Research Question
Research Question: (can you please help me make this question better if needed)
Does a change management leadership strategy effect management systems as reflected at Hospital X.
It seems that past and current literature grasps for answers to determine an appropriate concept of leadership for administrative management. At this juncture in history, administrative management has also become a forward moving debate thanks to its inherent relationship to bureaucratic leadership in the public sector. There are many layers towards identifying leadership strategy within the context of administrative management depending on the organizational structure. It seems that these layers of identification have not been clearly collected in a single source of literature. This question of leadership strategy is simultaneously capable of deepening the foundations of public administrative theory, forming the basis for a new theoretical framework, and of pinpointing a single leadership strategy by mining the effects on performance outcomes for organizations, and the public good.
Doctoral research in public administration performs a service to the field and to society when it maintains the tension between basic and applied research. This research question can meet the needs of both types through a form of research called strategic research. According to Rip (2004) strategic research is the basic way of carrying out research that possesses a linearity between basic research and practical usefulness. It seems that the strength of doctoral research in public administration rests upon its ability to be broadly applicable while being capable of deepening and expanding theory (Felbinger, 1999). By including basic research as a cornerstone of its definition, strategic research is basic research carried out with the expectation that it will produce a broad base of knowledge. In turn, this base of knowledge will be capable to produce the theoretical background to the solution of the question at hand, and provide some solution for practical problems. This is the intent and explorative possibility latent in my research question.
Hypothesis ?
That change management style leadership strategy effects internal and external outcomes at Hospital X. This leadership stye reflects the capacity of change management to determine development and growth in public administrative systems.
Significance of Research Question
Problem Statement
A capstone paper that I would like to explore is: The effect of change management strategy as demonstrated by evidence based practice in the private and public sector as reflected at Windsor Gardens. This capstone paper intends to explore the effects of change management strategy being used by Windsor Garden’s and other evidence based studies, in an effort to create a capstone paper that will answer the question; Do evidence based leadership strategies, as highlighted by the change management strategy, affect management and governance in the private and public sector, especially at Windsor Gardens?
As a result of this capstone paper two outcomes are intended. The first is to identify how change management strategy impacts the target organization’s management. This concerns areas that include; the constituents, organizational goals, and measure the challenges and/or benefits of it’s implementation for the organization. Secondly, this paper will determine whether or not these leadership strategies are based upon evidence based practice, and if or if not evidence based practice in the use of change management strategy or other appropriate strategies is an effective tool for leadership practice.
In order to look at how the change management strategy is effective at Windsor Gardens, various cross studies will be used to compare and contrast affects and outcomes at Windsor Gardens. This capstone paper will rely on these studies and other research to help identify the affect of its use of change management strategy and its effect as a tool for its leadership. As a result, these supplemental studies in the private and public sector will aid in increasing reliability of this capstone paper.
Significance of this Study
In my personal experience, I have seen a lack of evidence based practice that guides the direction of leaders in the implementation of policy, procedure, and other organizational areas. In particular, a lack of exploration into the effect of leadership strategies in management and governance on performance outcomes in the private and public sector. Strategic concepts and practices first evolved in the private sector, and they created a lot of controversy when they migrated to the public sector. The reform movement of the 19th century began a series of discussions and theoretical evolutions which assisted in defining the politics/administration dichotomy by drawing from private sector sources. For example, the advocacy of a merit system was sought to replace the control that the political government had on public service employment and was a result of this migration from the private sector. The Pendleton Act became the defining moment for that period of the administrative state and the field of public administrators in America. It was during this time that President Wilson advocated a “science” of administration that evolved into theories that covered areas of business administration and public administration. The New Public Management (NPM) mode of governing and management for the public sector as birthed by the Harvard Business School’s Business Policy Model (BPM) (Christensen et al. 1982). BPM is undoubtedly the most widely read and long standing strategic management framework. As a result, Alford and Greve (2017) argue that NPM can be used equally for private sector approaches. For these reasons, this NPM framework becomes a foundational starting point for our capstone paper in deciding upon a governing strategy.
