1. What is qualified immunity 2. What is the rule regar.docx

1. What is qualified immunity?
2. What is the rule regarding review of summary judgment on
appeal after a final
judgment is rendered?
3. What is the rule applied to litigants that fail to timely object
to evidence at trial and
attempt to raise an objection to such evidence on appeal?
4. What is the rule regarding leave to amend as it applies to the
discretion of the
district court? Note underlying purpose of Fed. R. Civ. P. 15
(2015).
5. What is the rule regarding federal judges supervising trials,
and how does that rule
apply to a trial judge’s behavior/rulings?
6. What is the test applied when a lawyer asserts that a member
of the jury engaged in
juror misconduct by purposefully withholding information

during voir dire (the
questioning of a jury panel to determine the fitness to serve on
the jury) indicating bias?
7. What is the rule regarding an appellant seeking a reversal
based on their own
evidentiary errors?
8. What is the rule regarding a judge participating in the
examination of witnesses?
9. What is the rule regarding the authority of a federal judge to
determine the extent
and nature of a post-trial evidentiary hearing?
You are limited to no more than 5 pages of text, Times Roman
12 point, 1-inch margins on
all sides, 1.5 spacing. Put the sources you use to document your
responses on a separate
page as “endnotes” not footnotes.
1.Introduction- Change.docx
1 Introduction to Book 7
(Author: Jeni Grubb, with revisions by Ingrid Brooks)

In this book we introduce the important issue of change which,
for Carlopio and Andrewartha (2008) is the most common
activity that demonstrates leadership in organisations. In Yoder-
Wise and Menix’s (2003) words: “Change is a natural social
process of individuals, groups, organizations, and society”
(p.322).
As we have seen in previous discussions, organisations can be
conceptualised as open systems, with the forces for change
coming from both inside the organisation and outside. They are
essentially processes and are composed of people in
relationships with other people; nothing more than relationships
and social contracts between people. All organisational change
therefore “requires personal change in an organisational setting”
(Carlopio & Andrewartha, 2008, p.496). However personal
change is not easy – it takes effort, persistence and time. With
change we adapt, learn and grow although there can be a sense
of loss as old ways of doing things become redundant.
Change is a generic term, which, for our purposes, can refer to
macro change in the overall health care system, changes at
organisational level, or micro change within your specific work
unit or department. Indeed it is likely that a macro change, such
as a change in the direction of health care policy by the
government, can create a ripple effect throughout the health
care system (including the private sector), right down to micro
changes in actual service delivery. For example, if the
government decides to rationalise services in some manner,
community hospitals may be amalgamated into a large health
care network. Administration may be streamlined; health care
services at each campus may be rationalised and staff relocated
into new units. Specific work practices may be altered or new
technologies introduced. Economies of scale may be achieved
through this restructuring but there will be some unpalatable
costs, such as staff redundancies, less local input into decision-
making, or clients having to travel further to receive care.
According to Beerel (2009) the main purpose of change is “to

attune and align the organization to new realities that are
continuously emerging and presenting themselves” (p.xvii). If
the organisation is to survive, it must adapt to changing
conditions, ensuring that employees acquire the knowledge,
skills and attitudes required to remain productive and to
maintain quality service provision. The sooner the organisation
recognises new and emerging realities, the more opportunity
and time it has to initiate appropriate strategic responses. Beerel
(2009) points out that failure to recognise new realities, or
instigating change initiatives based on a false reading of the
new realities, is a “sign of poor organisational leadership and
inevitably has a detrimental effect on the organization’s future
survival (p.xvi). Effective leaders are attuned to environmental
changes and trends “because new realities always signal
change” (Beerel, 2009, p.xvi).
In this book we will discuss the role of the nurse manager in
leading change and consider the challenge of change in health
care. We will identify various forces of change and some
responses to change; and discuss change theories and strategies.
Leading change proactively can offer opportunities to control
outcomes and achieve goals. However reacting to changes that
are imposed upon the unit/organisation is also an important
management responsibility.
2 Learning outcomes
By the end of this book and with further reading and research,
you are expected to be able to:
· describe the role of the change agent in planned care;
· discuss the types of change that occur within health care
organisations;
· identify forces which facilitate and inhibit the change process
within health care organisations;
· evaluate theoretical approaches to planned change; and
· initiate and manage change applying appropriate models and
strategies.
3 Leading change

Given the pace and size of change in health care, nurse
managers are continually involved in some form of change,
ranging from the introduction of new equipment or care
practices through to major organisational change. These changes
will continue with or without the expert guidance of nurses.
Nurses cannot afford to simply survive change; they need to be
proactive in the change process and in shaping future health
care services (Sullivan & Decker, 2009).
Unplanned change is reactive and introduced to deal with
unanticipated, or previously ignored, internal or external
circumstances. As Marquis and Huston (2009) point out that the
nurse manager should be receptive to change and view planned
change as a challenge; an opportunity for growth; and a chance
to do something creative, new and innovative.
Reflection: your experience of change
Spend a few moments reflecting about the changes that have
occurred in your workplace in the past two years. Have these
changes been predominantly accidental or have they been
planned?
Who has been the initiator of change?
Has change been imposed on you (personally or nursing as a
group)?
How have you responded?
To what extent did you have a leadership role?
What is the outcome in a personal cost/benefit analysis?
How did you go? I would be surprised if all of the changes that
have occurred have felt totally comfortable for you, even if you
are relatively open to change.
Planned change is a proactive enterprise in which change is
anticipated and where a change agent, skilled in the theory and
practice of organisational change, initiates and manages the
change. The change agent may be an external person, such as a
consultant or, not infrequently, the manager. Whilst external
consultants or newly appointed Chief Executive Officers
(CEOs) can provide a more objective assessment of the need for

organisational change, they may be at a disadvantage in terms
of not understanding the organisational culture, personnel and
operating procedures. Further, as external change agents (and
some CEOs) move on and do not have to live with the
consequences of their changes, they are likely to initiate more
drastic changes than insiders. In larger organisations a
transitional management team may be allocated the time and
responsible for managing the change process. This could
include both insiders and outsiders.
For Marquis and Huston (2009) the key to success is to involve
all of the people affected by the proposed change in the
planning process. They argue that people hate “information
vacuums” and propose that if there is no on-going discussion
about the change, gossip and negativity will fill the void.
Arguing that a partnership between staff and higher
management is more effective in producing change than a top-
down approach, Sullivan and Decker (2009) identify a number
of characteristics of effective change agents that can be
cultivated and mastered with practice:
· the ability to combine ideas from unconnected sources;
· the ability to energise others by keeping interest levels up and
to have high personal energy levels;
· the ability articulate a vision through versatile thinking and
insights;
· well developed interpersonal communication, group
management and problem-solving skills;
· the ability to retain the big picture focus whilst dealing with
each part of the system;
· enough flexibility to modify ideas when this will improve the
change, but enough persistence to resist non-productive
tampering with the plans;
· confidence and not inclined to be easily discouraged;
· the ability to handle resistance;
· realistic thinking; and
· trustworthiness: a track record of integrity and success with
previous changes (pp.73-74).

A change agent views change as healthy. In initiating needed
change proactively, the nurse leader is imaginative, bold,
ingenious, persistent and determined.
The first reading is from Carlopio and Andrewartha (2008). It is
quite long we would like you to read up to page 505 and come
back to the rest of the chapter later on in the topic. Carlopio and
Andrewartha (2008) initially focus on personal change, in an
organisational context – as you read try to be reflective. We
have included this chapter for your convenience and because of
their approach to this key topic.
Reading
Carlopio, J., & Andrewartha, G. (2008). Developing
management skills: a comprehensive guide for leaders (4th ed.).
Frenchs Forest, NSW: Pearson Prentice Hall, Chapter 10:
Managing change, pp.492505.
Your reading can be accessed here
We will now consider some forces for organisational change.
4 Forces for change
Change can be considered in terms of intensity or according to
the level of change. Intensity can range from almost
imperceptible to a radical transformation of the whole
organisation or system (Tappen, 2003). If we view organisations
as an open system, change can occur on different levels:
environmental, organisational and individual levels. Robbins,
Judge, Millett and Waters-Marsh (2008) identify several forces
for change, with examples, in today’s dynamic environment:
· technology: advances incomputerisation, deciphering of the
human genetic code;
· nature of the workforce: aging population, more cultural
diversity;
· competition: mergers and consolidations, global competitors;
· social trends: retirement of baby-boomers;
· world politics: wars,opening of markets in China; and
· economic shocks: the global financial crisis.

