful.

For this Discussion, you will read a scenario and determine the best method for successfully implementing an organizational change and overcoming resistance to change.

To prepare for this Discussion:

Review the Learning Resources for this week.
Review the following scenario.

Case Study: Funding Denied

Health Abounds, Inc., is a community clinic that receives the majority of its funds from the state government. Sally, the Director of Health Abounds, discovered that the grant proposal for state funding was denied due to quality and safety problems. This denial caused her to make some difficult and overarching changes in the organization, including the following:

Instituting a new clinicwide database system to include patient records that could be accessed anywhere in the clinic. This new database is intended to reduce medical errors. It will also provide consistent information to the staff quickly and easily, allowing them to provide quicker patient care.
Requiring doctors to use laptops when consulting with patients. This approach will allow them to enter easy-to-read notes into the patients’ electronic charts, quickly find information about adverse events associated with medications, and quickly search for information in the patient history.
Requiring a week-long training program for the staff to learn the new database system, especially because some of the staff will need to learn the basics of using a computer.

Post a comprehensive response to the following:

What type of resistance might arise among the staff?
How might you, as the director of the organization, attempt to overcome the resistance?
What other consequences of implementing the change might the organization experience? Please explain. Chapter 12, “Leadership”
The authors compare the terms leadership and management. They also present various leadership
theories and the types of leadership. Methods for selecting and creating leaders also are addressed.
Additionally, the authors describe circumstances when leadership may not be necessary.
Chapter 13, “Power and Politics”
This chapter contrasts the terms leadership and power. It explores the bases of power and power
tactics, the causes and consequences of political behavior, and the ethics of behaving politically.
16 Personalities. Retrieved from https://www.16personalities.com/free-personality-test
This web site gives you the background for the Myers-Briggs Type Indicator and its uses.
This page includes a brief description of the characteristics of each of the “types” identified
by the Myers-Briggs tool and allows you to identify your own personality type.
Reinhold, R., & Poirier, D. (n.d.). Myers-Briggs personality types, your best fit type, and an
introduction to the 16 personality types-Part 1. Retrieved from
http://www.personalitypathways.com/type_inventory2.html
This is where you’ll find a more detailed explanation of the various personality types
defined by the Myers-Briggs Type Indicator.
Michaelis, B., Stegmaier, R., & Sonntag, K. (2009). Affective commitment to change and
innovation implementation behavior: The role of charismatic leadership and employees’
trust in top management. Journal of Change Management, 9(4), 399. Retrieved from
http://ezp.waldenulibrary.org/login?url=http://proquest.umi.com.ezp.waldenulibrary.org
/pqdweb?did=1919976501&sid=4&Fmt=2&clientId=70192&RQT=309&VName=PQD
This article describes a study demonstrating that charismatic leadership and trust in top
management are both positively associated with the willingness of employees to adapt and
embrace innovation.
Required Media
Laureate Education, Inc. (Executive Producer). (2010). Good Samaritan Hospital
organizational chart—Week 4: Leadership. Baltimore, MD: Author.
This week, several Good Samaritan administrators share their thoughts on what leadership
means to them in their current positions.
Video Transcripts (zip file)
Roberts, R. (Host). (2007, April 11). Exploring the psychology of the boss [Radio broadcast].
Retrieved from http://www.npr.org/templates/story/story.php?storyId=9517852
This National Public Radio program is a freewheeling conversation about the
characteristics of effective leaders and of inferior ones.
Optional Resources
Management Study Guide. (n.d.). Great man theory of leadership. Retrieved from
http://managementstudyguide.com/great-man-theory.htm
Accel-Team. (n.d.). Human relations contributors: Douglas McGregor: Theory X and Theory Y.
Retrieved from http://www.accel-team.com/human_relations/hrels_03_mcgregor.html
Learning Resources
Required Readings
Robbins, S.P., & Judge, T. A. (2017). Essentials of organizational behavior (14th ed.). Upper Saddle River,
NJ: Pearson.
Chapter 16, “Organizational Culture”
The authors compare the functional and dysfunctional effects of organizational culture on employees
and the organization. They also explain the factors that create and sustain a positive organizational
culture.
Chapter 17, “Organizational Change and Stress Management”
This chapter describes the forces that can produce important changes in organizations, including
technology, economic shocks, competition, and social trends.
Tsasis, P., & Bruce-Barrett, C. (2008). Organizational change through lean thinking. Health Services
Management Research, 21(3), 192–198. Retrieved from
http://ezp.waldenulibrary.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=rzh&