Change Management Strategy and NPM
According to Hansen (2011), extensive studies have shown that strategic management is increasingly relevant in public organizations due to new public management (NPM). The affect of NPM among public and private sectors in the USA is only seen when specific strategic tools are used within this framework. The relevance of this capstone paper is given strength by Hansen’s (2011) recognition that there is a lack of studies investigating how public organizations practically apply strategic management tools within an NPM framework. An important aspect of strategy is its practical implication. This capstone paper investigates change management strategy as a tool applied at Windsor Gardens and whether or not changes take place in the application of this type of tool within the context of a NPM. The results are intended to not only clarify the need of using a strategic management tool, but to have an impact on the public interest and the organization itself.
Public Interest: Personal Interest and Public Good
I think that at the root of American political scientist’s thinking is the idea that the
American administrative state is a necessary evil. It prevents further deterioration into barbarism,
communism, and other such states. Yet, I think that the administrative state in America is a
necessary component and natural evolution of maintaining civil order and pursuing the benefits
of the common good.
In the course of writing a capstone assignment, there is an assumption that the
administrative state is good. Yet, the functioning of the administrative state, or any organization’s
success is ultimately dependent upon the level of it’s management and leadership. This
leadership and management ability is necessary on both the side of the administrator and the
politician or executive. James Madison wrote in Federalist 51,
“If men were angels, no government would be necessary. If angels were to govern men, neither external nor internal controls on government would be necessary. In framing a government which is to be administered by men over men, the great difficulty lies in this: you must first enable the government to control the governed; and in the next place oblige it to control itself.”
This success falls almost exclusively into the hands of performance managers and a team that works alongside the managers of the existing organization. With a joint effort of actuation, the performance of a change management strategic plan for Windsor Gardens or any organization will be carried out with a level of success that I think will render an organization stable. A resultant favorable transparency for both internal and external constituents assists benefits the public interest. The public interest is benefited by promoting integrity through transparency. There are many case study examples that support the benefit of transparency in the management, development, and execution of strategic plans. Too many organizations and governments do not approach strategy from this scientific evidence based perspective. Instead they consider a situation myopically or too subjectively, and end up making the same mistakes as larger organizations and poorly run government systems. Therefore, to have an effective implementation of a program for the public interest, a well-rounded, scientifically based capstone will include these elements to maintain it’s external validity and prevent bias in its inception, production, and solutions.
The benefits of using evidence based practice in public administration provides the public with transparent management and government practice. It is in the public interest for public administrators to be utilizing the evidence based practice for management and governance. The public has a right to have public administrators that utilize best practices to carry out administrative duties.
Real World Administrative Problems: Technology and Development
There are some key factors to look for when seeking to align a strategy to an organization
or a government agency. One of these factors is environment. While most organizations have a stable and consistent environment, there will be still be a need to adapt program strategies for each individual organization. The administrative state historically evolved due to a variety of reasons, one of which is environment. The increase in technology allows the government or organization to be more visible and at times more transparent to its constituents. A certain tension can exist between the administrative state and the polis that is constantly evolving due to technology and development. An important goal of strategic management is to adapt its strategies of development towards an ease of use and implementation among those in the administrative state. Simultaneously, this sensitivity to implementation requires feedback from constituents. Technology or IT management has become a crucial bridge in maintaining and developing interactions with the public and requires team that consists of quality assurance, not just IT specialization. How the IT management is executed and its use in implementing strategic management plans can make or break an organization.
Organizational Setting
Windsor Gardens is a convalescent hospital in Los Angeles, California. It consists of over 130 employees, 11 departments with respective department heads, 1 administrator, and a corporate based oversight committee that assists the hospital in accomplishing its goals. The uniqueness of this organization is that it participates in public sector sponsored programs of Medicare and Medicaid. However it operates as a private sector entity. Yet, it contains aspects of non-profit philanthropic activities with its clients and the community by occasionally providing charity care where patients can be cared for without charge, and conversely the organization can and does receive donations to support its care efforts for the community. This organization has partnerships with the State, local and federal departments, as well as with other private and non-profit entities in which it conducts business and other vital relations.