Which of these do you consider relevant to health care systems
and organisations in your country?
Hernandez and Kaluzny (1994, p.297) propose that health care
organisations experience forces for change from four main
sources: technical changes; service or product change,
administrative, structural or strategy change; and human
resources change.
Technical change could involve changes in surgical procedures;
altered job assignments; or the introduction of new equipment.
Service or product change could include the introduction of a
new service, such as renal dialysis services in a regional centre
where previously it was only available in metropolitan
organisations.
Administrative, structural or strategic change could involve
changes to the organisation’s financial management systems; a
flattening of the hierarchal structure; or shifting district nursing
services out of an acute care hospital and into a community-
based health care service.
Human resource change involves efforts to shape attitudes,
values, behaviours and skills of employees (Hernandez &
Kaluzny, 1994, p.298).
Graetz, Rimmer, Lawrence and Smith (2002) argue that, in a
post-industrial era, the global business environment is
characterised by “complexity, uncertainty and turbulence”
(p.17). Traditional modes of operating are no longer sustainable
and change is random and discontinuous. By definition, this
type of change is rapid, revolutionary and traumatic and
requires different leadership skills if the challenges faced are to
be managed opportunistically and innovatively. What are the
challenges for nursing leaders, managers, clinical nurses and
change agents in health care organisations in this environment?
To what extent has this global business environment affected
health care organisations in this decade?
4 Forces for change
4.1 Analysing forces for change
Change can be analysed in terms of the external and internal

factors influencing an organisation’s need for change. These
factors are used as the basis for analysing the driving forces of
change and forces impeding change. Without doubt, the way in
which organisations provide health care is influenced by forces
beyond the organisation. Increasingly we are part of a global
community with political, economic, technological, and
environmental factors impacting upon health care.
In monitoring the external environment, managers consider
factors such as:
· changes in health care policy and funding;
· economic changes;
· funding cutbacks;
· demands for better health care at lower costs;
· societal values and expectations;
· consumer demands (e.g. more informed patients);
· demographics;
· developments in health care;
· fluctuations in labour markets;
· education trends; and
· the activities of other health care organisations.
Within the organisation, internal factors considered include
changes involving the:
· people (e.g. greater employee participation; need to address
human resource problems, including poor performance; revised
strategic vision; reducing staff numbers);
· technology (e.g. advances in medical technology);
· structure (e.g. restructuring, contracting out for services); and
· tasks (e.g. new clinical pathways).
These factors are some of the main entry points for
organisational change. They are so interrelated that a change in
one area invariably requires change in the other areas as well. A
factor not included in this model is financial resources, a factor
that can facilitate or impede change or can be a change in its
own right.
4 Forces for change
4.2 The challenge of change in health care

The transformation of healthcare delivery creates contextual
alterations in change situations, requiring planning, decision
making and information. Uncertainty in the changing workplace
challenges nurse managers and change agents to communicate
more extensively and perhaps differently than in more stable
climates.
As discussed in previously, planned health care system reforms
in Australia and countries such as the USA will require
innovation and change management. Other forces are escalating
costs of healthcare; workforce shortages; aging populations; and
the technology to continue to be forces for changes. Much of
the change is being economically driven, with the government,
insurance companies, consumers, employers, and unions
exerting pressure to control spending and to redistribute health
care to more cost-effective care.
Given that change processes are influenced by organisational
culture, it may be necessary to change the organisational culture
in order to make progress. Marquis and Huston (2009) claim
that healthcare organisations lag behind trends in American
corporations that demonstrate that investments in developing
the organisational culture translate into high performance. Does
this apply in Australia/your country?
The organisational culture is largely set by the leadership and a
constructive organisational culture is essential characteristic of
a healthy organisation (Marquis & Huston, 2009). Changing the
underlying culture to facilitate change can be difficult but, if
the goal is important enough, worthwhile.
In every probability the pace of change will continue to
accelerate, affecting every part of our life including our
personal values and work practices. And yet people often don’t
like to change, especially if their current situation feels
comfortable. When events move too quickly, individual and
organisational long-term stability can be threatened. The people
and the organisation may exhibit signs of stress and resistance
to change may strengthen. The success or otherwise of an

organisation may well depend on how well leaders/managers
initiate and manage change.
All too often changes in health care have occurred without
adequate input from clinical nurses and nurse managers. The
challenge is that these changes will continue to occur with or
without nurses’ input. Nonetheless, opportunities do exist for
nurse managers to participate in changes to the system about
which they complain.
Remember: It is not enough to just survive the change. This is
true for all levels of change: the system, organisation, work
unit, for the nursing profession and for you individually.
Reflection: The challenge of change
List the major changes in health care in your state/country over
the past few years.
How has your organisation managed within this environment?
How well does the organisational culture assist in the
achievement of effective change?
How have you coped with the challenge of change, both
professionally and personally?
5 Response to change
The response to change depends on many factors, including the
type of change; the degree of stability in the organisation; the
pace of change. For example, if the organisation is very stable
and the change considered threatening, it may require
considerable force to implement the change. Resistance is the
expected response to any change and, rather than attempting to
eliminate opposition, the change agent can identify and
implement strategies to reduce and manage the resistance to
change.
According to Marquis and Huston (2009), the level of resistance
can depend on the type of change proposed. For example, the
introduction of new technology (such as a new intravenous
pump) will encounter less resistance than a change in
established customs and norms (e.g. a change in who is able to

administer a certain type of intravenous medication). If self-
esteem or personal security is threatened, there is apt to be
greater resistance to the change.
The main sources of resistance to change, both individual and
organisational, are identified by Robbins, et al. (2008) as:
Individual sources:
· habit: people rely on programmed responses to cope with life
and when confronted with change they respond in their
accustomed ways;
· security: those with a high need for security are more likely to
feel threatened and resist change;
· economic factors: changes in work practices can arouse fears
that we will not be able to perform the new tasks or routines to
our previous standards, especially if productivity and pay are
linked;
· fear of the unknown: change substitutes uncertainty and
ambiguity for the unknown; and
· selective information processing is used to keep perceptions
intact; people may hear what they want hear and ignore what
information that challenges the world that they have created.
Organisational sources:
· structural inertia: the organisation has built in mechanisms
(such as formalised regulations) to produce stability which act
as a counterbalance to sustain stability;
· limited focus of change: because organisations are made up of
interdependent subsystems, change in one affects the others.
Therefore limited changes in a subsystem may be nullified by
the larger system or may impact on the whole organisation;
· group inertia: group norms may act as a restraint, even if some
individuals favour behavioural change;
· threat to expertise: changes in practices may threaten the
expertise of specialist groups;
· threat to established power relationships: a redistribution of
decision-making authority can threaten established power
relations in the organisation; and
· threat to established resource allocations: change can be a

threat to groups in the organisation with control over sizable
resources.
Within any organisation there are a range of individual attitudes
towards change. Individual response to change usually falls into
particular patterns of behaviour: innovators, early adopters,
early majority, late majority, laggards and rejectors (Rogers as
cited in Marquis & Huston, 2009).
Innovators thrive on change, may participate in change
involving opposing sides and may effect change in the midst of
controversy. Early adopters are open and receptive to new ideas,
supporting and facilitating change. The early majority prefer the
status quo but, after careful thought, usually adopt the change.
The late majority are followers who frequently express their
resistance to the change until most others have adopted it.
Laggards are the last people to adopt the change. They are
traditionalists who are sceptical of change and innovators.
Rejectors oppose innovation and actively encourage others to
also oppose the process. Rejectors may covertly seek to
undermine the change process and the change agent.
The change agent should seek to recognise these behaviours,
capitalising on the willingness of early adopters and the early
majority to facilitate the change process. As they threaten the
success of the change process, both laggards and rejectors pose
a challenge to the manager/change agent (Rogers as cited in
Marquis & Huston, 2009). The change agent’s challenge is to
provide opportunities to channel the various responses of
workers into actions that are supportive of the change process.
Staff members often go through an emotional grieving process
resulting from the loss of their former work situation. As this
can impact on their attitudes, energy levels and ability to
engage in the change process, the change agent should be
sensitive to the stages of loss and employ appropriate
interventions such as problem solving, active listening and
informing (Kubler-Ross as cited in Carlopio & Andrewartha,
2008).
The change agent should assess the organisational climate for

change. How has the organisation coped with change in the
past? If recent changes have been relatively few or traumatic,
more preparation will be required. Do the employees have the
knowledge and skills to implement the changes? What is the
level of trust between management and employees and amongst
the employees themselves?
Lack of trust between management and employee is probably
the greatest factor contributing to resistance to change. Marquis
and Huston (2009) believe that this trust depends on the
employee’s desire for predictability and security. Trust is
eroded when the status quo changes; when the employer-
employee “contract” changes. The proposed change may be
assessed more in terms of the affect on the employee’s career,
personal life and status than on the welfare of the organisation.
There needs to be trust in the capability of both management
and employees to successfully achieve the proposed change.
Roles and responsibilities of those involved in the change
process need to be negotiated and accepted before such trust can
be established.
Overcoming the inevitable resistance to change can be aided by
involving employees or their representatives in planning groups;
maintaining empathy with resisters; assessing potential and
actual problems; and consistently and honestly informing people
about how the change will affect them personally.
Robbins et al. (2008) suggest a number of tactics for change
agents, including communicating and educating staff;
encouraging participation; building support and commitment;
negotiating; selecting people who will support the change; and
manipulating and coopting; coercing resisters. The last two
tactics are relatively easy and inexpensive but the change agent
will lose credibility and employee trust.
Reflection: Recognising response of change
Recall a recent change within your organisation or workplace.
Identify the players in the situation.
Who were the innovators, early adopters, early majority, late
majority, laggards and rejectors?

