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Master of Business Administration

MBA Semester4
Change Management - MU0009
Assignment Set- 1
______________________________________________________________________________
Q.1 Discuss culture driven change .
Bringing about significant change in the way an organization works,
frequently necessary in our current environment of major technological
innovation and globalization, is a tremendous challenge. On the technical
side, it may be relatively easy (although costly) to introduce new technology,
work processes and structures. Experience tells us, however, that getting
people to enthusiastically support such change is a more complex and
difficult task.

The Myth of Resistance

Understanding why change is frequently difficult for people can help us build
in methods for easing the process and increasing the likelihood that it will
succeed. Many people talk about "resistance" as if it were an irrational
response to be overcome with rational persuasion. In fact, it is always the
case that, from an individual's point of view, one's own behavior is rational.

Generally, when people have worked in an organization for very long, they
have absorbed a set of norms and expectations about what is expected,
what is rewarded and what is least approved. They have "learned" the way to
behave that will, at the very least, keep them out of trouble. This set of
widely shared beliefs about what is "right" and "wrong", "true" or "false",
"good" or "bad", is the organization's culture.

What Is Organizational Culture?

An organization's culture is multi-layered, consisting of assumptions, values,
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beliefs, norms and behaviors that have developed gradually and may have
become relatively unconscious. It can explain much about how an
organization functions, both internally and in relation to its external
environment. When there is a need to change the way an organization
works, it may become necessary to make this implicit set of beliefs explicit
as they may no longer be consistent with the actions and behaviors that are
now required.

Managing Change
Whether or not it is possible to fully "manage change", we believe that being
very clear about what changes are required and being very intentional about
building a culture that supports the new mission, goals, strategies and
practices increases the probability of success exponentially. This necessarily
involves a large cross section of the organization in assessing the current
system of norms and beliefs, determining what changes are needed, and
designing an implementation plan.

An Example of "Managed" Culture Change

A classic example involves a regulated utility for which de-regulation meant a
change in how they do business. Assumptions about customer expectations
in a regulated environment led utilities in general to attend more to being a
"good neighbor" than to providing low cost service. Those assumptions often
meant that "good neighbor" behavior, i.e., courtesy to customers, was
rewarded more than efficiency and this value was reinforced by training
programs, performance reviews, and the company newspaper along with
more subtle forms of communication.

These beliefs and resulting behaviors needed to be elevated to a conscious

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level so that the company could choose how it needed to modify its
practices. New assumptions and values were articulated and systematically
communicated through every vehicle and reinforced at every opportunity.
(One would hope that the utility would not throw out the original intent to be
a good neighbor, but only reassign priorities.)

As people at every level of the organization participated in meetings and

activities to identify new goals and practices, they also created inventories of
all the old ways of thinking and doing that would have to change. They
actually developed a humorous system for "catching" each other in the old
ways and rewarding the new. In this way, what might have become the
source of serious resistance became a source of comraderie and com
mitment to the new way of doing business.

Culture Driven Change

A culture is the values and practices shared by the members of the
group.Company Culture, therefore, is the shared values and practices of the
company's employees. Company culture is important because it can make or
break your company. Companies with an adaptive culture that is aligned to
their business goals routinely outperform their competitors. Some studies
report the difference at 200% or more. To achieve results like this for your
organization, you have to figure out what your culture is, decide what it
should be, and move everyone toward the desired culture.

Company cultures evolve and they change over time. As employee leave the
company and replacements are hired the company culture will change. If it is
a strong culture, it may not change much. However, since each new
employee brings their own values and practices to the group the culture will
change, at least a little. As the company matures from a startup to a more
established company, the company culture will change. As the environment
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in which the company operates (the laws, regulations, business climate,

etc.) changes, the company culture will also change.
These changes may be positive, or they may not. The changes in company
culture may be intended, but often they are unintended. They may be major
changes or minor ones. The company culture will change and it is important
to be aware of the changes.
Assess the Company Culture

There are many ways to assess your company culture. There are consultants
who will do it for you, for a fee. The easiest way to assess your company's
culture is to look around. How do the employees act; what do they do? Look
for common behaviors and visible symbols. Listen. Listen to your employees,
your suppliers, and your customers. Pay attention to what is written about
your company, in print and online. These will also give you clues as to what
your company's culture really is.