This organization has recently undergone a change in its leadership, and has begun to implement a change management strategy. The diversity of this organization contributes to the growing body of evidence that shows the cross sectional usefulness of strategic management plans in the science of public administration for both public and private sectors.
Possible Challenges and Benefits
The historical significance of evidence based management and administration in both public and private sectors has many relevant applications. The initial challenge of this capstone is to show the relationship between Windsor Gardens, a private sector organization, and how it relates to NPM. Yet, there are many organizations, both public and private that are continually addressing this issue. For example, the analysis of the strategy of New Zealand’s Department of Correction suggested that the government department acted under different constraints than a private sector organization might have experienced, and that there were many responses that the Department could choose from, but ultimately it had to engage other stakeholders in them for legitimacy purposes (Department of Corrections, 2008). The lynchpin for this capstone thesis rests on the principles set forth by Alford and Greve (2017) who argue that NPM can be used equally for private sector.
This capstone paper will provide an avenue for exploring solutions to address the lack of the use of strategic management tools for both public and private sector organizations. Program implementation may need to be addressed in order to ascertain if outcome, impact, and efficiency goals are matching the management strategy being used. This can pose a challenge, because these areas can be difficult in terms of collecting comprehensive data from Windsor Gardens. Personnel already work at a 24 hour availability and this creates some data collection difficulty. Lastly, in this capstone paper, a final challenge will be to see the immediate impact of change management strategy for Windsor Gardens. This is because this industry is often subject to change of those governing organization. So this challenge also poses a benefit to Windsor Gardens, because this type of change management can become a permanent hallmark of this organization.
Summary
This capstone proposal paper is only a draft that is intended to be more fully studied and researched according to the principles and guidance of this class.
Literature Review
Change Management Strategy: Literature Review and Guiding Framework
Introduction
Organizations that operate in the private and public sectors usually implement different strategies in terms of strategic management, leadership, and governance due to the distinctions in terms of the organizational structure. Specifically, the private sector is driven by the rules of business, where the expansion, client-orientation, and competition are primary characteristics of the market. Public sector operates in the paradigm of providing the service to the population with no competition or orientation towards the growth and expansion. The goals and priorities of these two sectors are radically different, which requires different frameworks in strategic management.
Nevertheless when it comes to administrative management, organizations that operate in both of these dimensions have to either implement a hybrid approach to strategic management or choose one of the frameworks used by the private or public sectors. The second option may not be plausible in the healthcare sector which is the focus of our study. These types of companies cannot be driven only by private business rules because they are regulated by government and state policies, and they cannot solely prioritize the aspect of serving which is prevalent in the public sector. Private hospitals are obligated to serve the public good. Yet, they also have competitors and must take care of the business, as these organizations are only partially funded by the government. Our study’s hospital is not an exclusion from this rule. Due to the recent alterations in this company, the leaders have to implement a change management strategy that considers the needs of the organization to operate in both private and public sectors. Once a NEEDS assessment has been completed, we will need to consider various models, frameworks, and organizational examples of best practice. In the research below, we will consider the pros and cons of each of these areas. Afterwards, we will need to identify the best approach in deciding upon a guiding framework for the hospital.
Strategic Management Framework
One of the most important improvements in the approaches towards the strategic management of the organization is the orientation towards evidence-based practices. According to the study by Bausch & Fitza (2013), Evidence-Based Strategic Management (EBSM) is one of the most important directions in the development of public administration. Currently, public administration is dominated by meta-analyses and quantitative studies. At the same time, as Bausch & Fitza (2013) imply, this field is quite new, which generate certain limitations in terms of the validity and credibility of the new frameworks utilizing EBSM methods.