Analyse how these individuals influenced the change process.
Which pattern dominated and how did they affect the final
outcome?
What pattern of behaviour did you demonstrate?
Is this usual for you in change?
Can you capitalise on this attribute in your role as a change
agent?
In some instances managers are too keen to impose change for
change sake. Listening to insightful objections to change may
enable the organisation to maintain its stability while the value
of the proposed changes is carefully evaluated.
It may be about time for you to take a nice break and then come
back to explore change theories.
6 Change theories
The theory and practice of change management draws on several
social science disciplines and traditions. For Burnes (2009), the
theories of change fall into two main approaches: a planned
change approach and the emergent approach to change. If you
examine the current nursing leadership and management texts,
most start with Lewin’s (1951), classic force-field model of
change. Other authors divide the theories into linear approaches
to planned change and non-linear change theories.
6 Change theories
6.1 Classical and linear models of planned change
Kurt Lewin coined the term, planned change, as an alternative
to unplanned change and his theory has been influential since
the early 1950’s. His classical theory of change comprises of
four parts: field theory, group dynamics, action research and a
three step model.
Lewin (1951) recognised that individuals experience two major
obstacles to change. Firstly, people have great difficulty in
altering well established behaviours and attitudes. They may be
unable to change because they lack the ability or skills required
or they may not want to change because they can see no

personal benefit in effecting the change. Secondly, Lewin found
that change often lasts for a short period only. After a brief
period of trying to do things differently, people often return to
their established pattern of behaviour. His model is an attempt
to overcome these obstacles.
Lewin (1951) saw behaviour as a dynamic balance of forces
working in opposing directions within a field such as an
organisation. Driving forces push participants in the direction
of the desired direction thus facilitating change whilst
restraining forces lead participants in the other direction and
impede change. Change is accomplished by analysing these
forces and shifting the balance in the direction of the desired
change though the three step process: unfreezing, moving and
refreezing. This process is an iterative, cyclical process that
involves diagnosis, action, reflection and evaluation, and
further action and reflection and evaluation. It recognizes that,
once implemented, the change needs to be self-sustaining and
that staff do not regress to old behaviours.
In the unfreezing stage, motivation is created for some form of
change to occur. The change agent identifies a problem, decides
that change is required and makes others aware of the need for
change. The role of the change agent is to analyse and then
disrupt the forces which are maintaining the status quo. As
people become unsettled or discontent, awareness of the need
for change develops.
The force field analysis should take into account factors in the
external environment (such as changes in policy or consumer
demand) and internal environment (such as people, financial
resources; technology, structures and tasks). According to
Lewin (1951), the analysis may identify many factors but some
will be more significant than others and it is there that the most
energy will be required. For example, let’s say the change agent
is aiming to improve communication processes by introducing a
new computer information system within an aged care facility.
The analysis may reveal that, whilst the available technology,
the support from upper management and adequate financial

resources are the factors driving change, a major source of
resistance could be that the staff don’t want to change because
they lack the computer skills.
Whilst both forces are important, Lewin (1951) advocates more
emphasis on reducing the forces resisting the change rather than
on increasing driving forces. Active participation of staff in
identifying the problem and generating options for action can
help prepare people for change. Readiness for change increases
if the level of dissatisfaction is high. So if the level of
dissatisfaction is low the change agent needs to increase it by
introducing new ideas or new information. This is the time to
“rock the boat” by making people uncomfortable with the status
quo.
The moving stage involves detailed planning and actually
initiating the change, or moving to the desired situation. This
includes identifying, planning and implementing using
appropriate strategies. At this point the driving forces should
exceed the restraining forces.
In recognition of the complexity of change, the timing of the
change should be appropriate and the change implemented as
gradually as circumstances allow. Once implemented, the
change should be evaluated and modified if necessary.
During the refreezing stage, the change agent assists in
stabilising the change so that it becomes integrated into the new
status quo. Permanency should be cultivated – for example,
through formal structures, such as establishing written policies,
by monitoring staff actions and by providing positive
reinforcement. Personnel should be supported until the change
is fully accepted, usually for about three to six months.
Refreezing does not eliminate future improvements. As they
say, “the proof of the pudding is in the eating” and the success
of the change should be evaluated when the change agent
terminates the supportive relationship by delegating the
responsibility to target system members.
Reading
It is time to return to the Carlopio and Andrewartha (2008)

reading. Please read pages 505 to 530
Reading link
William Bridges (as cited in Gratetz et al., 2002) developed a
model of transition, arguing that change is situational: a new
boss, a new site, new policy, or new team roles. He also argues
that people go through a transition; i.e. a psychological process
through which they come to terms with the new situation. For
him, change is external and transition is internal. The three
stages in the process of transition are: endings, the neutral zone
and new beginnings. As with all psychological stage theories,
there is a degree of overlap between stages.
Endings: the first stage of the transition involves assessing what
will be lost in the change process and accepting this loss. For
example a new breakthrough technology may mean that existing
knowledge will become obsolete and other people become the
“expert”. Bridges (1991) proposes that the biggest single
problem encountered by organizations in transition is the
“failure to identify and be ready for the endings and losses”
(p.5). The neutral zone: the second stage of transition is a
period when old habits, beliefs and attitudes are extinguished
because they are deemed no longer appropriate. New patterns
are learned, practiced and adjusted to by staff. It is a period of
discontinuity and discomfort. Anxieties will be high; motivation
may be problematic; and productivity can suffer. On the
positive side, opportunities for creativity exist in this period.
New beginnings: the third stage of the transition occurs only
when and if the staff have made an ending and have spent some
time in the neutral zone. Bridges points out that, while it is the
last stage of the change process, managers and change agents
sometimes mistake it for the first stage. Unlike the first two
stages, it is a psychological rather than a situational stage and is
open ended. There is not manageable timetable that can be
devised.
6 Change theories
6.2 Non linear approaches to change in organisations

More contemporary change theorists argue that the linear
approach is suited to the industrial era where change was more
predictable, infrequent and the environment more stable.
Today’s health care organisations are likely to experience
intense transformation, followed by periods of stability. As
change is ever present and unforeseeable, non-linear change
theories are now influencing the thinking of many leaders
(Marquis & Huston, 2009). Daly et al. (2004) agree and explain
that the nonlinear models” are based on the premise that change
occurs naturally from self-organising patterns. These newer
theories include chaos theory, learning organisations and
complex adaptive systems theory.
Chaos theory is one of the main complexity theories and works
on the assumption that organisations are open systems operating
in a “complex, unpredictable, and orderly disorder in which
patterns of behaviour unfold in irregular but similar forms”
(Burnes, 2004, p.597). From this perspective, organisations are
in a state of flux and the periods of stability are a departure
from the norm that requires explanation. Emphasising policies
and rules is short-sighted and waste time (Yoder-Wise & Menix,
2007).
Learning organisation theory is a related approach. Learning
organisations organisations place emphasis on flexibility and
responsiveness. By using a learning approach, leading
organisations try to survive in an unpredictable healthcare
environment by using a learning approach. The aim is to be
more responsive and adaptive to external and internal
influences. For Senge (as cited in Marquis & Huston, 2009), an
organisation achieves this learning organisation status when all
of the critical elements are present, interacting and linked.
These are identified as five disciplines:
1. Systems thinking
2. Personal mastery
3. Mental modes
4. Shared vision
5. Team learning.

Please now read a chapter from Burnes (2009). He critiques the
planned theory approach, discusses and critically evaluates
emergent approaches to change, including complexity theories,
and the role of the manager as change agent. In the process he
draws together a number of related topics in this unit, including
organisational structure, managerial behaviour, and power and
politics.
Reading
Burnes, B. (2009). Managing change: a strategic approach to
organisational dynamics (4th ed.). Essex: Financial Times
Prentice Hall. Chapter 9: Development in change management:
the emergent approach and beyond, pp. 392-398.
Reading link
A key point of the emergent approach is that organisational
change is messy, unpredictable, open-ended and political
process. From this perspective, top managers can no longer be
expected to be able to identify and implement all of the changes
necessary to successful align the organisation to its
environment. Therefore, from this perspective, the change
process should be bottom-up, emergent and responsive to
events.
7 Change strategies
The change agent and those supporting the change employ
various strategies to facilitate both planned and non-linear
changes processes. Some of these have been featured in your
readings. The aim is to promote movement towards integrating
the change and to minimise harmful resistance to the change.
The choice of strategies for planning and implementing change
depends on many factors, but may include the type of problem,
the environment, the type of organisation, and the values of the
organisation. To be successful, the chosen strategies should be
congruent with such factors and should be chosen
collaboratively by organisational representatives and the change
agent.

Kotter and Schlesinger (as cited in Yoder-Wise & Menix, 2007)
advocate the selective use of various strategies to overcome
resistance, to promote the involvement of those affected by the
proposed change, and to facilitate the overall change process.
These include: participation and involvement; facilitation and
support; education and communication; negotiation and
agreement; manipulation and co-optation; and coercion and can
be used individually and in combination with each other. Chaos
theory and learning organisation theory support the use of
vision development, information management strategies and
relationship building (Yoder-Wise & Menix, 2007).
Three classic strategies for effecting change in others have been
proposed by Bennis, Benne and Chinn (as cited in mainstream
nursing management texts such as Sullivan & Decker, 2009;
Marquis & Huston, 2009). These are: rational-empirical
strategies, normative-reeducative strategies, and power-coercive
strategies. The choice of strategy will be influenced by the
power of the change agent and the amount of resistance
anticipated.
Rational-empirical strategies work on the assumption that
people act in rational self-interest and are rational beings who
will accept the change if provided with factual information
which convinces them of the need for change. These strategies
are usually most successful when there is little resistance to the
proposed change and the change is considered reasonable
(Sullivan & Decker, 2009; Marquis & Huston, 2009).
Normative-re-educative strategies utilise group processes to
socialise and influence people so that the change will occur.
The change agent uses collaboration and is focused on non-
cognitive determinants of behaviour, such as people’s attitudes,
feelings, roles and relationships to increase acceptance of the
proposed change (Sullivan & Decker, 2009; Marquis & Huston,
2009). As these strategies enable the creative problem-solving
and emphasise a human relations approach, they are generally
most suitable for planned change in nursing and health care
(Sullivan & Decker, 2009).