Determine the Desired Company Culture

Before you can change the company culture, you have to decide what you
want the company culture to look like in the future. Different companies in
different industries will have different cultures. Look at what kind of a culture
will work best for your organization in its desired future state. Review your
mission, vision and values and make sure the company culture you are
designing supports them.
Here are some characteristics of company cultures that others have used
successfully. Decide which work for your company and implement them.
• Mission clarity
• Employee commitment
• Fully empowered employees
• High integrity workplace
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• Strong trust relationships

• Highly effective leadership
• Effective systems and processes
• Performance-based compensation and reward programs
• Customer-focused
• Effective 360-degree communications
• Commitment to learning and skill development
• Emphasis on recruiting and retaining outstanding employees
• High degree of adaptability
• High accountability standards
• Demonstrated support for innovation
Align the Company Culture
You need to align your company culture with your strategic goals if it is not
already.
• Develop a specific action plan that can leverage the good things in your
current culture and correct the unaligned areas.
• Brainstorm improvements in your formal policies and daily practices.
• Develop models of the desired actions and behaviors.
• Communicate the new culture to all employees and then
• Over-communicate the new culture and its actions to everyone.
Only a company culture that is aligned with your goals, one that helps you
anticipate and adapt to change, will help you achieve superior performance
over the long run.

Q.2 Write the techniques for managing change effectively.

Organizational change occurs when a company makes a transition from its

current state to some desired future state. Managing organizational change
is the process of planning and implementing change in organizations in such
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a way as to minimize employee resistance and cost to the organization, while

also maximizing the effectiveness of the change effort.

Today's business environment requires companies to undergo changes

almost constantly if they are to remain competitive. Factors such as
globalization of markets and rapidly evolving technology force businesses to
respond in order to survive. Such changes may be relatively minor—as in the
case of installing a new software program—or quite major—as in the case of
refocusing an overall marketing strategy.

The most common reason that change efforts fail is that they encounter
resistance from employees. Change appears threatening to many people,
which makes it difficult to gain their support and commitment to
implementing changes. Consequently, the ability to manage change
effectively is a highly sought-after skill in managers. Companies need people
who can contribute positively to their inevitable change efforts.

Technological changes are often introduced as components of larger

strategic changes, although they sometimes take place on their own. An
important aspect of changing technology is determining who in the
organization will be threatened by the change. To be successful, a
technology change must be incorporated into the company's overall
systems, and a management structure must be created to support it.
Structural changes can also occur due to strategic changes—as in the case
where a company decides to acquire another business and must integrate it
—as well as due to operational changes or changes in managerial style. For
example, a company that wished to implement more participative decision
making might need to change its hierarchical structure.

People changes can become necessary due to other changes, or sometimes

companies simply seek to change workers' attitudes and behaviors in order
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to increase their effectiveness. "Attempting a strategic change, introducing a

new technology, and other changes in the work environment may affect
people's attitudes (sometimes in a negative way),

In any case, people changes can be the most difficult and important part of
the overall change process. The science of organization development was
created to deal with changing people on the job through techniques such as
education and training, team building, and career planning.

A manager trying to implement a change, no matter how small, should

expect to encounter some resistance from within the organization.
Resistance to change is a normal reaction from people who have become
accustomed to a certain way of doing things. Of course, certain situations or
tactics can increase resistance. "Individuals, groups, and organizations must
be motivated to change. But if people perceive no performance gap or if they
consider the gap un-important, they will not have this motivation

Employees can be informed about both the nature of the change and the
logic behind it before it takes place through reports, memos, group
presentations, or individual discussions. Another important component of
overcoming resistance is inviting employee participation and involvement in
both the design and implementation phases of the change effort

Managers should be sure to provide employees with the resources they need
to make the change, be supportive of their efforts, listen to their problems
with empathy, and accept that their performance level may drop initially.

Some companies manage to overcome resistance to change through

negotiation and rewards. They offer employees concrete incentives to ensure
their cooperation. Other companies resort to manipulation, or using subtle
tactics such as giving a resistance leader a prominent position in the change
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effort. A final option is coercion, which involves punishing people who resist
or using force to ensure their cooperation. Although this method can be
useful when speed is of the essence, it can have lingering negative effects on
the company. Of course, no method is appropriate to every situation, and a
number of different methods may be combined as needed.

