Change Management and Implementation
What is it?
Procurement managers are often required to implement changes in the organisation. This may be the creation of a new sourcing strategy, a change to the specification, a new supplier, a change in structure, or process improvements. They will therefore need to act as an internal change agent for the organisation, responsible for managing the change and implementing the initiative.
The change agent first of all needs to fully understand the change, its scope and time-frame, whether the organisation is ready for the change, and whether the required resources and capabilities exist to make the change happen. A stakeholder analysis should be undertaken, identifying all relevant stakeholders and ascertaining whether they are for or against the change.
A force-field analysis is a useful technique for visualising and mapping the driving forces (forces for) and restraining forces (forces against) the change. Identifying the driving forces enables you to build a case for the change and co-opt support for implementing it. Identifying the restraining forces allows you to focus on and mitigate these challenges in order to overcome resistance.
Secondly, the change agent needs to manage the change effectively. This requires a robust change management approach which addresses the behavioural aspects of the change:
|
Change existing behaviour |
Create an awareness of the need to change Establish a sense of urgency Form a guiding coalition of stakeholders Create a compelling vision Communicate the vision widely and clearly Create a desire to participate and support the change Provide knowledge of how to change and what the change looks like |
|
Make the change |
Ensure that people have the ability to implement the change Empower people to act on the vision Create short-term wins to create momentum Consolidate improvements to produce further change Encourage participation and involvement Provide facilitation and support Communicate and celebrate progress |
|
Consolidate new behaviour |
Institutionalise the change Embed it in the culture, procedures and systems of the organisation Provide training and reinforcement to keep the change in place Monitor the change, evaluate it and measure the benefits Communicate the results and benefits |
The change agent also needs to implement the change. This requires an implementation plan, which breaks the change down into manageable chunks. It will include details of the required activities, their timings and sequences. A responsibility matrix complements this, by displaying who is responsible for each action, who is accountable, who requires close communication, and who should merely be kept informed.
What does it look like?
How does it work in practice?
A meta-analysis of the implementation of telemedicine services in healthcare organisations identified a number of change management practices commonly used in relation to ten change steps:[1]
The study also identified change management practices which were not evident but would benefit implementation success: anticipate and identify gaps and areas of resistance; integrate change management plan into a project plan; and celebrate success and short-term wins. The need for both strategic and operational practices was another finding.
A study of health information technology implementation in a public hospital in Ghana identified five critical change management factors.[2] These were: stakeholder participation; proof of experience in similar projects; availability of committed change agents; a clearly articulated change implementation strategy; and a training and improvement mechanism post-implementation.
The study also found that there are multiple stakeholders with differing interests, necessitating the need for multi-layered change teams to arrest the concerns of sceptics and reassure them by drawing on past successes. Clear and reliable change information communicated in advance also contributed towards successful change management and effective implementation.
A study of organisational change in relation to the redevelopment of a large metropolitan public hospital identified a number of positive and negative change management factors within four main themes:[3]
|
THEME |
EXPLANATION |
EXEMPLAR QUOTE |
|
Engage actors |
Staff, patients, families, community members should be engaged in the move. For example, certain staff can be used as ‘champions’ to address concerns and inform co-workers about the new build. |
“I was involved in this part of the build, so it gives a bit of ownership to the new unit” |
|
This may foster commitment, a sense of ownership, renewed motivation, engagement in work, and excitement that may aid in the smooth transition and adoption of the new build. |
“We need people who are keen, committed and positive about the move and able to support staff in that transition.” |
|
|
Plan and train |
Hospital staff suggested that having a concrete plan and training staff for the new facilities is essential. Planning and training will give staff the opportunity to acclimatise to the new environment and reflect on how it will change their ways of working. |
“I think it’s really important that we be organised so that staff are well oriented and ready for the move rather than just moving and staff are not ready for it” |
|
Learn from the past |
The hospital redevelopment is part of a multi-stage project similar to other hospitals. Hospital staff highlighted that individuals running this project must learn from the issues that occurred in the first stage of the redevelopment, as well as the experiences of other hospitals. |
“I’ve been across to […] and spoken to them because they’ve come from a very similar thing… Just looking at what challenges they had… learn from their experiences.” |
|
Increase managerial engagement |
Hospital staff in more junior positions expressed a lack of collaboration with executives and a lack of communication regarding elements of the redevelopment process. There was a general sense of disconnect between hospital management and staff, expressed by front-line clinicians. |
“I think there probably needs to be more collaboration from above, as in more information, because it’s like this is what’s happening. And you’ve had no involvement in the process. I think that’s wrong.” |
[1] https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-020-05657-w
[2] https://www.emerald.com/insight/content/doi/10.1016/j.aci.2019.11.007
[3] https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-019-4704-y
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