Power-coercive strategies are based on the application of
“power by legitimate authority, economic sanctions, or political
clout” of the change agent (Sullivan & Decker, 2009, p.71).
Such strategies are useful when time is short, the survival of the
organisation is at stake and/or significant resistance to the
change is anticipated. There is little participation by the target
group and resistance is managed by authoritative measures. If
employees don’t like it they can leave (Sullivan & Decker,
2009). Of course the employees may choose to adopt this
strategy also, perhaps by taking industrial action.
Whilst normative-re-educative strategies may be considered
most appropriate, the change agent may opt to use all three
types of strategies to increase the chances of successful change.
8 Concluding comments
If we accept that change is a constant, has always been with us
and will continue to dictate reality, it behoves the nurse
leader/manager to be knowledgeable and skilled in initiating
and managing different types and levels of change. The skilled
change agent fulfils a leadership and management function in
the organisation, identifying areas where change is appropriate
and needed, or is perhaps already occurring. Intelligence, skill
and experience are essential for survival in the continuously
changing work context. The change agent has to be
knowledgeable about models of both planned change and non
linear approaches to change and the different strategic
approaches to change. The leader/manager must maintain an
awareness of the big picture of change in healthcare
organisations, whilst sensitively managing each part of the
system, including staff members’ responses to the change.
Change is an opportunity for growth and progress but it can be
disruptive and traumatic for some. The range of skills required
by the leader/change agent is broad but includes being able to
share a vision and to creatively solve problems. The change
agent should be a good communicator, trustworthy and a role

model for change.
9 References
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1.1 ,,5.6Mento Change management theories.pdf
avoiding major errors in the change
process. It is best viewed as a vision
for the change process. It calls
attention to the key phases in the
change process. Two key lessons
learned from the model are that the
change process goes through a series of
phases, each lasting a considerable
amount of time, and that critical
mistakes in any of the phases can have
a devastating impact on the momentum
MODELS OF THE CHANGE PROCESS
Three models have stood as exemplars
in the change management literature.
The first model is Kotter’s (1995)
eight-step model for transforming
organisations. Kotter’s model was
developed after a study of over 100
organisations varying in size and
industry type. After learning that the
majority of major change efforts failed,
Kotter couched his model as a way of
� Henry Stewart Publications 1469-7017 (2002) Vol. 3, 1, 45–
59 Journal of Change Management 45
A change management process:
Grounded in both theory and practice
Received (in revised form): 30th May, 2002

Anthony J. Mento
is a professor of Organizational Behavior at the Sellinger
School at Loyola College. Dr
Mento has taught in executive programmes at such institutions
as Aegon, Deutsche
Bank and the US Government as well as at Loyola.
Raymond M. Jones
is a professor of Organizational Strategy at the same university.
Prior to academic life, he
was an executive at Occidental Petroleum Corporation. Dr Jones
helped design and
taught in the executive programmes of this paper’s anonymous
corporation.
Walter Dirndorfer
is a graduate of Loyola’s executive MBA programme. He is a
project manager at a
defence contractor who requested anonymity as a result of
increased security measures
after the events of 11th September.
KEYWORDS: change management, lessons learned, mind
mapping, project
management, storytelling, metaphors
ABSTRACT There exists in the literature a number of change
models to guide and instruct
the implementation of major change in organisations. Three of
the most well known are
Kotter’s strategic eight-step model for transforming
organisations, Jick’s tactical ten-step model
for implementing change, and General Electric (GE)’s seven-
step change acceleration process
model. This paper introduces a framework that draws from these

three theoretical models
but is also grounded in the reality of the change process at a
Fortune 500 defence industry
firm. The purpose of the paper is to provide guidance to the
practitioner leading an
organisational change process. This guidance is grounded in
both theory and practice. The
guidance is further enriched by the demonstrated use of such
methodologies as mind
mapping, lessons learned, storytelling and metaphors.
Anthony J. Mento
Professor of Organizational
Behavior, Sellinger School,
Loyola College, 4501 North
Charles Street, Baltimore,
MD 21210, USA
Tel: �1 410 617 1507;
Fax: �1 410 617 2005;
e-mail: [email protected]
accessible, ensuring that all essential steps
are followed. Discipline, not discovery is
the goal of the checklist.
The three models of the change
process are configured in Figure 1 as a
Mind Map. Mind mapping is a creativity
and productivity enhancing technique
that can improve the learning efficiency
and capability of individuals and
organisations (see eg Buzan, 1989; Mento
et al., 1999). The Mind Map visually

shows the intellectual roots upon which
we drew. Three plus years of practical
experiences, however, further shaped
these theoretical constructs with change
management at an anonymous defence
contractor (ADC). Because of increased
security measures after the events of 11th
September, the defence firm requested
anonymity after the write-up of the
projects had commenced. Thus drawing
lessons learned from both the theoretical
literature and a practitioner’s experience,
this paper provides guidance to the
leader of an organisational change
process. This guidance is grounded in
both theory and practice. Furthermore, it
demonstrates and is enriched by the use
of such methodologies as mind mapping,
lessons learned, storytelling and
metaphors.
COMPANY BACKGROUND
In the 1990s, the defence industry was
greatly affected by a shrinking defence
budget after the collapse of the former
Soviet Union. The reduced defence
expenditures caused a consolidation of
firms within the industry. The division
under study was acquired and became a
core business area for the acquiring firm
in the mid-1990s. Additional acquisitions
created a de facto market of internal
engineering organisations, all vying for
the same corporate resources to fund
both product improvements and new
product development. A critical

of the change process. Kotter’s model
is aimed at the strategic level of the
change management process.
Jick (1991a) developed a tactical level
model to guide the implementation of
major organisational change. His ten-step
approach serves as a blueprint for
organisations embarking on the change
process as well as a way to evaluate a
change effort already in progress. He
notes that implementing change is an
ongoing process of discovery, with
thoughtful questions continually being
asked throughout the change journey.
Jick states that implementation is a blend
of both art and science. How a manager
implements change is as important as
what the change is. How well one does
in implementing a particular change
depends ultimately on the nature of the
change, on how sensitive the
implementers are to the voices in the
organisation, and on the recognition that
change is a continuous, not a discrete
process.
The seven-step change acceleration
process used at GE (Garvin, 2000: 131)
follows closely Lewin’s (1947) notion of
unfreezing, movement and refreezing as
the essential components of the change
process. In essence, the model focuses on
the leader’s role in creating urgency for
the change, crafting and communicating

the vision, leading the change, measuring
the progress of change along several
dimensions, and institutionalising the
change. Institutionalising the change, or
the refreezing, involves changes in the
organisational design factors, ie creating a
fit of systems and structures to enable
change. Kerr (quoted in Garvin, 2000),
one of the developers of the model,
refers to the series of seven steps as a
pilot’s checklist. According to Garvin
(2000) checklists are used by even the
most experienced pilots; yet they offer
no new insights. Instead, they make
existing knowledge more visible and
46 Journal of Change Management Vol. 3, 1, 45– 59 � Henry
Stewart Publications 1469-7017 (2002)
Mento et al.
Figure 1
Three models of
the change
process
A change management process

Figure 2 Visual
metaphors
Mento et al.
leading a change effort around ideas
developed through creative tension as
opposed to implementing fixes to current
organisational problems. When one
focuses on problem solving, the energy
to change comes from the desire to
escape an unpleasant status quo. With
creative tension, the energy for the
change comes from the vision, of what
one wants to create, juxtaposed with the
current reality. With problem solving, the
energy for the change diminishes as the
problems become less pressing and the
situation is improved. Senge notes that
the energy for change that drives the
problem-solving process is extrinsic
because it represents a way to escape
from the status quo. Change driven by
creative tension tends to be intrinsic.
The extrinsic/intrinsic orientation can
have a significant impact on the
consequences of the change effort. In the
context of a learning organisation,
extrinsic motivation for change produces
adaptive learning, whereas change driven
by creative tension yields generative or
new learning. Recognising change (the

need for, the idea of, and the context
thereof) is just the first step.
Step 2: Define the change initiative
Defining the change initiative tracks
closely with Jick’s step 1 of analysing the
organisation and its need for change. It is
useful at this point to define the roles of
the key players in all change efforts:
Strategists, implementers and recipients
(Jick, 1991a). Change strategists are
responsible for the initial work:
Identifying the need for change, creating
a vision of the desired outcome, deciding
what change is feasible, and choosing
who should sponsor and defend it. The
vision creation assists in the formation of
creative tension that can yield generative
learning. Change implementers are the
ones who make it happen. Their task is
imperative for the divisions internally,
and the company externally, was to learn
how to adapt more quickly to this
changing environment. The munificent
environment of the 1980s was being
replaced by a more parsimonious context
in the 1990s. Given this environmental
shift, it became imperative for ‘our’
division to have an effective change
management programme. Two of the
authors became involved with this
project, one very directly and one in a
consultative capacity.
The paper will explicate 12 steps that