AN=2009991312&site=ehost-live&scope=site
Lean thinking is becoming pervasive in health care organizations as a means of providing a
comprehensive approach toward improving the health care process. This article provides an example
illustrating when lean thinking was used to improve efficiency, contain costs, and effect organizational
change.
Eaton, M. (2010). Making improvements stick: The importance of people over process. Human Resource
Management International Digest, 18(5), 30–35. Retrieved from
http://ezp.waldenulibrary.org/login?url=http://proquest.umi.com.ezp.waldenulibrary.org/pqdweb?did=
2082622801&sid=6&Fmt=2&clientId=70192&RQT=309&VName=PQD
This article involves how to maintain an organizational change initiative—how to make it stick. It
proposes that a top-level champion for change is extremely important, and the champion should
encourage comments about the change from the employees. The article also emphasizes that people
are more important than process in any organizational change.
Scott, T., Mannion, R., Davies, H., & Marshall, M. (2003). Implementing culture change in health care:
Theory and practice. International Journal for Quality in Health Care, 15(2), 111–118.
Implementing culture change in health care: theory and practice. International Journal for Quality in
Health Care, 15, 2 by TIM SCOTT; RUSSELL MANNION; HUW T O DAVIES; MARTIN N MARSHALL.
Copyright 2003 by Oxford University Press. Used by permission of Oxford University Press via the
Copyright Clearance Center.
This literature review analyzes some of the key debates about the nature of organizational culture and
culture change in health care organizations.
D. (2010, January). Getting the Klingons on your side. Training Journal, 33–37. Retrieved from
http://ezp.waldenulibrary.org/login?url=http://proquest.umi.com.ezp.waldenulibrary.org/pqdweb?did=
1941228791&sid=4&Fmt=3&clientId=70192&RQT=309&VName=PQD
This article offers useful advice on how to manage corporate “Klingons”, i.e. employees who “cling” to
outmoded processes and resist changes intended to introduce improvements.
U.S. Department of Veterans Affairs, Office of Research and Development. (2000, May). Organizational
change primer. Washington, DC: Author.
Read pages 1–11.
This document presents a concise and useful introduction to organizational change and how it can be
successfully implemented and managed.
Required Media
Laureate Education, Inc. (Executive Producer). (2010). Good Samaritan Hospital organizational chart—
Week 5: Organizational change. Baltimore, MD: Author.
This week, administrators offer insight into how important changes were successfully managed at Good
Samaritan Hospital.
Video Transcripts (zip file)
Optional Resources
PRNewswire. (2010, April 6). Health reform lays ground for new era of individualized care and more
patient-focused health system, says PricewaterhouseCoopers in new HealthCast report. Retrieved from
http://www.prnewswire.com/news-releases/health-reform-lays-ground-for-new-era-of-individualizedcare-and-more-patient-focused-health-system-says-pricewaterhousecoopers-in-new-healthcast-report89976312.html
Accel-Team. (n.d.). Force field analysis. Retrieved from http://www.accelteam.com/techniques/force_field_analysis.html
Adventure Associates. (n.d.). Barriers to change. Retrieved from
http://www.adventureassoc.com/resources/newsletter/nl-barriers-to-change.html
Antariksa, Y. (n.d.). OD intervention success indicators. Retrieved from
http://www.explorehr.org/articles/Organization_Analysis/OD_Intervention_Success_Indicators.html
International Journal for Quality in Health Care 2003; Volume 15, Number 2: pp. 111–118
10.1093/intqhc/mzg021
Policy Roundtable
Presenting the views of experts from around the world on policy-making as it relates to health care quality
Implementing culture change in health
care: theory and practice
TIM SCOTT1,2, RUSSELL MANNION3, HUW T. O. DAVIES4 AND MARTIN N. MARSHALL5
1
Department of Health Sciences and 3Centre for Health Economics, University of York, 4Department of Management, University of
St Andrews, 5National Primary Care Research and Development Centre, University of Manchester, UK, 22002–2003 Harkness Fellow
and Visiting Scholar, School of Public Health, University of California, Berkeley, CA, USA
Abstract
Objectives. To review some of the key debates relating to the nature of organizational culture and culture change in health
care organizations and systems.
Methods. A literature review was conducted that covered both theoretical contributions and published studies of the
processes and outcomes of culture change programmes across a range of health and non-health care settings.
Results. There is little consensus among scholars over the precise meaning of organizational culture. Competing claims exist
concerning whether organizational cultures are capable of being shaped by external manipulation to beneficial effect. A
range of culture change models has been developed. A number of underlying factors that commonly attenuate culture
change programmes can be identified. Key factors that appear to impede culture change across a range of sectors include:
inadequate or inappropriate leadership; constraints imposed by external stakeholders and professional allegiances; perceived
lack of ownership; and subcultural diversity within health care organizations and systems.
