Phase 1: mandate for change
People need to understand the reason for the change. They need to know what the current situation is and why it needs to change to something different. This is the first phase of change management referred to as a mandate for change. Change management is a process that involves people. Change is not a standalone process that offers a solution to any organization. People will resist change because it is likely to affect their comfort zones. Therefore, change management involves reducing the possibility of people resisting the new changes. I work in the radiology department, in the field of healthcare.
Radiology has undergone changes over the past few years in the way it is a practice. One of the major changes that we have to adapt to is the need to be more involved in the affairs of the hospital where we work. There was also need to understand the new proposals made to the healthcare sector and know how they will influence how we practice radiology. These proposals meant that we had to develop a system of governance to help in implementing changes within our areas of operation. It meant having a new model of payment for the work we do.
All these are critical changes that the people practicing radiology had to understand. The department faced over utilization of unnecessary procedures. Imaging and radiology was a significant source of over utilization and was commonly a form of defense medicine or self referral. Radiologists also underwent delayed retirement and decline of reimbursement. This was because their retirement plan valuation was not as expected. These challenges had to be addressed by defining the need for change. Workers within the department had to be presented with a state of the current reality and given reasons why the current reality needs to change. The change could not happen if one person had to implement it alone. I required the participation all stakeholders within the department including workers. All the people with credibility and sufficient power had to be assembled so that the changes may be realized.
Phase 2: Empowerment
The second critical step in the process of change management is empowerment. This step seeks to address the concern of how people can be empowered in order to realize change. Empowerment may involve imparting people with new skills, knowledge, and capability for change. Training and management are the cornerstone for knowledge development and skill development necessary for change. The management team members spearheading the process of change management will have to come up with training requirements according to the behavior, knowledge, and skills necessary for change. In the radiology department where I worked, workers had to develop knowledge about the new changes. The vision had to be communicated over and over again so that workers could understand the need for changes. Ignorance was the greatest obstacle that had to be eliminated. Educating practitioners and imparting them with the necessary skills and knowledge was the key to empowerment.
Radiologists, for a long time, hardly maintained a close relationship with other practitioners in the medical and healthcare field. They were always secluded from the rest of the medical team. Our focus was only to do what we know to do best, imaging. It was difficult to find a radiologist seeking a leadership position within the hospital. However, with implementation of the new changes, radiologists were encouraged to have a broader impact in the affairs of the hospital. They were encouraged to venture out and seek leadership and managerial positions at the hospital. We began to develop close ties with other physicians, being proactive, and listening to their feedbacks. We also began to make out perception and input heard in the entire hospital. Therefore, the new capabilities that empowered us for change were venturing into positions where our impact in the hospital began to be felt. The new knowledge that empowered for change was information about changes in healthcare policy and a vision for the department. Practitioners had to gain new skills especially managerial and leadership skills in addition to their area of expertise.
Phase 3: New Mental models
Phase three involves new mental models. This implies that the new knowledge, skills, and capabilities gained in phase of the change management process should be able to promote a sense of awareness and value system required for the change. The transformation process is created because of the new attitudes and belief system formed. Without new mental models, transformation to the new changes will not be possible. As attitudes and value systems translate to transformation, the intended culture and behaviors necessary for change begin to grow. In essence, every worker within the unit or department needs to have a mental grasp of what needs to happen. This is crucial for the success of change.
Within the hospital where I work, change is not fully realized in the radiology unit. However, there is evidence of first steps towards change. This can only be attributed to the mental grasp that we have held in our minds of what needs to happen in order to realize change. We believe in the new vision for the unit and the entire radiology fraternity. Every day we work with the deliberate intention of achieving what we believe should be the face of the unit and the field. As earlier mentioned, we began to do the strategic actions for realization of change. We began to develop close relationships with other medical practitioners at the hospital. We worked closely with nurses and physicians with the needs of patients taking central focus. The previous culture was no longer practiced at the unit. We developed a new culture that is in line with the changes we wanted to see. The new culture was primarily created because of the mental models we developed.
Phase 4: Repeating phases
The final phase in the change management process is that of repeating the experiences developed in all the previous phases. Each phase has its own learning experiences which are used to address new decisions and issues that arise. The process of change management makes it possible for organizations to be ready to adopt new realities. The experiences and lessons learned in the first three phases are used to handle any new reality that might arise. In other words, the new realities offer opportunities for applying the experiences and lessons learnt in the first three phases.
The field of radiology and imaging continues to face new challenges of economic and political nature. It is heading towards a new paradigm with new key principles governing practice. A lot of attention will have to be paid on team membership and data sharing, documentation, performance measure, group norms, individual norms, cost effectiveness, and patient outcome. All these are new realities that face the unit. Radiologists have to be prepared to handle and address these new realities. They will affect across the board defying boundaries of location and time.
The process of realizing all these new changes begins with the first phase which defines the change and identifies the need to create change based on the current realities. For instance, at the hospital where I practice radio imaging, performance measure is most likely to be the new reality to hit the unit. All workers including radiologist will be subjected to a new set of rules which require undertaking performance evaluation. The functioning of all units has been aligned to the strategic objectives and goals of the institution. This makes it mandatory for all units to yield their expected outcome and goals. This new set of rules will also imply that departments will have to share knowledge and information. They will have to be integrated into a system where access of information is simplified all across the various units.
Defining this change and sharing the need to head in this direction is notable for its realization. Secondly, the management team spearheading the change process will step out and empower all the necessary stakeholders required in the change. This process of empowerment will involve imparting them with the capabilities, knowledge, and skills necessary for change. In effect, the empowerment will translate into mental models that will be manifested in the form of behaviors and organizational culture.
References
Covey, S. R., & Hal, B. G. (2011). It starts with one: changing individuals changes organizations (2nd ed.). John Wiley and sons.
Edgehouse, M. A., Edwards, A., Gore, S., & Harrison, S. (2007). Initiating and leading change: a consideration of four new models. The catalyst, 32 (2), 3.
Greiner, L. E., & Schein, V. E. (2008). Power and Organization Development: Mobilizing Power to Implement Change. Alexandria: Prentice Hall.
