unit “ 10 “ controlling. controlling final step in the management process: actions taken to...
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ControllingFinal step in the management
process: actions taken to ensure that actual outcomes are consistent with those Planned and anticipated.
Involves setting standard, measuring performance, reporting the results, and taking actions. (this lead to corrective action).
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Management of Change
Change: Change is the process of making something different from what it was
Change Agent: the one who works to bring about change
Change: - The essence of life, it is as long as life
goes on- Necessary for growth.- It often produces anxiety and fear. - The process of making something
different from what it was.
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- There is a sense of loss the familiar the status.
Nurses are seeing change in the field of patient care, new medications, new equipment and new methods treatment
Change can make crises or improvement it depends on how the change is managed
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Change strategies :appropriate strategy depends upon
the power of the change agent and the resistance expected
- Change agent should be able to facilitate and implement change effectively by:
a. Focus on the appropriate change target
b. The willingness and ability to change
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Change strategies:…cont. 1- Rational - empirical strategies:Based on the assumption that people are
rational.Used when there is little anticipated resistance
to the change or the change is reasonable.2- Normative - re - educative strategies:Participative strategy: participate in
identifying the problem, choosing solution and implementing the change.
-Based on the assumption that people act according to their commitment to socio cultural norms
- Does not require the change agent to have a legitimate power base.
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Change strategies:…cont.
The change agent gains power by skills in interpersonal relationships.
Change agent must be accepted, sensitive to person’s perceptions and values and open trust relationship.
3- Power – coercive strategy:- based on the application of power:
(economic sanctionsعقوبات or political clout سياسي (نفوذ
- Based on the assumption that: People with less power comply to the plans, directions and leadership.
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- Individuals will only change when rewarded or forced to change.
- Resistance is handled by authority: the person must accept it or leave.
- Used when high resistance is expected
- The individual will change to avoid threat, peer pressure, or loss of job.
- Used when immediate change is necessary (The quicker strategy)
Should be combined with other strategies to have a permanent change .
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Change Theories: Lewin's theory:- Lewin provides a social -
psychological view of change process.
- He sees behavior as forces working in opposite directions within a field
- The process of change here is affected by two types of forces :
a. Driving forces: facilitate change.b. Restraining forces: keep system
from change
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Lewin's theory:…cont.
The change agent begin by analyzing the entire system in order to identify two forces
Stages needed before the planned change becomes a part of the system:
1.Unfreezing stage 2.Moving stage.3.Refreezing stage
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Lewin's theory:…cont.1- Unfreezing Stage :Gather data: - Problem identification- Decide if change is needed.- Motivate participants to change. - Build a trust .
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According to Lewin: create change occurs
through three mechanisms A. Lack of confirmation: - (Expectations have not been met).B. Guilt and anxiety: - Tension level system (goal is not
met)C. psychological safety: - Providing sufficient security to
minimize the risk. -People will feel comfortable and
attempt the change.
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2- Moving Stage (Implementation)
- The leader put the planned change into effect.
- Move the target system to a new level of equilibrium
Activities in which the leader will be engaged during the changing phase:
- Get participants to agree that current status is not good
- Develop a plan including persons will be affected.
- Sets goals and objectives - Identify areas of support and resistance.- Set target dates. - Introduce any new related information.
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- Encourage the new behavior.- providing support to avoid
resistance to change.- Ventilate the guilt and anxiety
and other feelings .- Provide feedback on progress to
reinforce the change process - Keep communications open.- Act as Energizer to keep interest
high- Over come resistance (tactics of
unfreezing phase)
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3 -Refreezing Stage:The change is stabilized and
becomes a part of the target system
Leader continue to act as Energizer, and delegates responsibility for change behavior to others in the target system
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An Example of change: "The change to new computerized record system" by using lewin's theory of change
The new system has several advantages over the old one:
1. It requires less writing 2. Eliminate repetition 3. Quicker access to stored information 4. Provides total picture of the client’s
progress 5. Different kinds of health care.6. Strongly supported by the
administrators and executives
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However: None of the staff have ever used it
before . They also have not expressed any need to
change the old system A side from staff members seem
concerned about providing high quality care .