are recommended when one wants to
implement change. These 12 steps are
based on lessons learned from the change
models discussed above filtered through
the actual experience that occurred
throughout the late 1990s. These 12
steps are shown holistically as visual
metaphors (Morgan, 1998; Davenport,
1999) in Figure 2. They are detailed in
what follows.
A FRAMEWORK FOR CHANGE
Step 1: The idea and its context
It is important as the starting point of a
change effort to highlight the idea for
what needs to be changed or what new
product should be introduced or what
particular innovation might bring a
significant lead over competitors. A
source for ideas for improving the
organisation can arise through creative
tension (Senge, 1990). Senge notes that
creative tension evolves from clearly
seeing where we want to be, our vision,
and telling the truth about where we are
now, our current reality. The gap
between the two generates a natural
tension. In an interview (Tichy and
Charan, 1989), Jack Welch similarly
notes a key characteristic of any leader is
to first face reality.
There is a key distinction between

to be repeated. In such situations, a
gradual non-threatening, and more
participative process is advocated to
break the failure syndrome.
The authors’ tactical radio project
experience reinforced the need for
assessing the company’s readiness to
support a change initiative. Two indices
were utilised to evaluate the readiness of
a company to change. One measure
evaluates the current organisational stress
of the company (see Beer’s matrix for
assessing the impact of a change effort;
Beer, 1980: 58). No product
development or improvement ever
occurs without someone else’s effort
being hindered. There is the stress of
everyone competing for the same
common resources — money, people and
sponsorship. A non-trivial hurdle for any
new initiative is not the competitor from
outside your company, but rather the
one you face down the hall. The second
measure is historical readiness to perform
new projects. Scepticism is very natural
when the change is a Big Hairy
Audacious Goal (the BHAG components
of a vision of effective companies, as
defined by Collins and Porras, 1996).

Patterns of the past are often hard to
break. It is helpful to champion a
concerted effort of using lessons learned
(Daudelin, 1996). Learning from past
development efforts will avoid making
errors in the planned change. Executives
and managers will continue with familiar
patterns of operations unless they are
taught a more retrospective approach.
The lessons learned methodology is
further discussed in step 12.
Compatibility of change goals with the
company’s Long-Range Strategic Plan
(LRSP) is a significant plus. To gain
support for the previously mentioned
radio project, it was important to tie into
ADC’s LRSP goal of expanding into
commercial airborne radars. The
division’s efforts were sold internally as
to help shape, enable, orchestrate and
facilitate successful progress. Change
recipients represent the largest group of
people that must adapt to the change. In
the case of a new product development,
the end user is also a recipient who must
be convinced that the change will be
beneficial to them. If the initiative lacks
credibility with any of the targeted
audiences, the initiative is dead before it
even begins.
The actual case was a late-1990s
project that involved the development
of a tactical radio system for the

military. The idea was that the
revolution in the cellular market would
allow for the development of one
radio whose software could be
reprogrammed to mimic any of the
military’s current inventories of radios.
The change management team was
successful in defining the change and
getting the target audience behind
them.
Step 3: Evaluate the climate for
change
This step is similar to Jick’s step 1
(analyse the organisation and its need for
change) but with further elaboration.
Both change strategists and implementers
must implicitly understand how the
organisation functions in its environment,
how it operates, and what its strengths
and weaknesses are. Such understanding
will assist in developing alternative
scenarios that could be created by the
proposed changes. This will facilitate
crafting an effective implementation plan.
As part of this analysis, change masters
need also study the company’s history
with previous change. Although failures
of the organisation in implementing
previous change efforts do not forever
doom an organisation to future failure,
Dalziel and Schoonover (1988) suggest
that these patterns of resistance are likely

Mento et al.
to discover what seeds will be most
fruitful or whether the ground needs to
be broken apart forcefully (the hammer)
before anything will take root and grow.
Many times, the approach also depends
on the needed speed of implementation.
Short-term pressures usually involve the
hammer, but this does not win people
for a long-term project. Listening to and
actively seeking the involvement of the
recipients of the change will prove
fruitful in performing many of the later
steps in the process. Getting people to
see a future return on their personal
investments today (carrot) is a successful
method in long-term projects. FOR
involves more than just deciding ‘Pay me
now or pay me later’. Rather, the proper
balance must be reached between the use
of power to ensure order compliance and
the use of time to build commitment.
Hill (1994) offers insights on these
issues when discussing power dynamics
in organisations. She notes that the
existence of organisational politics is a
way of life. Political conflict can be
viewed as a function of three variables
— diversity, interdependence and
competition for scarce resources.
According to Hill, both precipitating and

prevention factors exist in all
organisations with respect to political
conflict. The use of both positional and
personal power is needed to successfully
manage the interdependence between
various stakeholders in the modern
network organisations. Being cognisant of
the change time frame and one’s power
sources segues to the most critical
decision in implementing change with
the tactical radio project, the sponsorship
step.
Step 5: Find and cultivate a sponsor
This stage corresponds to both Kotter’s
(1995) notion of developing a powerful
guiding coalition and Jick’s (1991a) step
being part of an integrated avionics sales
pitch. Most aircraft vendors want only
one company to install the avionics, of
which the radios and radar are the major
components. This programme was sold
on the idea that either the division could
continue to buy the radios from the
people against whom it was competing
or could build its own in-house radio.
This radar alliance created a silent partner
rather than a vocal opponent. Three
words to follow are to prioritise, focus
and align your efforts such that you build
an internal alliance(s) to support your
efforts.
Step 4: Develop a change plan
This step tracks closely with Jick’s step 7

— craft an implementation plan. At a
minimum, the plan should include
specific goals and provide detailed and
clear responsibilities for strategists,
implementers and recipients. A plan that
does not solicit input with respect to
both the content of the change as well as
the process of the change will surely
prove to be non-optimal. A proper
balance between specificity and flexibility
is key; too much specificity can lead to a
plan that does not mesh well with
evolving organisational needs.
When developing a plan for
implementation, one must tailor the
approach to the frame of reference
(FOR) of the individual participants. A
change will require the efforts of people
at many levels in the company with
many diverse roles. Each person will
have their own FOR that will affect
how resistant or open to the effort they
will be. Some of the basic framing
methods to consider are the hammer, the
carrot, the challenge and the prestige
(often useful with researchers). In all
instances, creating the implementation
plan is very much like planting seeds in
a garden. Groundwork needs to be done

organisation to whom all the change
recipients report is often a good choice.
Implementation of the change occurs
from the top down, but the content for
the change must be developed from the
bottom. A sponsor at too high a level
may introduce unnecessary risk due to a
lack of direct involvement.
A second ADC project involved a
missile development programme. The
authors’ goal was for the sponsor to
support the replacement of the current
seeker portion of the missile with their
own department’s version. A sister
department within their division was
responsible for integrating the missile and
was presently purchasing the seeker
section from the major competitor. The
VP responsible for the entire division
was recruited as a sponsor. He had
influence over the current Program
Manager (PM). More importantly, the
VP changed how success was to be
measured for the PM. The measurement
for success was changed from the
number of units produced to the profit
per unit produced for the firm as a
whole. Without the actions of this
sponsor, the PM would have, most likely,
resisted change because there would have
been little reward for the increased risk
for making such a change. The sponsor
expressed, modelled and reinforced the

initiative. It was successful. In contrast,
difficulty with sponsorship occurred on
the AMC’s radio project. Sponsorship
was never secured high enough in the
organisation to obtain an alignment of
changing goals. While initially viewed
favourably, the new product development
activities were frozen when a potential
large-scale merger was announced. It was
never possible to change the FOR of the
negative risk/reward ratio engendered by
the proposed change at the time of the
proposed merger. The sponsor was not
sufficiently powerful to prevent the
freeze on activities.
7 — line up political sponsorship. Kotter
is referring to the support of powerful
line executives who can help create a
critical mass of support for the change.
Jick tends to offer more specific
guidance. He urges the recruitment of
influential informal leaders and the
development of a commitment chart.
The commitment chart should help one
to: Identify target individuals or groups
whose commitment to the change is
needed; define the critical mass needed
to ensure the effectiveness of the change;
develop a plan to gain the commitment
of the critical mass; and create a
monitoring system to assess the
progress.
In the radio project, a single individual
played the role of the sponsor. The

sponsor is to be viewed as the person
that will legitimise one’s cause. The
strategy used to win and keep a sponsor
must be defined in the FOR. It must
emphasise the needs, expected levels of
pain for the organisation, clear goals and
a time frame. Points for possible exit
along the way must be indicated.
Sponsorship is easier to win and maintain
when the person believes their decision
is not irreversible. If the sponsor does
not show a real commitment, however,
the resistance from the recipients will be
significant, and one’s ability to acquire
the required resources will be more
complex. The sponsor needs to be
informed frequently and regularly of
progress in order to adapt their talk or
their walk to push the effort. He/she
must possess a sufficient amount of
organisation power and influence to
obtain the resources required for success.
The sponsor must express, model and
reinforce the initiative for the maximum
effect. He/she should be pushing to
generate strategic convergence both
vertically down and horizontally across
the organisation. Recruiting the
individual at the lowest level in the
Mento et al.