Conclusions. Managing organizational culture is increasingly viewed as an essential part of health system reform. To
transform the culture of a whole health system such as the UK National Health Service would be a complex, multi-level,
and uncertain process, comprising a range of interlocking strategies and supporting tactics unfolding over a period of years.
Keywords: change management, leadership, organizational culture, quality improvement
The management of organizational culture is increasingly
viewed as a necessary part of health system reform. In the
United Kingdom, the latest National Health Service (NHS)
reforms are based on the premise that a major cultural
transformation of the organization must be secured alongside
structural and procedural change to deliver desired improvements in quality and performance [1]. In the United
States, in the wake of high profile reports documenting gross
medical errors, policy thinking is embracing the notion of
culture change as a key element of health system redesign [2],
and there is evidence to suggest that many other OECD
(Organisation for Economic Cooperation and Development)
countries are focusing on cultural renewal as a potential lever
for health care improvement [3].
Appeals for culture change in health systems draw upon
a belief that culture is related to organizational performance.
Some studies have suggested that culture might be an important factor associated with the effectiveness of a wide
variety of organizations across a range of sectors [4–6],
including health care. For example, health care cultures that
emphasize group affiliation, teamwork, and coordination have
been associated with greater implementation of continuous
quality improvement practices [7] and higher functional health
status in coronary artery bypass graft patients [8]. By contrast,
organizational cultures that emphasize formal structures, regulations and reporting relationships appear to be negatively
associated with quality improvement activity [9]. However,
most studies suggesting a link between culture and performance are methodologically weak and their findings should
be interpreted with caution [10].
If the nature of the relationship between culture and
performance remains to be clarified, is it reasonable to plan
Address reprint requests to Dr Russell Mannion, Centre for Health Economics, University of York, Heslington, York YO10
5DD, UK. E-mail: rm15@york.ac.uk
International Journal for Quality in Health Care 15(2)
 International Society for Quality in Health Care and Oxford University Press 2003; all rights reserved
111
T. Scott et al.
interventions to instil those cultural attributes thought to
underpin continuous performance improvement? This begs
other questions, such as what is organizational culture? Are
organizational cultures capable of being shaped by external
manipulation? If so, what strategies are available to managers
wishing to inculcate an appropriate organizational culture? In
this article we aim to shed some light on these issues. We
review key theoretical debates on the nature of organizational
culture(s) and consider what practical strategies are open to
health care organizations to implement culture change. The
literature discussed formed part of a larger project, including
a systematic review of literature on culture and performance
in health care and non-health care settings [10–12,32]. The
systematic literature search was conducted using Medline,
CINAHL, Helmis, PsychLit, DHdata, and the database of
the King’s Fund in London, using the phrase ‘organizational
culture’. The information presented in this article is drawn
from the systematic review, supplementary reading, and the
advice of 30 experts in health services policy and management
research in the UK and USA.
Organizational culture
1. Origins and development
There is little consensus among scholars over the precise
meaning of ‘organizational culture’. The term ‘culture’ is
derived from the Latin, meaning to tend crops or animals [13].
Early in the last century social anthropologists applied a
culture metaphor to describe processes of socialization
through family, community, educational, religious, and other
institutions [14]. The idea that an organization’s effectiveness
can vary as a function of its culture can be traced back at
least as far as the Hawthorne studies [15] and related work.
Those studies observed how the informal, social dimension
of enterprise mediated between organizational structures and
performance, and how those dimensions could be manipulated to affect employee effort and commitment. This
interest in the organization as a social institution evolved into
their study as microsocieties or -cultures [16]. In the postwar period, a number of researchers, including behavioural
economists [17], industrial sociologists [18], and organizational
psychologists, emphasized the importance of culture in shaping organizational behaviour. However, it was not until the
1980s that the concept entered mainstream management
thinking via the influence of a number of best selling
management handbooks, which popularized the notion that
culture was a critical determinant of organizational
performance [19–21].
We focus here on the implications of using culture change
as a lever for performance improvement. However, we are
aware of the limitations of the managerialist perspective and