Techniques for Managing Change Effectively

Managing change effectively requires moving the organization from its

current state to a future desired state at minimal cost to the organization.
Bateman and Zeithaml identified three steps for managers to follow in
implementing organizational change:

1. Diagnose the current state of the organization. This involves identifying

problems the company faces, assigning a level of importance to each
one, and assessing the kinds of changes needed to solve the problems.
2. Design the desired future state of the organization. This involves
picturing the ideal situation for the company after the change is
implemented, conveying this vision clearly to everyone involved in the
change effort, and designing a means of transition to the new state. An
important part of the transition should be maintaining some sort of
stability; some things—such as the company's over-all mission or key
personnel—should re-main constant in the midst of turmoil to help
reduce people's anxiety.
3. Implement the change. This involves managing the transition
effectively. It might be helpful to draw up a plan, allocate resources,
and appoint a key person to take charge of the change process. The
company's leaders should try to generate enthusiasm for the change
by sharing their goals and vision and acting as role models. In some
cases, it may be useful to try for small victories first in order to pave
the way for later successes.
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"Successfully changing an enterprise requires wisdom, prescience, energy,

persistence, communication, education, training, resources, patience, timing,
and the right incentives, " John S. McCallum wrote in the Ivey Business
Journal. "Successfully leading and managing change is and will continue to
be a front-burner responsibility for executives. Prospects are grim for
enterprises that either cannot or will not change. Indeed, no industry
member is quite so welcome as the one that steadfastly refuses to keep up."

The effects of change impact morale, productivity,

interpersonal relationships and even financial success. Change management
thus is a big concern, especially in the business world. Controlling the effects
of change means that a person has to find techniques by which to manage
change effectively. If people use such techniques in a systematic way, then
transitions at home or in the workplace may be much easier because the
anxiety or ill feelings change produces are lessened.
Readiness
1. According to change-management.com, readiness assessments are
one of the primary techniques for managing change effectively.
Readiness assessments measure how prepared employees and
administrators are to handle modifications. These assessments may
include evaluations of inventory or other resources, but they also may
include interviews with employees and administrators to analyze what
is needed to accommodate the change.
Resistance Management
2. Resistance management basically means that you prepare yourself for
anything anyone might do in order to stop the change. For example,
you might set up a policies and procedures manual that clearly states
what the consequences of not following the changes are. Another
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resistance management option is to place strong leaders who are

accepting of changes as project managers.
Feedback and Progress
3. Evancarmichael.com states that feedback and progress are important
for change management. People may be more likely to accept change
if they have a chance to tell leaders their thoughts and concerns.
Feedback also gives administrators a chance to monitor progress and
determine whether action plans related to the change are working
properly.
Success
4. According to Evancarmichael.com, effective change management
involves rewarding success. Simple acknowledgment or thanks for
what someone has done well can make a lot of difference in the
attitude of employees regarding change. Other forms of celebrating
success might be announcing positive outcomes on a bulletin board or
holding a company picnic if a goal related to the change is met. The
key here is consistency--if a leader points out successes of only certain
people, employees will end up divided.

Explanation
5. People may be more receptive to change or handle it more
appropriately if they have a logical understanding of why the change is
happening. Thus, an effective change management technique is to
hold formal or informal meetings in which leaders can explain why the
change is taking place, the potential impacts of the change, and the
goals related to the change. Such explanations, when done in an open
forum, give the impression that all members of the group are valued
equally, which creates a sense of unity. This sense of unity may help
the group turn toward the change with a common purpose.
Training
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6. One of the biggest complaints people have about change is that they
are not equipped for it. For example, a computer programmer might
resist a requirement to write code in Java if he has dealt primarily with
HTML. Providing adequate training lets individuals meet the challenges
the change requires and eliminates the excuse that the change cannot
be implemented for lack of knowledge or preparedness.

Q.3 Discuss the employee involvement in change management.

Fall2010
Here are additional words of wisdom about change management spoken by
participants in my change management survey. The words of my participants
demonstrate the nuances of change management: change strategy,
planning, implementation, and courage, much more graphically than any I
can offer on my own.

Consequences of Change

• "Carry the wounded; help the long term stragglers find another place
to work."

• "At the same time, and again in scenarios of critical change, do not
retain (for too long) any key management personnel who show no signs
of willingness to accept change."

• "Publicize rewards and recognition for positive approaches and

accomplishments, and celebrate each small win publicly."

• "Provide positive consequence for change, and negative consequence

for not adopting the change. Set up some early wins."