Hultman (1979) states: ‘Without
resistance to change, we are skeptical
of real change occurring. Without real
questioning, skepticism, and even
outright resistance, it is unlikely that
the organisation will successfully move
on to the productive stage of learning
how to make the new structure
effective and useful.’ Resistance to
change should have previously been
considered at Step 3, ‘Evaluating the
climate’.
Step 7: Create the cultural fit —
Making the change last
During the evolution of any change
effort, the change must became rooted to
the existing culture. In essence,
organisation members need to accept and
understand the fact that change is in
reality ‘how things are done around
here’. In Kotter’s step 8, failure to anchor
the change initiative with the corporate
culture is a grievous error. Step 5 in the
GE change model deals with getting
change started with concrete actions and
developing long-term plans to ensure
that change persists. ‘Changing systems
and structures’ (step 7 in the GE change
model) is concerned with altering
staffing, training, appraisal,
communication and reward systems, as
well as roles and reporting relationships,
to ensure that they complement and
reinforce change. A strategic initiative

that is congruent with the established
organisational culture has a high
probability of success. When a disconnect
exists between the corporate culture and
the change, culture can diminish the
potency of the change initiative. If a
conflict is expected, it should be
discovered during the climate evaluation
and the development of change plans
steps. An adaptation plan can be created
through a consistent vision, BHAGs and
development of clear linkage between
Step 6: Prepare your target audience,
the recipients of change
This stage of the change process is best
understood from the perspective of the
recipients of the change. This issue is
not clearly dealt with in any of the
other three models of the change
process. Jick (1991b) argues that change
is not possible unless, at the very least,
the change recipients accept the
change. Change is not possible unless
people are willing to change
themselves. Jick makes the cogent
points that change can be ‘managed’
internally by those who decide when it
is needed, and how it ‘should’ be
implemented. Actual implementation,
however, occurs only when employees
accept the concept of change, generally,
and of the specific change, internally.
It has been observed that it does
not matter whether the change is

perceived as being a positive or a
negative. Resistance is generated
because the status quo will be affected.
People are comfortable with knowns.
The introduction of a change, even for
the better, is an unknown. It adds
stress to people. Specific strategies for
dealing with resistance as well as the
advantages and disadvantages of each
approach can be found in Kotter and
Schlesinger (1979). They advocate the
use of focus groups, surveys and
suggestions to bring the issues of
resistance to the surface. Resistance to
change efforts is directly related to
how the situation is framed (Gabarro
and Kotter, 1993). Speaking with the
audience most affected by the change
gives immediate feedback and allows
the target to express their FOR.
Resistance is a natural emotion that
must be dealt with and not avoided. If
one can look at the positive aspects of
resistance to change, by locating its
source and motives, it can open further
possibilities for realising change.
people who did the necessary design,
marketing and fieldwork. Team members

had to rely and trust that their
counterparts were equally committed to
the change goal. They did have highly
visible sponsorship. The sponsor would
drop by the development lab and check
the progress. He would bring sandwiches
for dinner as the team worked late at
night. He was available continually to
listen to their concerns. He knew they
all were motivated by the challenge (no
carrot or hammer) of creating a new
business area for the company. In all
change efforts, timing is critical.
Unfortunately, new business creation
ceased to be a high priority when the
LRSP shifted, owing to a proposed
large-scale merger. When anti-trust issues
subsequently killed the merger, new
business creation again became a part of
the LRSP. By that time the team was no
longer together. Nor were they anxious
to reassemble. They were no longer
motivated by the thrill of the challenge.
Step 9: Create small wins for
motivation
Creating short-term wins as a way to
motivate employees is critical during a
long change effort (Kotter, 1995). One
must plan for and create visible
performance improvements. Employees
involved in those improvements should
be recognised. Without specific
important and visible short-term wins,
people may give up and default to
change resister status. A change team

may be working on a BHAG that
requires a multi-year effort. It is very
difficult to keep the change leader team
self-energised if they do not see any
tangible benefits corresponding to their
level of effort. The longer and more
drastic the change, the more necessary it
is for small victories to be celebrated.
The further the goal is in the future, the
strategic direction, core competencies and
corporate culture. When this occurs and
when the cultural changes are viewed as
an investment over time rather than a
quick fix or a change de jour, the
likelihood of success is significantly
enhanced.
Step 8: Develop and choose a change
leader team
In his ten-step tactical model for
implementing change, Jick (1991a) makes
the observation that, in large-scale
change, the leader plays a critical role in
creating the corporate vision. The leader
both inspires the employees to embrace
the vision, and crafts an organisational
structure that consistently rewards people
who focus their efforts on pursuing the
vision. In step 5 of the model, which
deals with supporting a strong leader
role, Jick takes the view similar to the
one learned in the change process at
AMC. A change leader team can better
provide the necessary leadership role than
can a single individual. A team can be

carefully assembled to maximise the
appropriate skill sets. Billington’s (1997)
review of the team literature found that
there are three essentials of an effective
team: Commitment, competence and a
common purpose. Commitment refers to
the achievement of specific performance
goals. Core competencies of team
members are a critical determinant of
how effective a team can be. The best
teams invest the time and the effort to
explore, shape and agree on their
purpose that is to be internalised both
individually and collectively. The team
must be self-energising and
self-motivating in believing they are the
agents of change. Diversity of skills and
opinions makes a team strong as long as
all share the vision. (Katzenbach and
Smith, 1993).
In our radio project, there were seven
Mento et al.
At ADC, the focus was on
communication with the sponsor and the
strategists and implementers who held
needed resources. Effective
communication with the sponsor had
been a recurring theme. The tides in a

company will constantly be changing and
so will the needs of the programme. As
an effort becomes larger, often the
resource power of the sponsor will be
exceeded, and the sponsor either needs
to draw additional support or to obtain
sponsorship themselves. Communicating
the message in the same way will not
have the desired affect at the different
levels of the organisation. It is important
to tailor each communication to the
FOR of the audience. The radio project
sponsor failed to communicate
strategically in his efforts to obtain
higher-up sponsorship at the time of the
proposed merger. The sponsor failed to
recognise that the proposed merger had
changed his superiors’ FORs. His
communication was no longer effective,
as it was not couched in terms of how it
would impact the merger.
Step 11: Measure progress of the
change effort
This step is in concurrence with step 6
of GE’s Change Acceleration Process,
which is Monitoring Progress. This
involves creating and installing metrics to
assess programme success and to chart
progress, using milestones and
benchmarks. The notion of assessing the
effects of change goes hand in hand with
developing a small wins strategy (step 7)
in order to motivate sustained effort for
the change effort. Schaffer and
Thompson (1992) caution companies to

avoid the ‘rain dance’ of change
improvement programme measurement
that entails a concentration on activities,
as opposed to tangible, measurable
results. They recommend focusing on
more important are the achievable goals
that must be built as part of the roadmap
to success. It is human nature to work
on what we are measured against.
The constant battle for resources and
the continual need to update the sponsor
also drive the need for small victories.
Often, the sponsor is in fear of
over-commitment and must feel that
positive progress is occurring. The small
victories can be as simple as meeting a
design milestone and having a special
lunch or happy-hour event. The display
of appreciation by the sponsor goes far in
spawning more teamwork and opening
the lines of communication. It is often
through the informal small win
celebrations that new ideas will surface.
The authors’ project experience has
shown this to be true. New
opportunities originated from ideas that
were first surfaced at these informal
gatherings. In essence, the small win
events are transformed into brainstorming
events. The more informal setting
frequently results in the better mixing
and generation of ideas.
Step 10: Constantly and strategically

communicate the change
The concept of constantly
communicating the change throughout
the organisation is adapted from Jick’s
step 9 — ‘Communicate, involve people,
and be honest’. From the very beginning
of the change effort, effective
communication is critical. The process by
which the change is introduced can set
the tone among recipients with respect
to acceptance or rejection. The goals of
the communication effort should be: To
increase the organisation’s understanding
and commitment to change to the fullest
extent possible; to reduce confusion and
resistance, and to prepare employees for
both the positive and negative effects of
the change.
similar manner, many people measure
success on winning a contract. If the
contract win is done at a price too low
or under the assumption of too great a
technological risk, however, the contract
in actual financial terms is a loss with
subsequent cost over runs and late
deliveries.
Step 12: Integrate lessons learned