Several studies demonstrated the efficacy of the EBSM by implementing different strategies. Specifically, a research in the higher education sector that also operates in the private and public sectors revealed that the implementation of Waal’s High Performance Organization (HPO) Framework enabled the organization to improve its performance (de Waal & Kerklaan, 2015). HPO refers to the orientation of the organization towards the improvement of financial and non-financial results, which will be better than the results of the peer group organizations for at least five years (de Waal, 2017). This framework requires the companies to shift the focus towards the discipline and the analysis of individual issues experienced by the specific company. Specifically, HPO focuses on quality of management, openness and action, long-term orientation, constant renewal and improvement, and quality of employees (de Waal, 2017). As the research performed by de Waal & Kerklaan (2015) in higher educational establishments revealed, it is possible to achieve financial and strategic success with the help of HPO. Notwithstanding, it is important to notice that this is a new framework that has not been tested by many studies and the current evidence is based on only minimal sampling of inquiries.
Several studies were performed in the area of healthcare organization management that focused on specific characteristics of EBSM. Specifically, Liang, Howard, Leggat, & Murphy (2012) analyzed the efficacy of Evidence-in-formed decision-making (EIDM) in healthcare strategic management. The results showed that EIDM improves the quality of management decisions, which positively affected the service delivery and client satisfaction. However, it was revealed that few healthcare managers implement it in practice (Liang, Howard, Leggat, & Murphy, 2012). The researchers considered that the barriers preventing the implementation of EIDM framework is the specificity of organizational level in healthcare facilities. This may be due to the fact that healthcare facilities more like public sector areas which is why this model was more effective in the private sector compared to the public one (Liang, Howard, Leggat, & Murphy, 2012). As it was mentioned earlier, the companies that have to operate in both dimensions (private and public) encounter certain conflicts in terms of management and governance. The administrators as well as the employees have to consider the conflicting values, namely the financial profits and public good in their everyday operations. For example, healthcare professionals are obligated to assist patients in their health problems, and yet, they have to consider the profits of the facility in order to maintain the business.
Despite the fact that in the U.S. the Medicaid and Medicare programs provide partial refund for healthcare services, not all people are covered by these benefits. Sometimes, the patients cannot use these programs and at the same time they do not have the financial resources to access healthcare services in any other way. In these conditions, the healthcare facilities have to work pro bono or refer to charities and non-profit organizations. As Popesko, Novák, & Papadaki (2015) implied, strategic management can adapt the framework of Activity-Based Costing (ABC) in order to solve the problem of conflict in the money allocation for these services.
Healthcare organizations usually encounter the conflict of economics versus ethics. Within this dynamic, they have to make sure that both dimensions are not affected significantly and their constituents are cared for. For example, the healthcare facility is not able to provide citizens with services free of charge due to obvious reasons relating to budget demands. At the same time, it is unethical to refuse providing the services to those, who cannot afford it. Popesko, Novák, & Papadaki (2015) propose the allocation of financial resources through third parties and government only for the people who need it, and ABC framework provides the practical tools for this approach. The majority of healthcare organizations rely on the charities, non-profits, and private donations in order to satisfy the needs of all clients.
All of these frameworks address different dimensions of strategic management and leadership. Yet, when considered within the conditions of an organization having to operate in both sectors, it is impossible to limit it’s options with a single evidence-based model. It is more effective to use the benefits of all frameworks that have proved to be effective in either of these dimensions or in both of them. The adoption of the hybrid model of strategic management will likely be more effective for a healthcare organization due to its specificity and value for the community. For instance, another framework that was adopted in the public sector is the New Public Management (NPM) model that approaches organizational change with the help of disaggregation, competition, and incentivisation (Dunleavy, Margetts, Bastow, & Tinkler, 2006). This approach received mixed reviews from the earlier and modern researchers due to its irregular success in public organizational management. Yet, NPM has the qualities of the private sector orientation that may be helpful for the companies that have to operate in both fields. Specifically, competition and disaggregation are the characteristics of the business rules in the private sector rather than the public one.