Employee Involvement During Change

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• "Lao Tzu... the best change is what the people think they did
themselves... i.e., high involvement is better so long as it is not overlay
cumbersome and doesn't interfere with people being successful in their
regular roles."

• "I find personally and I believe for most employees that it is critical that
they are involved in the process. The level of involvement will depend on
the employee--inviting suggestions and feedback, delegating aspects of
the process, etc. The process is more successful, I believe, when the
employees are bought into the process and see that their input is valued
and makes a difference."

• "Hold facilitated groups to solicit input after a presentation that focuses

attention to a specific area are most effective during the planning stages.
I've seen too many loosely organized wide open requests for group input
that turn into free-for-all's. These generate frustration and hurt feelings,
contributing to further resistance because there was no focused purpose
to identify achievement."

In any change, especially ones that affect a complete organization, it is

impossible to involve every employee in each decision. Respondents to my
change management questions over the years suggested, however, that
when change works, the organization has gone out of its way to try
employee involvement.

Employee Involvement for Effective Change Management

• Create a plan for involving as many people as possible, as early as
possible, in the change process.
• Involve all stakeholders, process owners, and employees who will feel the
impact of the changes, as much as possible, in the learning, planning,
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decisions, and implementation of the change. Often, in change

management, a small group of employees learns important information
about change and change management.
If they fail to share the information with the rest of the employees, the
remaining employees will have trouble catching up with the learning curve.
If a small group makes the change management plans, employees affected
by the decisions will not have had needed time to analyze, think about, and
adjust to the new ideas. If you leave employees behind, at any stage of the
process, you open the door in your change management process, for
misunderstanding, resistance, and hurt.

• Even if employees cannot affect the overall decision about change,

involve each employee in meaningful decisions about their work unit and
their work.

• Build measurement systems into the change process that tell people
when they are succeeding or failing. Provide consequences in either case.
Employees who are positively working with the change need rewards and
recognition. After allowing some time for employees to pass through the
predictable stages of change, negative consequences for failure to adopt
the changes, are needed.

You cannot allow the nay-sayers to continue on their negative path forever;
they sap your organization of time, energy, and focus, and eventually,
affect the morale of the positive many. The key is to know, during your
change management process, when to say, enough is enough.
Help employees feel as if they are involved in a change management process
that is larger than themselves by taking these actions to effectively involve
employees in change management.
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Master of Business Administration

MBA Semester4
Change Management - MU0009
Assignment Set- 2

______________________________________________________________________________
Q.1 Discuss types of organizational teams

A team is a collection of individuals organized to accomplish a common

purpose, who are interdependent, and who can be identified by themselves
and observers as a team. Teams exist within a larger organization and
interact with other teams and with the organization. Teams are one way for
organizations to gather input from members, and to provide organization
members with a sense of involvement in the pursuit of organizational goals.
Further, teams allow organizations flexibility in assigning members to
projects and allow for cross-functional groups to be formed.

TYPES OF TEAMS

There are six major types of teams: informal, traditional, problem solving,
leadership, self-directed, and virtual. Table 1 describes some of the
characteristics of these six types of teams.

INFORMAL TEAMS.

Informal teams are generally formed for social purposes. They can help to
facilitate employee pursuits of common concerns, such as improving work
conditions. More frequently however, these teams form out of a set of
common concerns and interests, which may or may not be the same as the
organization's. Leaders of these teams generally emerge from the
membership and are not appointed by anyone in the organization.
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TRADITIONAL TEAMS.

Traditional teams are the organizational groups commonly thought of as

departments or functional areas. Leaders or managers of these teams are
appointed by the organization and have legitimate power in the team. The
team is expected to produce a product, deliver a service, or perform a
function that the organization has assigned.

Informal

• Social in nature

• Leaders may differ from those appointed by the

organization
Traditional

• Departments/functional areas

• Supervisors/managers appointed by the

organization
Problem-Solving

• Temporary teams
• Frequently cross-functional

• Focused on a particular project

Leadership

• Steering committees

• Advisory councils
Self-Directed

• Small teams
• Little or no status differences among team
members
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• Have authority to decide how to get the work done

Virtual

• Geographically spread apart

• • Meetings and functions rely on available

technology

PROBLEM SOLVING TEAMS.

Problem-solving teams or task forces are formed when a problem arises that
cannot be solved within the standard organizational structure. These teams
are generally cross-functional; that is, the membership comes from different
areas of the organization, and are charged with finding a solution to the
problem.

