The Fundamental Steps of Managing Change in the Organization

Change management is a planned process which can achieve and consolidate, through various stages, the vision of the medical center. 

The fundamental steps of managing change in the organization include 

Analyze the organization’s situation, both externally and internally: 

• Identify a (current, potential) critical situation. 

• Identify opportunities for improvement. 

Generate a powerful group of promoters or change agents. It is important to have personnel with professional or clinical leadership and sufficient credibility to lead change efforts. The group performs the analysis of the situation and is guided by the change plan. This should include baseline, main areas for improvement, identification of the key professionals, positive and negative previous experiences and brake system or pre-structures to be reinforced and consolidated. 

Create a vision to help clarify what direction the organization will advance. An organization has an essential purpose (mission) and core values that are permanent. The vision provides guidance about what to keep and what to change. 

Communicate the vision. It is necessary to use all communication channels to transmit the new vision and strategies. Leaders must incorporate the messages in their regular activities and their formal meetings. 

Empower others to implement the vision. Transmission of vision must generate new supporters, who reproduce the message of change and promote the new idea. At this stage, it is important to promote the idea of participation and involvement of professionals in the change to neutralize resistance and previous negative experiences. 

Planning short-term successes. Actions to make improvements with visible short-term results can gain credibility. It requires agile management, but usually has low costs and high impact. It is important to recognize feedback and professionals involved in the improvements. 

Consolidate improvements and produce more changes. The process of change must be dynamic; It must be seen as continued progress. They must seize the increased credibility to change systems, structures, and policies that fit the vision. It is also necessary to select, promote and train professionals who can implement this vision, and to strengthen the process with new projects, themes, and change agents. 

Institutionalizing new methods. The leaders must articulate the connections between new behaviors and organizational success. New behaviors must be consolidated by regulatory changes and developing means to ensure the continuity of the project in succession periods. 

Any change process should consist of three phases: diagnosis, change, and reinforcement, which corresponds to those defined by Kurt Lewin as thawing and freezing change. As in the scientific process, the first action will be to define the problem. 

For the definition of the problem or improvement area, there are some diagnostic methods: SWOT technique, technical GAP, and others. It is recommended that nursing leaders look for simplicity, adaptation time available for such an analysis, the participation of professionals involved and managing expectations from the start. 

Communication and dissemination plan 

Internal communication is a management tool to catalyze change and the involvement of professionals. It is essential to have explicit operational communication throughout the change process, including concrete and consistent messages and answer basic questions such as what, how, when, who, and where. Another very important aspect is transparency; her commitment effect is achieved. The aim of the Communication Plan is to enforce a stable and formal communication process so that the information concerning the implementation of the change is channeled to all professionals (Corazzini, Twersky, White, Buhr, McConnell, Weiner & Colón-Emeric, 2014). The key is to inform professionals to involve them, drive continuous improvement, and enhance communication among those involved, as well as follow up and evaluation of a fulfilled-mentation plan for change. 

Methodology for designing an internal communication plan 

It should include information on the following points: description of the implementation plan, objectives an implementation strategy, and key success factors. 

The key success factors for a full, fluid and permanent communication include: 

respecting objectives, activities, and dates 

committing to implementing change 

minimizing the potential barriers: flexibility 

involving professionals 

Preparation for Negotiations 

At the preliminary stage, it is necessary to get the consent of the parties to participate in the negotiations, agree on confidentiality, and discuss ways of preliminary exchange of documents. Identify goals and objectives, object, subject, interests and positions, subjects of negotiations (it is necessary to take into account not only their interests but also the positions of the opposite side of the negotiators (Shirey, 2013). Accordingly, each of the parties will pursue its goals, but if a positive outcome of the negotiations is reached, we can talk about a mutually beneficial partnership. Plan the negotiations and prepare for them (draw up a plan of negotiations, determine the date, time, place, duration, the scope of negotiations, the number of participants on each side, organize coffee breaks, and prepare a presentation). Make a list of issues for discussion, as well as the alleged issues of the other party. To study the information on the parties-participants of negotiations, about their priorities, services / prospective products, to get acquainted with the documentation for the type of activity in respect of which negotiations will be held. Get information about the people themselves (status, and cultural values). Find out who will be the participant on their part. If several participants are supposed to - distribute roles (who is the leader, who collects and analyzes the information, sets clear questions, and makes an objective summary). Identify the points of contact and disagreement between the parties involved. Prepare arguments / counterarguments, facts, and statistics. Define tactics and strategy of negotiations (logic/emotions, conversation, dispute, bargaining, involving, pushing, suppressing, manipulating, drawing, rivalry/fighting, avoiding, adjusting, adjusting, attacking, persuading, cooperating, and compromising). To forecast the results of the talks (including assessing the positive and negative outcome of events), the development of events, to develop scenarios for negotiations in case the first plan does not work, outline alternative solutions, options for options and options for concessions. The planning and preparation stage for negotiations is the most important and laborious. The more "scenarios" they work on, the easier it will be to overcome obstacles and achieve the goal. 

Conduct of Negotiations 

At the stage of direct negotiations at the very beginning, it is important to create a favorable atmosphere (coffee, tea, compliments, an abstract theme, common interests, hobbies). Maybe it will be appropriate to exchange souvenirs. In the course of negotiations, it is important to adhere to the developed plan, regulations, keep the situation under control, not to kindle the conflict, not to respond to provocations (if they do not pursue such a goal). The stage of clarification of the situation allows them to hold on to their positions or, conversely, to revise goals, tasks, identify strengths, weaknesses, and establish hidden goals. The main tool for negotiations is questioned. It is necessary to coordinate the issues (topics) discussed with the opponents (this can be done better in advance). If there are too many questions on the way to the goal, then the negotiations will be protracted, their opponents will have more chances to identify weak, and problem areas. Questions should be able to ask; they must be clear, correct, do not contain a double meaning. 

Complete Negotiations 

Before the end of the negotiations, determine: to what extent their goals have been achieved and the interests are satisfied, to what extent are the obligations undertaken. It is necessary to conclude negotiations at once, as soon as the parties have found a solution satisfying all (when the conflict is exhausted, the positions are clear, the interests of the parties are satisfied to the proper degree). Achieving the agreement (signing) and the intention of the parties to fulfill their obligations (on implementation, on terms, control, etc.) indicate the success of the negotiations. Before the conclusion of the negotiations, once again, confirm the agreements reached, agree on the timeframe for implementation, determine the criteria for the proper implementation of commitments (on both sides). Also, the success criteria are the improvement of relations between the parties, the agreements adapted to correspond to the norms of law, ethics, and morality; there are no unilateral concessions (including dependence on the second party), there are clear guarantees for the realization of the interests of the parties. It is important after the talks to conduct their analysis to identify their weaknesses and strengths to prevent such mistakes in the future and to take advantage of successful negotiation and achievement of go 

Models for Implementing Change Various models for implementing these changes are proposed. The three-step model for carrying out organizational changes was developed by K. Levin. This theory includes three consecutive stages of thawing, changing/moving, and re-freezing. 

References 

Corazzini, K., Twersky, J., White, H. K., Buhr, G. T., McConnell, E. S., Weiner, M., & Colón-Emeric, C. S. (2014). Implementing culture change in nursing homes: An adaptive leadership framework.  The Gerontologist ,  55 (4), 616-627. 

Shirey, M. R. (2013). Lewin’s theory of planned change as a strategic resource. Journal of Nursing Administration, 43(2), 69-72.