Learning Objectives

Leadership Role in Management of ChangeByDr. Naila H. AmerProfessor of Health Administration and Planning

Learning Objectives By the end of this workshop, participants will be able to: • Understand the role of leaders as change agents. • Describe “Planned Change.” • Discuss “Development of Change” including its three phases: Unfreezing – Movement (or Change) - Refreezing. • Analyze the general nature of change.

Describe people’s reaction to change. • Discuss the effect of Driving and Restraining forces on the change process. • Discuss Resistance to Change and how to manage it.

Leaders as Change Agents Most health organizations today find themselves undertaking a number of projects as part of change efforts. These change efforts are mostly directed at: • organizational restructuring, • quality improvement, and • employee empowerment. What differentiates a successful change effort from an unsuccessful one is the ability of the change agent.

A change agent may be defined as “the person responsible for moving others who are affected by the change through its different stages.”

It becomes clear, that initiating and coordinating change requires well-developed leadership and management skills. That is why the change agent is usually the leader/manager of the organization .

In this capacity he/she is required to have: • Expert planning skills, including skill in the theory and implementation of planned change. • Visionary in identifying where change is needed • Flexibility in adapting to the change he/she directly initiated or by which they have been indirectly affected.

Planned Change There are two types of change: • Planned change • Accidental change, or change by drift. Planned change is the kind of change we need, it: • results from a well-thought-out and deliberate effort to make something happen. • It is the deliberate application of knowledge and skills by a leader to bring about a change.

This type of planning requires the leadership skills of problem solving and decision making and interpersonal and communication skills. • Changes are implemented slowly after consultation with others. Although the leader/ manager is often the change agent, in some large organizations today, multidisciplinary teams of individuals, representing all key stakeholders in the organization, are assigned the responsibility for managing the change process. In this case the leader may be the coordinator of this team.

THE DEVELOPMENT OF CHANGE The need for change starts to appear when people begin to feel dissatisfaction with the status quo. Lewin identified three phases through which the change agent must proceed before a planned change becomes part of the system: • unfreezing, • movement (or change), and • refreezing.

UNFREEZING REFREEZING CHANGING The Change Process One way to visualize the process of change in an organization is to imagine an ice cube melting, turning into water, and then being frozen again into ice. In organizational terms, the process can be seen as three stages:“unfreezing”the existing status quo,“changing or movement” through some set of actions, and“refreezing”into a new stable pattern! Figure 1. The Change Process

1- Unfreezing Phase In the unfreezing phase, the change agent unfreezes forces that maintain the status quo to reveal the drawbacks of the present situation. Thus, people become discontented and aware of a need to change. Unfreezing is necessary because before any change can occur, people must believe the change is needed.

For effective change to occur, the change agent needs to have made : • a thorough and accurate assessment of the extent of and interest in change, • the nature and depth of motivation, • and the environment in which the change will occur.

Remember Change should be implemented only for good reasons. Change for change’s sake subjects employees to unnecessary stress and manipulation.

Exercise (1) Try to remember a situation from your own experience that involved unnecessary change and another where change was needed but not attempted. What was the result in each situation? If you were the responsible leader in each situation, what actions do you think should have been taken?

2- Movement or Change Phase Any change process is faced with a certain level of resistance. In the movement phase, the change agent identifies, plans, and implements appropriate strategies, ensuring that driving forces (forces supporting change) exceed restraining forces (forces resisting change).

Recognizing, addressing, and overcoming resistance may be a lengthy process. Any change of human behavior, or the perceptions, attitudes, and values underlying that behavior, takes time. Therefore, any change must be gradual to allow enough time for those involved to be fully assimilated in that change.

Points Regarding The General Nature Of Change • Change is unsettling, people (including ourselves) often tend to resist it, particularly if they have had no part in: • recognizing the need for it, • in shaping it, and • in influencing its introduction and its timing.

In most parts of the world,societyas a whole (which includes us and our staff) now expects to be more fully consultedabout the decisions that affect them. So the manager must earn the commitment of those affected by change through their involvement in achieving it successfully. This may require greater participation. • If change is to occur, people must not only understand the need for it, but also see its potential benefitand be sure that they will not be damaged by it.

While managers must know the detailed reasonsfor the change, they must also realize that emotionsare at least as important: it is not just enough to alter the rules. Thoughts, feelings, attitudes and habits that need changing must be brought to the surface and expressed and discussed openly. Such open discussions can help the individual to change his attitude as he sees others changing theirs.