LEADERSHIP TEAMS.

Leadership teams are generally composed of management brought together

to span the boundaries between different functions in the organization. In
order for a product to be delivered to market, the heads of finance,
production, and marketing must interact and come up with a common
strategy for the product. At top management levels, teams are used in
developing goals and a strategic direction for the firm as a whole.

SELF-DIRECTED TEAMS.

Self-directed teams are given autonomy over deciding how a job will be
done. These teams are provided with a goal by the organization, and then
determine how to achieve that goal. Frequently there is no assigned
manager or leader and very few, if any, status differences among the team
members.
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These teams are commonly allowed to choose new team members, decide
on work assignments, and may be given responsibility for evaluating team
members. They must meet quality standards and interact with both buyers
and suppliers, but otherwise have great freedom in determining what the
team does. Teams form around a particular project and a leader emerges for
that project. The team is responsible for carrying out the project, for
recruiting team members, and for evaluating them.

VIRTUAL TEAMS.

Technology is impacting how teams meet and function. Collaborative

software and conferencing systems have improved the ability for employees
to meet, conduct business, share documents, and make decisions without
ever being in the same location. While the basic dynamics of other types of
teams may still be relevant, the dynamics and management of virtual teams
can be very different. Issues can arise with a lack of facial or auditory clues;
participants must be taken at their word, even when video-conferencing tools
are used.

Accountability is impacted by taking a team virtual. Each member is

accountable for their tasks and to the team as a whole usually with minimal
supervision. Key factors in the success of a virtual team are effective
formation of the team, trust and collaboration between members, and
excellent communication.

The best teams invest a tremendous amount of time and effort exploring,
shaping, and agreeing on a purpose and role that belong to them both
collectively and individually. This “purposing and roling” activity continues
throughout the life of the team. By contrast, failed teams rarely develop a
common purpose. For whatever reason— an insufficient focus on
performance, lack of effort, poor relationship—they do not coalesce around a
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challenging objective.

Q.2 Mr. Ram is working in ‘United India’ a public sector company for
last 15 years. The organization is facing competition from various
private and Multinational companies. To meet the challenges,
management has decided to update their information system by
integrating information technology in every sphere of functioning.
Mr. Ram is accustomed to manual working system. He finds the new
technology and its working difficult to cope up with. To him the new
technology is a threat for his job performance. His professional and
personal life is badly affecting due to his new found job stress. After
listening to his problem his friend suggest him to develop self
mastery.

 What is self mastery?

Humans are multi-dimensional creatures. We are physical, emotional,

mental, and spiritual beings. Self mastery is the intentional pursuit of growth
and development in each of these areas. The physical aspects of self
mastery pertain to maximizing your body’s health and vitality, including
strength, flexibility, and cardio vascular training, as well as getting adequate
rest and eating a healthy diet.

On the emotional level, self mastery includes: 1) developing your ability to

identify and accept your emotions, 2) being authentic, 3) releasing negative
emotions in healthy and constructive ways, 4) being sensitive to others, 5)
expressing emotional vulnerability, and 6) fostering close and meaningful
relationships.
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The mental aspects of developing greater self mastery focus on your

mindset, in particular, your fundamental assumptions and beliefs. This is a
key component of self mastery because mindset is causative and determines
your potential for success. Here is how: your beliefs and assumptions
determine your perceptions and judgments, which then trigger your
emotions and behaviors, which in turn determine your performance and
results. In other words, the seed of each of your successes and failures is
always your mindset.

Spiritually, in the context of change leadership, self mastery pertains to

knowing who you are, pursuing your purpose in your work, being connected
to your higher self, and living in integrity with your core values. Being in
touch with these deeper aspects of yourself shapes your change leadership
strategies and behaviors, and unleashes your creativity, passion and energy.

Behavior is the fifth area of self mastery. Behavior is the external

manifestation of deeper internal processes. When you identify a behavior
you seek to change, you will need to also discover the beliefs and emotional
reactions that drive that behavior. Behavior change in its complete form
touches all four other areas of self mastery.

When you have good self-mastery, you have the ability to control yourself in
all situations, and move forward consciously and steadily toward your goals.
You know your purpose, and you're disciplined enough to do things in a
deliberate, focused, and honorable way.

Self-mastery also means mastering your emotions, impulses, and actions.