At the same time, some studies recognize NPM’s efficacy in the public and private sectors. For example, Alford & Greve (2017) imply that NPM can be used equally in private and public sectors. New Zealand’s Department of Corrections (2008) managed to implement this strategy successfully in their organization and achieve good results. Hansen (2011) also claimed that NPM is the effective framework for strategic management, as it can be applied in both sectors. Hansen’s (2011) recognition of NPM’s efficacy supports the opinion of some previous studies claiming that this is the solid model that can solve the problems related to both fields.
At the same time, several researchers expressed their concerns over the efficacy of NPM in terms of management. According to the study of Dunleavy, Margetts, Bastow, & Tinkler (2005), NPM is ineffective in the time of digital era governance, as the old model increases institutional and policy complexity as well as tending to the provision of unreliable services in the public sector. Such an approach to this problem shows that NPM does not produce positive results for all public companies, as its resemblance with the private sector decreases the possibility for the public organization to maintain its operations effectively. Hood & Peters (2014) labeled the current state of NPM as “middle ages” due to its irrelevant status in management. According to this review, NPM has a lot of disadvantages for the public administration embodied in human error and the system of rewards and punishments proposed by this approach (Hood & Price, 2014). In the organizations that adopted the NPM framework, managers have more operational freedom, yet at the same time, they are held accountable for the errors and successes of the organization, which is usually manifested in the system of fines and benefits. With technological improvement, the management of organizations experienced certain changes that may have affected the efficacy of NPM. At the same time, it is important to take into account that the drawbacks reported by the studies were observed only in the public sector, not the private ones.
One of the major issues of the strategic management in any company is leadership, which has to function effectively in order to retain the company’s success. As Stetler, Ritchie, Rycroft-Malone, & Charns (2014) saw that evidence-based leadership in healthcare organizations is essential, as almost every employee, from a nurse to administrator has to execute the leadership responsibilities. As the research revealed, evidence-based practices that implement such methods as reinforcement, support of a vision, aligning the planning and organization, and generate good results (Stetler, Ritchie, Rycroft-Malone, & Charns, 2014). Evidence-based practices can rely on leadership research provided by the public and private sector studies. For instance, nowadays, transformational and transactional styles of leadership are the most researched and promoted by scholars and are tested in many empirical studies. This approach to leadership can be used by the healthcare organization. Specifically, the transformational leadership style that promotes the changes and enables leaders to prevent unhealthy opposition from their employees leads to less altercations (Ljungholm, 2014).
Leadership Strategies
As our case study hospital is undergoing changes, transformational leadership may be an effective instrument in implementing change and sustaining success. According to the assessment of transformational leadership in the public sector performed by Ljungholm (2014), the leaders manifest superior levels of commitment towards fostering change and working towards the acceptance of changing environment among the employees. Overall, transformational leaders must have high ethical and moral values, have strong intellectual abilities, inspire followers, and allow employees to have autonomy. The framework of transformational leadership is very flexible, which will allow the healthcare leaders as well as the followers to implement its tools in the private and public arena. For example, when the healthcare facility undergoes the process of change, the adjustment to the new rules and procedures may be time-consuming. Yet strong leadership vision and methods can solve some of the many components that could prevent successful outcomes.
In the healthcare facility, time is very precious, as the clients require immediate assistance from the healthcare providers. Charlesworth, Jamieson, Davey, & Butler (2016) conducted the research testing the efficacy of transformational leadership in the healthcare facilities. This study revealed that when the healthcare providers used the transformational approach to a problem, it had been solved more quickly. Specifically, in one case, the healthcare facility dealt with a large number of visits to the acute care department with drug-related problems with clients who could not access their funds to pay for services. After the healthcare facility launched the campaign promoting the healthy behavior and drug use prevention in the community, the visits to the hospitals of the respective population was decreased by 42% (Charlesworth, Jamieson, Davey, & Butler, 2016). By achieving this result, the healthcare facility was able to improve the work of its employees as well as the health quality of people in the community.