No other model of the change process
directly deals with the process of
generating a set of lessons learned
through reflection. At the root of
lessons learned is reflection. Reflection
is a personal cognitive activity that
requires stepping back from an
experience to think carefully and
persistently about its meaning through
the creation of inferences (Baird et al.,
1997; Kleiner and Roth, 1997; Seibert,
1999). Reflection, using a set of
techniques first suggested by Daudelin
(1996), brings to light insights and
learning themes (concepts) by directing
and guiding change strategists and
implementers to think actively about
the learning that is going on during
the change process itself. Reflection
then connects learning directly to job
performance and yields more relevant
personal learning. Reflection is an
extremely powerful way to learn from
experience. It is a major component of
individual learning, and individual
learning is the building block for
organisational learning. At the heart of
the reflection process is the use of
carefully thought out trigger questions.
Research has shown that people are
generally poor reflectors unless provided
with questions about their experience
as stimuli (Seibert and Daudelin, 1999).
Very useful is a set of questions
developed by the US Army in their
After Action Review Process (AAR),

as documented by Garvin (2000).
results-driven programmes that bypass
lengthy preparations, and instead aim for
quick measurable gains within a few
months. The key is to measure often
only those variables believed to be
logically related to important milestones
in the change effort. In psychometrics,
the idea is to avoid criterion deficiency,
ie assessing the wrong or a deficient
measure of the true concept one wants
to assess.
Change progress needs to be measured
at all stages of the programme, not
merely at the end. In a recent Business
Week article (Burrows, 2001), Hewlett
Packard’s CEO Carly Fiorina comments
that business planning is similar to sailing
in that ‘you are going to need to tack at
times’. Tacking is highly dependent upon
knowing in what direction the winds are
blowing. In creation of the cultural fit
and in creation of the proper motivation
when building the team, it was
recognised that the proper measurements
and reinforcements are critical to keeping
the programme on track. Measurement is
also concerned with all members
involved in the change effort being
crystal clear with respect to roles, goals
and expectations. It has been observed
that organisations too often forget to
have the proper tools or information
available to measure the amount of

progress achieved. Using an example
from the HP article, implementers were
successful in changing the business into
four organisations instead of 83 business
units. This, however, required a new
cost accounting system that lagged the
changes. The company was claiming a
certain level of financial benefit but was
not measuring the proper characteristics
to support this result. As the
measurement system came on-line,
managers were shocked to discover that
the system was suffering a lack of
financial accountability and transition
costs were somewhat out of control. In a
Mento et al.
like when one intends to begin the
journey (Evaluate the climate for change).
Prior to departure, one must have an
accurate set of nautical charts and sailing
plans that will help to overcome
obstacles and barriers in the person of
pirates and rocks (Develop a change plan).
Similar to Columbus, before embarking
on the long voyage, one needs to line
up a powerful and benevolent sponsor
(Find and cultivate a sponsor). A sound
step to take next would be to work with
the selected crew in clarifying roles, goals

and expectations that they need to be
aware of during the duration of the
voyage (Prepare the target audience, the
recipients of the change). A further step is
to make sure that the ship is capable of
accomplishing the task and that the route
chosen, given the expected storms and
bad weather, is not beyond the structural
integrity of the ship itself (Create the
cultural fit — making the change last).
Along these lines, one of the most
important preparatory steps is to make
sure the carefully chosen crew are
committed, competent and share the
same goal of a safe and exciting journey.
People should work together like a
well-oiled piece of machinery (Develop
and choose a change leader team). There
must be specific milestones or goals to
reach during the journey to provide
feedback with respect to how well and
how fast one is sailing toward the
objective. Also one should stop in
various ports of call to celebrate one’s
good fortune in arriving safely and to let
off steam after being at sea and alone for
great lengths of time (Create small wins for
motivation). It is important to let one’s
sponsor know on a regular basis how
well one is doing, and to share with the
crew why one is taking the actions one
is taking, as well as taking the time to
listen and learn from the suggestions of
the crew (Constantly and strategically
communicate the change). As the voyage

These questions are: (1) What did we
set out to do? (2) What actually
happened? (3) Why did it happen? and
(4) What are we going to do next
time?
‘Those who forget the past are
condemned to repeat it’ is the quote that
often comes to mind with respect to
change efforts. At all times, not just at
the end of a project, effort needs to be
expended on a retrospective look at what
works and what did not. These efforts
allow for the continuous refinement of
the evolving process. Many of the lessons
learned should concentrate on the
problems and solutions of dealing with
both the formal and the informal
organisation. Organisation design factors
such as policies, procedures,
compensation and organisational structure
are just the tip of an iceberg when
evaluating your organisation.
Documenting the cultural norms,
unwritten rules of work, the political
system and informal leaders will serve
you well in your use of lessons learned.
The best companies are learning
organisations that will not forget, but
rather learn from the past.
CONCLUSION
The use of metaphorical storytelling
(Botkin, 1999; Jensen, 2000) based on
the theme of a ship embarking on a
perilous journey facilitates the summation

of the change stages encountered at the
authors’ firm. While preparing to embark
on the challenging voyage, one needs to
do certain things to improve the chances
of success. It has to be clear in one’s
mind why one is taking this trip (The
idea and its context). Next, one needs to
have a fairly good understanding of
exactly what one intends to accomplish
by taking this voyage (Define the change
initiative). It is always necessary to have
some idea of what the weather will be
the company. Hopefully, the authors’
change model will provide some
much-needed guidance along these lines
and will help to ensure that their voyage
will be successful.
REFERENCES
Baird, L., Henderson, J. C. and Watts, S.
(1997) ‘Learning from Action: An Analysis
of the Center for Army Lessons Learned’,
Human Resources Management, 36(4),
385–395.
Beer, M. (1980) Organization Change and
Development: A Systems View, Goodyear,

Santa Monica.
Billington, B. (1997) ‘The Three Essentials of
an Effective Team’, Harvard Management
Update, Reprint No. U9701A, Harvard
Business School Press, Boston.
Botkin, J. W. (1999) Smart Business: How
Knowledge Communities can Revolutionize
your Business, Free Press, New York.
Burrows, P. (2001) ‘The Radical: Carly
Fiorina’s Bold Management Experiment at
HP’, Business Week, cover story, 19th
February.
Buzan, T. (1989) Use Both Sides of Your Brain,
3rd edn, Plenum, New York.
Collins, J. C. and Porras, J. I. (1996) ‘Building
your Company’s Vision’, Harvard Business
Review, 74(5), 65-77 (Reprint No. 96501).
Dalziel, M. M. and Schnoover, S. C. (1988)
Changing Ways: A Practical Tool for
Implementing Change Within Organizations,
American Management Association, New
York.
Daudelin, M. W. (1996) ‘Learning from
Experience Through Reflection’,
Organizational Dynamics, 24(3), 36–48.
Davenport, T. (1999) Human Capital,
Josey-Bass, San Francisco.

Gabarro, J. J. and Kotter, J. P. (1993) ‘HBR
Classic — Managing your Boss’, Harvard
Business Review, 72(3), 150–157.
Garvin, D. (2000) Learning in Action: A Guide
to Putting the Learning Organization to Work,
Harvard Business School Press, Boston.
Hill, L. (1994) Power Dynamics in
Organizations, Note 9-494-083, Harvard
Business School Press, Boston.
continues over months and years, it is
necessary to consider the progress made,
whether one is indeed going in the right
direction or whether one has been
blown off course. It is necessary to
ensure also that the morale of the crew
is positive and that the route and plan
are flexible enough to accommodate
changes in sponsors, and in the weather
(Measure progress of the change effort).
Finally, at the end of the journey, an
after action review should be conducted
so that knowledge gained through
reflection is captured and disseminated
among other ship captains and crews
throughout the organisation who might
be embarking on similar perilous
journeys through the unforgiving
environment (Integrate lessons learned).
All 12 steps are not to be regarded
only sequentially, but also as an
integrated, iterative process to enable
change. Business and engineering are

about growing, changing, adjusting and
improving the accepted norms and
procedures today to make the future
brighter. Engineering is often referred to
as turning dreams into reality. But one
fails to realise that miracles often do not
occur overnight and that there is actually
a progression that must be painfully
followed. The thought for the 21st
century change leaders is that they must
be astute decision makers and marketers,
trusted innovators, agents of change,
preachers of difficulties, master
integrators, enterprise enablers,
technology stewards and knowledge
handlers. They will need first-rate
managerial, technical, interpersonal and
scientific skills. Complex systems and
issues will need to be embraced and they
must reach the decisions about the
amounts of time, money, people,
knowledge and technology they are
willing to commit to meet what should
be a common end goal that was well
communicated and accepted all around
Mento et al.
and E. Hartley (eds) Readings in Social
Psychology, Holt, Rinehart & Winston,
New York.

Mento, A. J., Martinelli, P. and Jones, R. M.
(1999) ‘Mind Mapping in Executive
Education: Applications and Outcomes’,
Journal of Management Development, 18(4),
390–407.
Morgan, G. (1998) Images of Organization,
Berrett-Koehler, San Francisco.
Schaffer, R. H. and Thompson, H. A.,
(1992) ‘Successful Change Programs Begin
with Results’, Harvard Business Review,
70(1), 80–90.
Seibert, K. W. (1999) ‘Reflection in Action:
Tools for Cultivating On-the-job
Learning’, Organizational Dynamics, 27(3),
54–65.
Seibert, K. W. and Daudelin, M. W. (1999)
The Role of Reflection in Managerial
Learning: Theory, Research, Practice,
Quorum, London.
Senge, P. (1990) ‘The Leader’s New Work:
Building a Learning Organization’, Sloan
Management Review, 32(1), 7–24.
Tichy, N. and Charan, R. (1989) ‘Speed,
Simplicity, and Self-confidence. An
Interview with Jack Welch’, Harvard
Hultman, K. (1979) The Path of Least
Resistance, Learning Concepts, Austin, TX.