You could also call this "self-discipline."
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Self-mastery is vital if you want to achieve your goals in life. Think about
people you know who don't have any self-mastery. They're probably
impulsive and rash. They might let their emotions control them, yelling at
colleagues when they're angry, and then being overly polite to make up for it
later. They're unpredictable and, as a result, people see them as
untrustworthy.

When you demonstrate self-mastery at work, you prove to your colleagues

that you have the inner strength and steadiness needed for effective
leadership. So it's well worth the effort to invest time in improving your self-
mastery. You'll likely become a happier, more balanced person – and you
never know what opportunities may arise because of this.

Self-mastery is a broad term that covers many aspects of your personal and
professional life. Improving your self-mastery can mean working on many of
these areas. (If so, it may be best to focus on one or two at a time so you
don't become overwhelmed.)

Self-mastery starts with a vision of how you want your life to be.

This is why it's so important to start with a clear vision of your short-term and
long-term objectives. Learn how to set personal goals, and get into the habit
of moving towards these every day. The clearer you are about what you want
to achieve in life, the easier it is to move forwards calmly and confidently.

Your attitude and emotions play a major role in self-mastery. Those who
show strong self-mastery don't let their emotions control them – they control
their emotions.

Resist the temptation to blame yourself when things go wrong. Self-sabotage

is a quick and cruel way to bring yourself down and stop yourself from
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reaching your true potential. If you find that you're undermining yourself,
consciously make yourself stop. Instead, think of something positive and
encouraging.

Being able to manage and control your emotions helps you build emotional
intelligence. This is the awareness of others people's needs and emotions,
and the knowledge of how your own emotions affect those around you.
Those who have good self-mastery are always aware of others, and they
work hard to make sure that their emotions don't negatively impact other
people.

Willpower is an essential part of self-mastery. It's what pushes you forward to

take action, even if you're feeling fear or hesitation. Willpower is also what
keeps you moving toward your goals in the weeks or months ahead.

To boost your willpower, make sure you have both rational and emotional
motives for what you want to achieve. For example, if your goal is to stop
surfing the web in work time, a rational motive could be that it's against
company rules, while an emotional motive could be that other people will
lose respect for you when they see that you are not working hard.

Improving your focus is also key to self-mastery. Start by working on your

concentration. Focus on one task at a time, and slowly increase your level of
focus.

At first you may find that you can't concentrate on a task for more than one
hour at a time, before you get tired and distracted.
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Achieving self-mastery takes time and hard work, but it's definitely worth the
effort. It's best to work on one or two areas at a time. Start by identifying
your life and career goals. Then, focus on maintaining a positive attitude
during the day.

Try not to let negative emotions impact anyone else. Other strategies, like
building your willpower and strengthening your focus, will help ensure that
you keep moving forward toward your goals – while further building self-
mastery

 Explain the various spheres of self mastery that Ram should

follow to cope up the situation?
self mastery - owning the responsibility

What is responsibility and why is it important? Response-ability is very simply

your ability to respond to the world. Whenever you claim responsibility, your
claim your power to do, to influence, to act, to change. Whenever you deny
responsibility, you deny your power to respond, leaving yourself powerless.
For example, if you say: "He made me angry," - you imply that the anger was
creating in you by him. If you say: "The leaky faucet irritates me," - you imply
that the irritation was created in you by the dripping water. In plain language
you are saying that how you feel was caused by someone or something else.
These shifts of responsibility away from yourself are perversions of reality (a
more technical term is distortion of reality). Another name for shifting
responsibility is blaming.

Blaming exists because it is an effective way to manipulate people. The often

unconscious logic of blaming goes like this: "I feel bad, you are responsible
for making me feel bad, now you are responsible for making me feel good. In
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any case, you owe me a favor." Clearly spelled out this way it becomes
obvious that blaming is just a power game. There is also an additional piece
of helplessness to it: "Since you caused my feelings, they are out of my
control. I am helpless to change anything and no effort is required from me."
So, blaming is a way to preserve status quo and to transfer all responsibility
for change to another party. Highly manipulative and effective in the short
run. Highly disempowering in the long run.

Seems simple? Then think how many times in the last week have you said to
yourself: "This is annoying" or "This is upsetting" or a similar phrase?
Denying response-ability every time. Next time try this phrase instead: "I am
choosing to feel annoyed" or "I am deciding to feel upset". If someone in your
presence says: "She is pissing me off", help them out by asking: "Why are
you deciding to feel pissed off?" Be careful with such phrasing though, many
people are so stuck in the constant cycles of blaming-helplessness, that they
will not even understand what you mean at first.