The same approach can be used by our case study hospital if the situation with the patients reach critical levels affecting organizational operations. As hospitals are morally obligated to help the patients, a simple orientation towards financial benefits will not be possible for the hospital. In case cited above, the healthcare facility had to balance between the public duty and the financial profits. By using preventive strategies that can be developed through the framework of the transformational approach, an organization will be able to eliminate any barriers in terms of provision of services to it’s people who cannot afford it. Simultaneously, adopting transformational leadership can become the solution for such problems as poor communication between the employees and leaders or healthcare providers and patients. As Odumeru & Ogbonna (2013) determined, transformational leaders were able to invest in the development of the employees and improve the organization’s performance. During the process of change in the organization, the employees tend to experience resistance, which may be easily managed with the help of a transformational approach.
Change Management Strategies
In order to help the company to implement innovations, it is possible to use the respective change management strategy. Campbell (2012) conducted a research in change management in the acute healthcare hospital, which determined that leadership, vision and workplace culture were the main factors determining the success of change management in the organization. Specifically, when the managers have adjusted the workplace culture, improved their leadership techniques, and linked the employees’ vision to their own professional goals, the hospitals will be able to improve their functionality (Campbell, 2012). The healthcare facility, as well as other companies that operate in both public and private sectors, have to take into account the importance of their employees as well as the methods used to maintain their work.
A real-life example of a successful change management strategy was used by a healthcare institution in Canada. Specifically, as Lavoie-Tremblay et al. (2012) reported the utilization of the Promoting Action on Research Implementation in Health Services (PARIHS) framework. This framework similar to EBSM, enabled a Canadian healthcare center to implement this change approach and make sure that it is accepted by the employees as well as allowing the center is able to function effectively. Moreover, as Lavoie-Tremblay et al. (2012) implied that the framework promoted the evidence-informed decision-making to apply successful implementation despite issues the company experienced due to the major transformation it was undergoing. PARIHS focuses on evidence-based practices as well as promoting research and exploration in the healthcare setting. One of the major advantages of this framework is its orientation towards the employees and the need to include them into the decision-making process. For example, as Tham et al. (2014) admitted, the organization has to take care of the employees and their attitudes during the process of transformation or major changes. In many cases, the organizations dismiss the voices of the employees and use the approach that decreases their value in the company. In order to avoid this issue, the change management has to include the workers into the process of decision-making.
Data and Methods
The study will use three main variables to provide answers for the research questions. However, the variables will be explored thoroughly to help give a clear picture of the situation at the hospital.
Participants: This study will be based in a single medical center but will involve the participation of nine different departments. Since the medical center has common policies for the department, each department has about 2 to 80 healthcare providers who offer services to patients and ensure that their medical needs are efficiently attended. The study will use 100 participants from all the department to complete the survey. The sampling method will be based on two major factors.
Willingness to participate: It is important for the participants to demonstrate willingness by assenting to the consent form that the researcher will provide. Therefore, the participants will not be forced to take part in the survey. Since the survey will cross-examine about 100 participants, consent is the first consideration that will be made. Not every person in the department will be willing to participate in the survey for various reasons. Before undertaking a study, it is essential for participants to provide their informed consent (Caldwell & O’Reilly, 2003). Some might be uncomfortable taking part in studies while others may not have time for the study due to official or unofficial commitments.
Position held at the hospital: Whereas the study will collect from members of the department, the emphasis will be put on the positions held by the individuals. The researcher will look for persons holding senior positions within the department due to their experience and understanding of operations at the facility. However, the study will seek answers for the research questions from at least three senior members of the department, where seniority will be based on the position held.
Dependent variable: the level of patient satisfaction will be the dependent variable in the study. The research will seek to examine whether or not there is an increase in patient satisfaction. It will involve contacting discharged patients from the departments to ascertain their level of satisfaction with the services and overall treatment at the facility. The discharged patients will be asked the following questions;
· Are you satisfied with the hospital’s service provision?
· Did the healthcare providers give you enough attention?
· What are the most satisfying gestures you received from the hospital?
· Who was the best person to attend to you and why?