refer interested readers to a number of excellent scholarly
publications that explore in-depth a range of theoretical
stances and epistemological positions on the nature of organizational culture and the feasibility of managed culture
change [22–24].
112
2. Conceptual frameworks
Organizational culture has been described as perhaps the
most difficult of organizational concepts to define [25].
The management literature is replete with overlapping and
competing definitions, a situation that has been referred to
as ‘an embarrassment of definitional riches’ [22].
Conventionally the culture literature is divided into two
broad streams [26]. One stream approaches culture as an
‘attribute’, something an organization ‘has’, along with other
attributes such as structure and strategy. Another stream of
literature regards culture more globally as defining the whole
character and experience of organizational life, i.e. what the
organization ‘is’. Here organizations are construed as cultures
existing in, and reproduced through, the social interaction of
participants. Some scholars view the ‘organization as culture’
approach as but one of a range of paradigms used in
organizational analysis. From that relativist perspective, a
global definition of organizational culture may be termed as
the ‘culture as metaphor’ approach.
The distinction between viewing culture as either an attribute, a defining quality, or a metaphor has important policy
implications. The view of culture as an attribute has been
instrumentally interpreted as an independent variable capable
of manipulation to satisfy organizational objectives. From
that perspective, culture change is viewed as a means to
commercial or other technical ends and comprises a range
of activities directed at ‘overhauling’ or ‘re-engineering’ an
organization’s value system (Table 1). Much popular management literature adopts this approach. If, by contrast,
organizations are approached as cultural systems, culture
becomes the defining context by which the meaning of
organizational attributes is revealed. Then, change agents are
offered fewer levers to influence the formation of desirable
cultures. Indeed the whole emphasis shifts from what organizations accomplish to a cultural anthropological understanding of how organizations are socially accomplished and
reproduced.
These different conceptualizations generate rival claims as
to the nature and feasibility of planned culture change. For
the purposes of this paper we tread a middle path between
the two dominant approaches by treating an organization’s
culture is an emergent property, concomitant with its status
as a social institution [27]. By this definition, culture is not
assumed a priori to be controllable. Instead we assume that
its main characteristics can at least be described and assessed
in terms of their functional contribution to broader managerial
and organizational objectives.
3. Subcultures
The management literature on organizational culture has
tended to assert a relationship between ‘strong’, unified
cultures and commercial success. Yet observation suggests
that few large, complex organizations are likely to be characterized by a single dominant culture. Moreover, there is
no convincing evidence that a unitary culture yields higher
performance than a pluralistic one. Where organizations are
differentiated along clear occupational lines, as health care
Policy Roundtable
Table 1 Key differences between approaches based on culture as an ‘attribute’ and culture as a ‘metaphor’
Culture as an attribute
Culture as a metaphor
…………………………………………………………………………………………………………………………………………………………………………………………………..
Epistemological assumptions
Positivist
Phenomenological
Disciplinary base
Anthropology/biology
Social psychology
Theory of cultural cohesion
Single, coherent culture
Coexisting subcultures
Theory of organizational order
Provides an adaptive regulating
mechanism to maintain status quo
Cultural conflicts can engender change
Creation and transmission of
culture
Directed by actions of senior staff to
change artefacts and espoused ideology
Reproduced by all culture members
through their ongoing negotiation of
symbols and artefacts
Culture change agents
Senior management only manipulate
culture to meet corporate objectives
Managers, as well as other
organization members, all seek to
influence the cultural direction of the
organization
organizations have traditionally been, a number of coexisting
subcultures are likely to be identified. Subcultures may share
a common orientation and similar espoused values, but there
may also be disparate subcultures that clash or maintain an
uneasy symbiosis [28]. Researchers have adopted two broad
frameworks for studying organizational subcultures. The first
defines subcultures relative to an organization’s overall cultural
patterns, especially its dominant values [28]. From this perspective, subcultures are classified in terms of whether they
support, deny, or simply coexist alongside the values of
the dominant culture (Figure 1). The second framework
acknowledges that subcultures relate to occupational, departmental, ward, speciality, clinical network, and other affiliations. Arguably, these two perspectives need to be
synthesized, as elements of both are likely to be found wit…
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