The change identified the following:I. Driving Forces:1. Advantages of the new system 2. Administrative support for the system 3. Staff concern about quality care.4. Staff ability to learn the new system
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II. Restraining forces:1. Lack of staff participation in the
selection of the system. 2. Little or no staff knowledge of
the new system. 3. Potential threat to staff feeling
of security (routine).4. Potential threat to various
disciplines because of equal access to information in the new system.
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These opposing forces diagrammed in the following figure :
Lack of staff participation
No knowledge of system
Threat to staff security
threat to various disciplines
Administrative support
Advantages of the new system
quality of care
ability to learn system
Restraining forces
Status quo
Driving forces
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1- Unfreezing stage: The change agent took the following
actions:A. Disconfirmation: (Actions )- Meet with every staff member in small
groups to discuss inadequacies and problems found in the old system.
B. Inducing guilt and anxiety: ( Actions )
- Demonstrate ways in which the old system interferes with quality care
- Tell staff members how strongly administrators support the new system .
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C. Providing psychological safety:( Actions)
- Assure staff members that they will learn the new system.
- Staff will be involved in planning the implementation Phase.
- Point out similarities between old and new systems .
- Express approval of staff concern for the quality of the care given and confidence in their ability to learn the system
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2 -Moving Stage (Changing)a) Introduce new information:Teach the staff how to use the new
system.b) Encourage the new behavior:- Begin with practice using examples
from ready situations - Have the staff begin using the new
system according to the plan.c) Continue the supportive climate:- Allow a adequate time for learning
and practice before implementation. d) Provide opportunities for
ventilation: - Ask staff how they feel about the new
system and listen and respond to what they say about it
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e) Provide feed back and clarification of Goals:
Check computerized records and evaluate progress
Ask staff how well new system is working
f) Present your self as Trustworthy :- Open and direct communication- Make sure that all staff were include
in implementation as promised g) Overcome resistance:h) Act as Energizer:- Take every opportunity to promote
the new system.- Demonstrate interest in staff
progress.
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3- Refreezing Stage (change agent actions)1) Continue acting as Energizer:- Keep the new system visible through
news letters, meetings and so forth.- Continue to show interest in staff progress
and feeling about the new system2) Continue guiding new behavior:- Continue to check computerized records
to see how well the new system is working
- Help staff correct mistakes and provide needed information
3) Delegate increased responsibility to others:
- the outcome of the new system is turned over to the staff member and their supervisors
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Comparison of Chang Models
Lewin Lippitt Havelock Rogers
1 -Unfreezing 1 -Diagnose problem
2-Assess motivation
3-Assess change
agent’s motivations and resources.
1 -Building a
relationship
2 Diagnosing
the problem.
3-Acquiring resources
1- Knowledge
2- Persuasion
3- Decision.
2- Moving 4- Select progressive change
5 -Choose change
agent role .
4- Choose the solution
5- Gaining acceptance
4-implementation
3 -Refreezing 6 -Maintain change.
7 -Terminate helping relationship
6- Stabilization 5 -Confirmation
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Barriers of Change (Resistance)1- Threatened self- Interest. 2- Inaccurate perception: example, staff resist use of computer basing on the
perception that computerization will reduce their freedom in choosing working hours and days off.
3- Objective disagreement: feel the change will benefit the organization.4- Psychological reaction: feel that their freedom has been threatened or
eliminated.5- Low tolerance for change : (low self
confidence)Change agent must understand why people
resist change and be able to deal with resistance.
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Techniques for dealing with resistance:
1. Participation: (persons affected by change)
2. Manipulation: (view change as less costly or more beneficial).
3. Education: (for individuals about the change)
4. External agents: (outside the organization)
5. Incentives: حوافز (the benefits)6. Supportive behavior: (training new skill,
counseling services)7. Gradual introduction: (change gradually)
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Functions &characteristics of change agent:
1. Developing specific, measurable objectives
2. Listing techniques needed to accomplish of activities .
3. Developing a timetable for completion of activities.
4. Assessing resources.5. Preparing a budget.
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Functions &characteristics of change agent…cont.
6. Selecting suitable persons needed for change plan.
7. Designing a method evaluating the outcome of activities
8. Anticipating resistance to change.
9. Developing strategies to manage resistance
10. Designing a plan to stabilize (refreeze) the change.