Independent variables: the study will use support for the change management strategy as the primary independent variable. In this regard, the study will explore the expected behavior of workers towards change. Lemieux-Charles & McGuire (2006) assert that behavior change is necessary in adopting and supporting new strategies for change. The expected behavior will be gauged using point scale system. The system will use a scale of 1-7 in which 1=strong disagreement and 7=strong agreement. The items for this variable include members’ perception of a leader’s execution, the department’s response to operational changes, how leaders handled change resistance, and how they defined and measured change objectives. The leadership ways of handling resistance can ease or motivate resistance (Oreg, 2003). These are important because they help understand employee’s view of the management’s handling of change. The following questions will be directed to participants from various departments.
· How did you react to the changes?
· How did members react to the proposed changes in the department?
· How did the leadership present the proposed changes?
· Was there any resistance to the proposed changes?
· How did the leadership handle the resistance?
· Did the response to changes surprise you?
Control variables: the research will use four control variables. Firstly, it will investigate equivalent health facilities to enhance the external validity of the study. Secondly, medical staff size will be used as the control variable due to its impact on the study outcomes. Third, tenure score will be also be used as a control variable. Tenure score is the person’s duration of service at the facility, which has been found to affect the way they handle change. According to Johnson (2014), tenure score is critical in understanding the perception of public administrators. Therefore, it will be measured in years. For instance SD=2.1 years, x=7.1 years. Fourth, the study will patient satisfaction will be measured using the already available survey at the facility.
Concepts
Major Conceptual Components
One of the major concepts that my research question will use is general systems theory, often called systems of organization (Easton, 1975). This is an extensive and holistic concept which strengthens the implementation methods of change management models. Having a systems of organization theory allows for variance in methods when there are different settings, and adaptability to use approaches of change for different types of organizational environments. A systems approach has been used historically to address policy making (Quade, 1968), but has evolved to include management and administration (Denhardt, Denhardt, & Blank, 2014; Torfing et al., 2012; Charlton, 2003; Ledingham, 2000). This is due to the fact that it tends to break down the policy by performing an analysis of the changed nature of the change systems involved. This analysis includes components such as the environment, the constituents, its historical complexity, and the problems involved in attaining it. At the center of systems theory is the issue of utilizing a practical application to assess and engage progress. In the change management model we find strategies that consist of structured and organized processes that will enable the transition from one state of the to another (Thierauf, 2006).
Confounding Variables
The dependent variable is the organizational performance while the independent variable is the change management strategies. The performance of an organization relies on the change management strategies of that organization, and high performance results occurs when the two variables work in tandem. There are other variables at play that work within the organizational system. A systems approach will embrace all of these variables and see their impact upon the dependent and independent variables. According to Kothari (2004) independent variables that are not related to the purpose of the study, but may affect the dependent variables are termed as extraneous variables. Extraneous variables as such are internal, and environmental factors that may impact the success of an organization. Internal factors will include; employees, stakeholders, vendors and constituents. These factors directly affect performance and make up the specific environment. Lastly, the external environmental factor includes areas like; tech changes, social aspects, economic factors, political persuasion, and legal, procedural and regulatory factors.
Academic and Applied Research with Relevant Dimensions
Change management is a large and expanding field of study, but the research and literature for this area is in development for public administration (Vann, 2004). It seems that the understanding of underlying theories and types of models associated with change management lacks cohesiveness (Kuhlman, 2010). It has been suggested by Kuipers, et al. (2014) that future research into change management within the public sector would benefit from at least seven particular areas including; context, content, process, outcomes, and leadership of sub-system, organizational and sectoral change. For my particular research question, these themes can be highlighted as subcategories to explore concrete implementation processes in public healthcare organizations (Charlesworth et al., 2016; Liang, Howard, Leggat, & Murphy, 2012; Lavoie-Tremblay et al., 2012).
Operationalization ?
Measurements
Appropriate Measures for Each Major Captures the Concept
This research explores how three variables can influence organizational members of a healthcare system to take action supporting a strategic shift pointed at improving quality of care. Three variables we are considering are the agreement with a change management strategy, the actions of leadership teams, and the health care organizations’ general orientation toward change. In a systems theory, each measurement for the variable will easily capture this concept. Analysis includes components such as the environment, the constituents, its historical complexity, and the problems involved in reaching it. At the center of systems theory is the issue of utilizing a practical application to assess and engage progress, and we find this in the change management model which is the focal point impacting each variable and how we will be measuring each variable (Kothari, 2004).