The timing of the change is, therefore, critical: whilst momentum for the change needs to be maintained there must be enough time and opportunity for people to express and modify their views in adjusting to the prospect of change.

3- Refreezing Phase • This is the last phase, during which the change agent assists in stabilizing the system change so it becomes integrated into the status quo. • If refreezing is incomplete, the change will be ineffective and the pre-change behaviors will be resumed. • For refreezing to occur, the change agent must be supportive and reinforce the individual adaptive efforts of those persons affected by the change. • It is important to realize that refreezing does not eliminate the possibility of further improvements to the change.

People’s Reaction to Change Several authors described people’s behaviour and reaction to change. Murphy, in a contemporary model, suggests that there are fourpredictable stages that people pass through when exposed to any change: • resistance, • confusion, • exploration, and • commitment.

There are predictable behaviors associated with each of these stages, and the most effective change agents study these behaviors and are able to respond appropriately to get their team committed and back on track toward the goals. It is critical that the change agent consciously and constructively deals with the human emotions associated with all phases of planned change.

DRIVING AND RESTRAINING FORCES People maintain a state of status quo or equilibrium by the simultaneous occurrence of both driving and restrainingforces operating within any field. • The forces that push the system toward the change are driving forces, • Whereas the forces that pull the system away from the change are called restraining forces. For change to occur, the balance of driving and restraining forces must be altered. The driving forces must be increased or the restraining forces decreased.

To know the type and strength of each group of forces, leaders need to make a thorough and accurate analysis of the fields in which they operate. This analysis is called Force Field Analysis. An example of drivingforces for organizational change may include: • a desire to please one’s boss, • to eliminate a problem that is undermining productivity, • to get a pay raise, • to receive recognition.

Restraining forces include: • fear of the unknown. • conformity to norms. • unwillingness to take risk, (See figure 1)

Goal: Undergo organizational change Driving Forces Restraining forces Please bossFear of the unknown Eliminate problemsUnwilling to take risk Get pay raise r R Conformity to norms Receive recognition Fig. 1: Model of Force Field Analysis

Numerous factors affect successful implementation of planned change. Many good ideas are never realized because of: • Poor planning skills • poor timing or • Non gradual implementation of change • a lack of power on the part of the change agent. • Poor communication and problem solving skills, • lack of participation of those involved in the change process • Lack of adequate availability of the required human, non human and technical resources……etc

Therefore, to guarantee successful planned change the change agent must overcome all such pitfalls in order to adequately prepare the Health Care Organization (HCO) for the coming changes. This may be accomplished by carefully following all the required instructions discussed concerning planned change.

Resistance: The Expected Response to Change • Because change disrupts the homeostasis or balance of the group, resistance should always be expected. • The level of resistance generally depends on the type of change proposed. • Technological changes encounter less resistance than changes that are perceived as social or that are contrary to established customs or norms.

It also is much easier to change a person’s behavior than it is to change an entire group’s behavior • Likewise, it is easier to change knowledge levels than attitudes. In an effort to eliminate resistance to change managers historically used: • an autocratic leadership style, • an excessive number of rules, and • a coercive approach to discipline.

The resistance, which occurred anyway, was both: • covert (such as delaying tactics or passive- aggressive behavior) and • overt (openly refusing to follow a direct command). This resulted in wasted managerial energy and time, Low productivity and a high level of frustration. Today, resistance is recognized as a natural and expected response to change.

Instead of wasting time and energy trying to eliminate opposition, contemporary leaders now identify and implement strategies to minimize or manage this resistance to change. One such strategy is to encouragesubordinates to: (i) Speak openly so options can be identified to overcome objections. (ii) Talk about their perceptions of the forces driving the planned change so the manager can accurately assess change support and resources.

Whenever possible, all those who may be affected by a change should be involved in planning for that change (participative or collaborative planned change). • Perhaps one of the greatest factors contributing to the resistance encountered with change is a lackof trust between the employee and the manager or the employee and the organization. Workers want security and predictability. That’s why trust is eroded when the ground rules change. Subordinates always fear how change will affect their personal lives and status ,therefore:

leaders should clearly communicate with the rest of the organization the goals and progression of the change process. • ensure that group members share perceptions about what change is to be undertaken, • who is to be involved and in what role, and • how the change will directly and indirectly affect each person in the organization. • Involve them in the change process so they feel they played a valuable role and work for it’s success.

When resistance is accepted as an expected natural process and handled adequately, the possibility of its smooth control is very high and successful implementation of change is remarkable.

Thank You

Learning Objectives