Browsing by Subject "Organizational change"

Now showing 1 - 6 of 6
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    Age Demographics and the Organizational Dilemma Facing Academic Libraries
    (2016-01) Lewis, David W.
    Academic libraries are, because of the age demographics of the librarian workforce, facing an organizational dilemma. Stated most simply the dilemma is: Academic libraries need to exploit new technologies using new service strategies to be effective. They will need to do so with a librarian labor force that consists of a large number of baby boomers many of whom will remain in the workforce for at least another decade. At the same time millennium librarians, who will replace the baby boomers, need to be attracted and provided an environment that will allow them to develop and grow, and that will productively use their skills and expertise. It will be important that both groups be productive and make contributions, but creating an organization with a structure and culture to do both will be difficult because in many cases aspirations and needs of the two groups will differ and be at cross purposes. These two imperatives, keeping baby boomer librarians productive and providing millennium librarians opportunities to grow and develop can be accomplished simultaneously, but not without creatively thinking about the libraries organizational structure and attention to its culture. This paper will layout the problem and suggest the issues that need to be considered.
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    Coping with organizational change: a multidimensional perspective
    (2011-03-10) Bussell, Stephen L.; Goering, Elizabeth M.; Parrish-Sprowl, John; Sandwina, Ronald M.
    This paper introduces a unified model for organizational change that is designed to help change analysts think through the decision-making process. Most organizational leaders do not manage change effectively because they fail to acquire the minimum amount of information necessary to make a sound decision. In large part, this deficiency is a result of considering only a small part of the organization’s total change reality, which can be expressed in terms of the following four categories: 1) Environment creates change, 2) Organization responds to environmental change, 3) Organization initiates new changes, and 4) Organization changes environment. Through the principle of diagnostic communication, leaders can adjust to the incoming changes [categories 1 and 2]. Through the principle of rhetorical communication, they can create effective outgoing changes [categories 3 and 4]. Through the principle of dialogical communication, they can achieve a strategic balance between too much conformity, which results from diagnostic communication in isolation, and too much non-conformity, which results from communication in isolation. By understanding and communicating about change from this multi-dimensional perspective, organizational leaders, both designated and non-designated, can learn to appreciate the extent to which they influence and are influenced by the larger cultural environment of which they are a part.
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    Improving Smoking and Blood Pressure Outcomes: The Interplay Between Operational Changes and Local Context
    (Annals of Family Medicine, 2021) Cohen, Deborah J.; Sweeney, Shannon M.; Miller, William L.; Hall, Jennifer D.; Miech, Edward J.; Springer, Rachel J.; Balasubramanian, Bijal A.; Damschroder, Laura; Marino, Miguel; Emergency Medicine, School of Medicine
    Purpose: We undertook a study to identify conditions and operational changes linked to improvements in smoking and blood pressure (BP) outcomes in primary care. Methods: We purposively sampled and interviewed practice staff (eg, office managers, clinicians) from a subset of 104 practices participating in EvidenceNOW-a multisite cardiovascular disease prevention initiative. We calculated Clinical Quality Measure improvements, with targets of 10-point or greater absolute improvements in the proportion of patients with smoking screening and, if relevant, counseling and in the proportion of hypertensive patients with adequately controlled BP. We analyzed interview data to identify operational changes, transforming these into numeric data. We used Configurational Comparative Methods to assess the joint effects of multiple factors on outcomes. Results: In clinician-owned practices, implementing a workflow to routinely screen, counsel, and connect patients to smoking cessation resources, or implementing a documentation change or a referral to a resource alone led to an improvement of at least 10 points in the smoking outcome with a moderate level of facilitation support. These patterns did not manifest in health- or hospital system-owned practices or in Federally Qualified Health Centers, however. The BP outcome improved by at least 10 points among solo practices after medical assistants were trained to take an accurate BP. Among larger, clinician-owned practices, BP outcomes improved when practices implemented a second BP measurement when the first was elevated, and when staff learned where to document this information in the electronic health record. With 50 hours or more of facilitation, BP outcomes improved among larger and health- and hospital system-owned practices that implemented these operational changes. Conclusions: There was no magic bullet for improving smoking or BP outcomes. Multiple combinations of operational changes led to improvements, but only in specific contexts of practice size and ownership, or dose of external facilitation.
