Initiating change in an organization
Organizational change requires focus and patience. New policies, practices, and training are implemented and embraced over time, and the pace at which they are adopted varies, but the overall characteristics of program change remain the same. Seven steps in the process are key.
The seven key steps of program change
1. Make a call to action.
A leader of the organization -- such as an agency director, a program director, a medical director, a respected physician, or a key clinical opinion leader -- makes a case to the organization that changes are needed.
2. Develop a reasonable consensus.
Key stakeholders agree that this change should take place. Key stakeholders might be the key leadership described in step 1, but they could also include frontline clinicians, community partners (referral sources and associated providers), and consumers.
3. Get organized.
This involves getting as specific as possible about what needs to change, how the change will take place, who will be responsible for it, and how key stakeholders will know whether it is working. One approach is the formation of a "steering committee." The people in these committees meet regularly and commit to the change and to one another to increase organizational accountability for the planned action steps.
4. Develop a concrete plan.
5. Actualize the planned changes.
Typically this step involves delegating specific tasks to individual staff members, as directed by the steering committee.
6. Decide whether the change was worthwhile.
Are the stakeholders and the steering committee happy with the change? Did it accomplish all that they wanted it to?
7. Sustain the change.
If the answers to the two questions in step 6 were yes, then step 7 asks, "How does the program maintain the change?" Sustainability is particularly important if the change was financially supported for the short term by a grant, a research study, or the presence of one or two people.
How would the change fare if this person left? What will happen after the grant money runs out? Sustainability will be more challenging with short-term funding than with long-term funding such as a long-term grant or a commitment to use an ongoing portion or organizational revenue as funding.