Journal of Healthcare Management - January/February 2014 - (Page 66)

Journal of H ealt H care M anage Ment 59:1 J anuary /f ebruary 2014 iNtrodUCtioN Strategic change capabilities have become a primary focus as hospitals and healthcare systems attempt to perpetually improve and position themselves in a competitive market characterized by continuous regulatory changes and opportunities for reorganization and growth. Yet few empirical studies focusing on success factors for effective organizational change have been conducted in hospitals or healthcare settings (Rosacker, Zuckweiler, & Buelow, 2010). The present study draws on management literature and examples of the successful implementation of strategic change initiatives in healthcare to further improve our understanding of how to plan for and implement such an initiative. The purpose of this study was to explore and identify specific change initiative success factors as depicted by healthcare leaders' assessments of change efforts in their health systems. Success factors available in the management literature are identified and contrasted to responses gathered from more than 60 administrators at two large healthcare systems engaged in multiple change initiatives. Prior research attempted to evaluate how strategic change initiatives are implemented (Edmondson, Bohmer, & Pisano, 2001), how leaders promote organizational successes (Bass & Riggio, 2006), and how culture affects organizational performance (Pfeffer & Veiga, 1999). Many of these strategies have even been categorized and summarized according to the organizational change theories applied (Van de Ven & Poole, 1995). However, variation frequently occurs within and across systems in innovative program success (Armutlu, Foley, Surette, Belzile, & McCusker, 2008; Hosler & Nadle, 2000; Manzo et al., 2005; Silow-Carroll, Alteras, & Meyer, 2007), and it may be that variations in success are related to an organization's ability to acquire and use new knowledge to ensure successful initiatives (Kash, Spaulding, Gamm, & Johnson, 2013). Healthcare strategic change initiatives research primarily focuses on outcomes that measure only one dimension of success at one level of the organization (Vest & Gamm, 2009). Generally, evaluations of change efforts have been found to fall short of increasingly high standards within health services research (Begun, Zimmerman, & Dooley, 2003). The healthcare management literature may benefit from a more industryspecific examination of success factors related to strategic change initiatives that will assist healthcare organizations along their transformation journeys. CoNCEPtUal FraMEWorK To define success factors, we viewed hospitals as open systems. Open systems are defined as those facing uncertainty in both their internal and external environment (Meyer & O'Brien-Pallas, 2010), making complex organizational change literature more pertinent to today's healthcare organization (the hospital system) than is the traditional change management literature of the pre1980s. Therefore, we restricted models of successful change initiatives to those described in the emergent change literature of the post-1980s. The emergent approach to change assumes that change is not linear or sequentially planned and 66

Table of Contents for the Digital Edition of Journal of Healthcare Management - January/February 2014

Journal of Healthcare Management - January/February 2014
Contents
Interview With Kenneth R. White, PhD, FACHE, Associate Dean for Strategic Partnerships and Innovation and the University of Virginia Medical Center Professor of Nursing, University of Virginia School of Nursing
Team-Based Care at Mayo Clinic: A Model for ACOs
The Management Springboard: Eight Ways to Launch Your Career as a Healthcare Leader
The Role of a Public–Private Partnership: Translating Science to Improve Cancer Care in the Community Donna M. O’Brien and Arnold D. Kaluzny
The Value of Patients’ Handwritten Comments on HCAHPS Surveys John W. Huppertz and Robert Smith
Can Inbound and Domestic Medical Tourism Improve Your Bottom Line? Identifying the Potential of a U.S. Tourism Market
Success Factors for Strategic Change Initiatives: A Qualitative Study of Healthcare Administrators’ Perspectives

Journal of Healthcare Management - January/February 2014