I would like to start an empowering mental virus of personal responsibility.

Here is how it works. First, forward this article to the people you spend most
of your time with - friends, family, colleagues. Then, after they have read it,
agree with each other to call out the refusal of personal responsibility,
whenever you notice it. So, if you hear each other say something that denies
responsibility, call it out: "You are choosing to be powerless right now." See
how fast you learn to notice and re-claim your response -ability to the world
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Q.3 Explain stages of organizational change.

Organizational change can be conceptualized in 4 broad stages:

1. awareness
2. adoption
3. implementation
4. institutionalization

Each stage is important in the development, implementation and

maintenance of a palliative care program.

Once the program has been institutionalized (stage 4), change continues
within the program and the organization through an ongoing cyclic process
of assessment and innovation.

Awareness

The goal of this stage is to create awareness that a need for change exists
and that there are possible solutions.

Awareness can be created in a variety of ways:

• conduct a needs assessment

This is a formal way of characterizing the existing situation. It provides
data upon which to base clinical services, education, training, and
quality improvement efforts.
• assess the quality of existing care
Eg, review charts for evidence of current approaches to symptom
management and palliative care.
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• identify unmet patient, family and caregiver needs, and

barriers
Interview patients, families, and caregivers about their experiences.
• assess institutional readiness for change, and barriers
Eg, conduct focus groups of professional caregivers

Awareness of possible solutions can be created in a variety of ways:

• brainstorm ways to meet the identified needs

• discover how others have met these needs

Adoption

The adoption stage begins with a signal from your institutional leadership
that planning for the program can begin. It is important to clarify the
resources you will need for the planning period including: staff time, office
supplies, consultant fees, etc.

First, finalize the program details. Conceptualize the populations you want to
serve. Examples of questions to ask are:

• What populations will benefit most from the proposed services? Are the
patients critically ill and technology-dependent or mostly elderly and
chronically ill patients?
• What are the leading causes of death at the institution?
• Where do patients die in the institution? Do most patients die in ICUs or
are they scattered throughout the hospital?
• Is space available to establish a dedicated inpatient unit or would it be
better to start with a consultation service?

A proposal usually needs to be written. The entire proposal may be written as

a strategic plan. A proposal generally includes:
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• Mission, Vision and Goals

• Justification for the program
• Proposed program description
• Multi-year budget plan with phase-in costs
• Implementation plan
• Plans for evaluation and quality improvement

Leaders and stakeholders should be consulted during the planning process to

pave the way for a positive decision to implement the recommended course
of action. Involve institutional planners early in the process.

Implementation

This stage begins with a signal from leadership that the program has been
authorized.

• funding sources are established to support the implementation

• staff are chosen and educated
• policies and procedures are developed and adopted
• the clinical service is begun
• marketing of the service is begun

Institutionalization

In the institutionalization stage, the program becomes accepted as part of

the institution. It's no longer a "new" thing.

Due to marketing efforts, solid performance, high patient and provider

satisfaction, referrals to the palliative care program become regular for
appropriate patients.

Policies and procedures guide patient care.

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Palliative care throughout the institution improves due to increased

awareness among other staff from informal communication, formal education
efforts and quality improvement endeavors.

Quality Improvement within the program assesses and improves care.The

success of the program is communicated to key leaders and stakeholders on
an ongoing basis.

Results of evaluation lead to modifications and growth of the program.

Stage Components Operationalization

1. Awareness • identify unmet • conduct needs
needs assessment
• search for possible • brainstorm / research
solutions ways to meet needs

• create tension for • communicate needs to

change key leaders
2. Adoption • decide upon a • develop a proposal
course of action • present the proposal to
• formulate key stakeholders
policy/procedure for
implementing • key personnel have time
change and resources to plan

• allocate initial
resources
3. Implementatio • resources allocated • obtain resources to
n for implementation launch program (money,
• carry out staffing, physical space,
innovation etc.)
• observe reaction of • begin palliative care
organization practice and observe
members response.
• market palliative care
• define roles program.
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• form clear roles among

program staff
4. Institutionaliza • integrate • referrals to palliative
tion innovation into care program become
routine regular
organization • policies and procedures
operations guide care
• palliative care
• internalize goals throughout institution
and values improves
surrounding
innovation • evaluation leads to
improved care