Variable and It’s Unit of Measure
Participants: Participants in this study are 9 departments of healthcare providers working in a single medical center. This medical center uses the same policies throughout the hospital. The department range in size from 2 to 80 providers. Within these departments, we can anticipate that around 100 will participate in the research study by completing surveys. The respondents’ data will be aggregated to reflect each departmental. I will exclude departments that do not possess at least three complete measures of all variables.
Dependent variable: Whether or not there is an increase in patient satisfaction. Every month, there is a facility survey that contacts each discharged patient to ascertain their satisfaction level after their hospital visit. This survey assesses each area within the facility, and as a result will touch upon each department.
Independent variables: Support for the change management strategy used by leadership. Consistent with previous research (Lemieux-Charles & McGuire, 2006; Lee & Alexander, 1999; Anderson & West, 1998; Schneider, Brief, & Guzzo, 1996), it is indicated that behavior change is necessary to support a new strategy and is often the result of organizational support. This can be measured using a survey for the healthcare providers drawing from research surrounding the support of change (Caldwell & O’Reilly, 2003; Oreg, 2003). In sync with these studies, a focus directly on worker’s expected behaviors can be gauged on a point scale system (i.e.: 1 = strong disagreement to 7 = strong agreement). A set of items will include how their department responded to operational changes, and members’ perception of how the organizational leader carried out actions to execute a goal, define and measure objectives, and handle resistance to change. These measures are given weight in such research found in Lord (1985); Meindl & Ehrlich (1987).
Control variables: Four control variables are included in the model of change management testing the hypotheses. First, this is focused on a single medical hospital, however other equivalent forms of organizations should be considered and reviewed for reasons of external validity. To counteract different levels of patient satisfaction possible within different organizations a dummy variable will be created used them in the analyses. Second, group size has been known to affect group outcomes, the size of the medical staff is a control in all analyses. Third, because a person’s tenure at an organization impacts how they handle organizational change and individual willingness to change, a tenure score can be calculated and used as a control variable (i.e. x = 7.1 years, SD = 2.1 years). Lastly, patient satisfaction is measured using the survey currently in place by the facility. Additional control variables may be added as the research study may require.
How these Help to Answer Research Question
There was consensus in our discussions that multiple outcomes, that meet the needs of different audiences, should be included in evaluation design and that further work was needed to articulate and agree how wider ‘value’ beyond effectiveness should be measured. Measuring both effectiveness and value appropriately in different contexts should be informed by greater dialogue between service leaders, researchers and policy-makers.
At the practical level, this research can contribute to the dialogue by engaging with how program designers define ‘effectiveness’ and whether or not they can use a program theory or model which might lead them to expect certain impacts. In this research, the model of change management operating under the larger concept of systems theory should produce information on valuable outcomes acting as a mechanism to incite changes in the process and practices employed by leaders of this organization, and of leaders and organizations as whole. At the broader policy level, this research can help to broaden the definition of outcomes or impact beyond effectiveness.
According to Eccles et al. (2009), it is often impossible to ascertain the internal effectiveness of an intervention employed as part of a system change. This is due to the simple fact of being able to separate the intervention from the context. From the vantage point of health-care organizations, relevant questions to improve practice can be taken from how we measure our variables. Helping us to understand how a program can be changed and catered to its individual context. This includes areas how to increase effectiveness and how to adapt and manage the organizational setting. Ultimately, our variables and the measurement thereof can give us research data towards explaining the ‘how, why, when and where does it work’ and, more specifically, ’how can we make it work better?’ (Langley and Denis, 2008).
Data Source ?
Sampling Method (Look above, maybe in Data section>?)
Possible Method for Data Analysis ?
Discussion ?
Weaknesses of Design ?
Next Steps ?
Conclusion ?