Jensen, W. (2000) Simplicity, Perseus,
Cambridge, Mass.
Jick, T. (1991a) Implementing Change, Note
9-191-114, Harvard Business School Press,
Boston.
Jick, T. (1991b) Note on the Recipients of
Change, Note 9-491-039, Harvard Business
School Press, Boston.
Katzenbach, J. R. and Smith, D. K. (1993)
The Wisdom of Teams, Harvard Business
School Press, Boston.
Kerr, S. (2000) Quoted in Garvin, D.
Learning in Action: A Guide to Putting the
Learning Organization to Work, Harvard
Business School Press, Boston, 131.
Kleiner, A. and Roth, G. (1997) ‘How to
Make Experience your Company’s Best
Teacher’, Harvard Business Review, 75(5)
(Reprint No. 97506).
Kotter, J. P. (1995) ‘Why Transformation
Efforts Fail’, Harvard Business Review, 74(2)
(Reprint No. 95204).
Kotter, J. P. and Schlesinger, L. A. (1979)
‘Choosing Strategies for Change’, Harvard
Lewin, K. (1947) ‘Group Decision and Social
Change’, in E. E. Maccoby, T. Newcomb

2.Book1 organisations.docx
1 Introduction to Book 1
The lectures have covered quite a bit of organisational theory,
introduced you to the concept of culture and introduced
leadership and management theory.
In building on these topics, this book provides both an
opportunity to provide new content and allow you to explore
further some of the concepts covered in the lectures.
To start with in the first chapter I have included a short video
on Weber and bureaucratic organisations which you can access
on the next page.
In the second chapter, we look at the Australian Healthcare
context. So far we have only dealt with the theory, yet we need
to understand the environment in which we work, as it will of
course shape our organisations and our roles. So there is some
reading for you to cover and also a couple of short videos for
you to look at as well on that topic.
At the end of that chapter, I will ask you to engage with your
peers by answering some of the questions I pose about the
healthcare setting we work in. It will be interesting to hear the
views of our international students!
The last two chapters explore organisations and culture and the
mission, vision and values statements that all of our healthcare
organisations have.
I hope you enjoy the activities
2 Learning Outcomes
By the end of this book and with further reading and research,

you are expected to be able to:
· explain the essentials of Weber's bureaucratic organisations;
· describe the Australian health system in broad terms and the
characteristics of the Australian health system that influence
organisational development and management
· discuss theories of organisational culture; and
· explain the purpose of vision, mission and value statements.
· 3 Max Weber
· The following YouTube video provides a nice and succinct
discussion of Weber's bureaucracy. It provides a description of
the ideal bureaucracy together with pros and cons.
·
4 The Australian Health System
(Author: Jeni Grubb, with revisions by Kylie Ward and Ingrid
Brooks)
A thorough understanding of changes in healthcare systems over
past decades is essential for those professionals who wish to
participate effectively in maximising the provision of optimum
healthcare for their people.
Australia, like many other countries, has undergone massive
corporate restructuring precipitated by macro economic change.
Healthcare provision in particular has been greatly affected by
these changes. In the decades following the Second World War,
healthcare and hospitals in Australia were dominated by large
bureaucracies, and characterised by stability, growth and clear
professional boundaries. Most health care debate over this time
was about private health care provision versus universal public
health cover. The Labor Government of the 1980’s introduced a
universal health care system – Medicare – and we have seen
many changes to this system over time, particularly with an
increasing role of the private sector during the decade of the
conservative Liberal-National Howard Government (Gardner &
Barraclough, 2002). Medicare is based on a philosophy of all
Australians having equal access to the healthcare they require,
thus contributing to social cohesion. Duckett (2007) argues that
the more Medicare is abandoned in favour of private health

services, the more universal cover and social cohesion is
threatened. The interplay of private and public healthcare
systems is a very complex and contemporary issue, and a key
election issue at almost every Federal election in recent years.
The other distinctive aspect of the Australian health care system
is the Federal – State funding split. The Federal Government
allocates funding to the States under the Council of Australian
Governments (COAG) and much lobbying occurs between these
levels of government through such avenues as the Australian
Healthcare Agreements. The Federal Government directly pays
the General Practitioner (GP) through the Medicare System and
the State Governments are responsible for running hospitals and
some community health services. One can see the tensions
played out, when for example, an acute hospital opens a GP
clinic alongside the emergency department – and the subsequent
arguments about whether this is for the benefit of the patient or
just cost-shifting.
The main features of Australia’s health system are:
· Universal access to benefits for privately provided medical
services under Medicare, which are funded by the Australian
Government, with co-payments by users when the services are
not bulk-billed.
· Eligibility for public hospital services, free at the point of
service, funded jointly by the states and territories and the
Australian Government.
· Private hospital activity largely funded by private health
insurance, which in turn is subsidised by the Australian
Government through the 30–40% rebates on members’
contributions to private health insurance.
· The Australian Government, through schemes such as the
Pharmaceutical Benefits Scheme (PBS), subsidises a wide range
of pharmaceuticals outside public hospitals for the public.
· The Australian Government provides most of the funding for
health research.
· State and territory health authorities are primarily responsible
for public hospitals, mental health programs, the transport of

patients, community health services, and public health programs
and activities (for example, health promotion and illness
prevention).
· Individuals primarily spend money on medications, dental
services, aids and appliances, medical services, other health
practitioner services and hospitals (AIHW, 2009, p.13).
· Duckett (2007, p.xvii) suggests that healthcare in Australia
remains “in part, a contested domain characterised by conflict
over values and policy choices” and no agreement on structure
and functioning of health care institutions.
It is of value to take a look at an article by Stephen Duckett at
this point - it is the first reading on your reading list.
Here is the link to the unit reading list
http://readinglists.lib.monash.edu/lists/1342F4C7-30D1-7D09-
17C4-9F0A561E2CCD.html
4.1 The politics of health
Brooks)
Duckett (2007, p.xvii) suggests that healthcare in Australia
remains “in part, a contested domain characterised by conflict
over values and policy choices” and no agreement on structure
and functioning of health care institutions.
This is exemplified by recent political history. For example in
2007 following their election victory, the Rudd Labor
Government introduced a National Health and Hospitals Reform
Commission to review the current health system. Following this
review, Rudd in 2010 proposed a new National Health and
Hospital Network (NHHN), that essentially proposed the
Federal Government as the funder of the majority of funding for
the entire public hospital system. (Rudd, 2010). Following
Gillard’s succession over Rudd this proposal was replaced with
the National Health Reform Agreement of 2011 which deals
with sustainable funding arrangements in particular:
· Financial and governance arrangements with states as

managers of the public hospital system; and
· The Commonwealth as funding aged care, and lead
responsibility for general practice and primary health care.
· Commonwealth and states being jointly responsible for
funding public hospital services and developing standards for
healthcare
· States being responsible for system management of public
hospitals having a lead role in public health
· The Commonwealth being responsible for establishing
Medicare Locals and promoting timely and equitable access to
primary health care. (Council of Australian Governments, 2011)
The implementation and funding arrangements under this
agreement are under threat following the election of the Abbott
conservative government and its 2014 Federal budget which
indicates a decrease in the commitment to public hospital
funding. (Fact Check, 2014)
Debates about health funding will continue to play out during
the year as the Australian Government negotiates their budget
through a hostile senate.
With this in mind, take a look at a short report from the ABC
below
http://www.abc.net.au/7.30/content/2014/s3966528.htm
4.2 Discussion
Having viewed the ABC report and read the article by Duckett, I
will pose a couple of questions:
1. How does the content of the ABC report compare with
Duckett's framework of equity, quality (adverse events),
efficiency and acceptability?
2. What impact could these reforms have on hospitals?
3. Do we need reform in aged care?

Post your thoughts on the discussion forum - the link is below
http://moodle.vle.monash.edu/mod/forum/view.php?id=2273126
4.3 Cost of Australia's health care
Brooks)
In Australia in the 1990’s the cost to the taxpayer of providing a
world class healthcare system began to mushroom. For several
years until this time, Australian spending had remained steady
at approximately 8% of GDP. This placed Australia, in OECD
countries’ level of healthcare spending, at about halfway
between the United States (at the upper end), and the United
Kingdom (at the bottom).
Duckett (2007) suggests that there are two indicators used for
measuring trends in expenditure – percentage of GDP spent on
health and per capita health expenditure. In 2011-12 health
expenditure was 9.5% of GDP, an increase from 6.8% of GDP in
1986-87, (AIHW, 2014).
As an international comparison, Australia’s health expenditure
as a proportion of GDP is slightly higher than other
Organisation for economic Co-operation and Development
(OECD) countries. By comparison, the United States’ health
expenditure as a proportion of GDP in 2011 was approx. 176.0%
(AIHW, 2014).
During 2001/02, in Australia the estimated per person
expenditure on health averaged $4,276, growing to $6,230 in
2011-12. Total expenditure on health is increasing at an average
rate of 5.4% each year over the last 10 years (AIHW, 2014).
Another way to view this expenditure is to breakdown costs and
usage. In the 2011-12 period, the biggest areas of expenditure
are hospitals (53.5 billion or 38.2% of total health expenditure)
and primary health care (50.6 billion)(AIHW, 2014). Not
surprisingly, most of the total health expenditure is on the
elderly, in their final years of life (Duckett, 2007).
The reasons for increasing costs of health care budgets have
included population growth; the increased survival rates of

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