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    An Organizational Informatics Analysis of Colorectal, Breast, and Cervical Cancer Screening Clinical Decision Support and Information Systems within Community Health Centers
    (2013-03-06) Carney, Timothy Jay; Jones, Josette F.; Haggstrom, David A.; McDaniel, Anna M.; Weaver, Michael; Palakal, Mathew J.
    A study design has been developed that employs a dual modeling approach to identify factors associated with facility-level cancer screening improvement and how this is mediated by the use of clinical decision support. This dual modeling approach combines principles of (1) Health Informatics, (2) Cancer Prevention and Control, (3) Health Services Research, and (4) Organizational Change/Theory. The study design builds upon the constructs of a conceptual framework developed by Jane Zapka, namely, (1) organizational and/or practice settings, (2) provider characteristics, and (3) patient population characteristics. These constructs have been operationalized as measures in a 2005 HRSA/NCI Health Disparities Cancer Collaborative inventory of 44 community health centers. The first, statistical models will use: sequential, multivariable regression models to test for the organizational determinants that may account for the presence and intensity-of-use of clinical decision support (CDS) and information systems (IS) within community health centers for use in colorectal, breast, and cervical cancer screening. A subsequent test will assess the impact of CDS/IS on provider reported cancer screening improvement rates. The second, computational models will use a multi-agent model of network evolution called CONSTRUCT® to identify the agents, tasks, knowledge, groups, and beliefs associated with cancer screening practices and CDS/IS use to inform both CDS/IS implementation and cancer screening intervention strategies. This virtual experiment will facilitate hypothesis-generation through computer simulation exercises. The outcome of this research will be to identify barriers and facilitators to improving community health center facility-level cancer screening performance using CDS/IS as an agent of change. Stakeholders for this work include both national and local community health center IT leadership, as well as clinical managers deploying IT strategies to improve cancer screening among vulnerable patient populations.
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    The Relationship between Perceptions of Due Process and Satisfaction with a Merit Pay System
    (2011-03-09) Grayson, Allison L.; Williams, Jane R.; Hazer, John; Devine, Dennis J. (Dennis John)
    Organizations continuously look to improve the implementation and ultimate success of organizational change. One way to facilitate organizational change is to effectively manage employee reactions to that change. Previous research has examined the use of a due process approach, specifically in relation to the performance appraisal systems. Past results have indicated that meeting the due process criteria for adequate notice, fair hearing and judgment based on evidence positively influences employee perceptions of the performance appraisal system, organizational justice, and other key variables. The current study expands on these findings by applying the due process approach to the implementation of a merit pay system. With the main goals of a merit pay system being to retain and motivate employees, successful implementation is key. The current study measured perceptions of due process over three measurement periods during the implementation of a new merit pay system. Results demonstrated that the due process components are meaningful in the implementation of a merit pay system. Perceptions of due process predicted system satisfaction and organizational justice perceptions both within and across measurement time periods.
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    Transitioning from One Electronic Health Record to Another: A Systematic Review
    (Springer, 2023) Miake‑Lye, Isomi M.; Cogan, Alison M.; Mak, Selene; Brunner, Julian; Rinne, Seppo; Brayton, Catherine E.; Krones, Ariella; Ross, Travis E.; Burton, Jason T.; Weiner, Michael; Medicine, School of Medicine
    Background: Transitioning to a new electronic health record (EHR) presents different challenges than transitions from paper to electronic records. We synthesized the body of peer-reviewed literature on EHR-to-EHR transitions to evaluate the generalizability of published work and identify knowledge gaps where more evidence is needed. Methods: We conducted a broad search in PubMed through July 2022 and collected all publications from two prior reviews. Peer-reviewed publications reporting on data from an EHR-to-EHR transition were included. We extracted data on study design, setting, sample size, EHR systems involved, dates of transition and data collection, outcomes reported, and key findings. Results: The 40 included publications were grouped into thematic categories for narrative synthesis: clinical care outcomes (n = 15), provider perspectives (n = 11), data migration (n = 8), patient experience (n = 4), and other topics (n = 5). Many studies described single sites that are early adopters of technology with robust research resources, switching from a homegrown system to a commercial system, and emphasized the dynamic effect of transitioning on important clinical care and other outcomes over time. Discussion: The published literature represents a heterogeneous mix of study designs and outcome measures, and while some of the stronger studies in this review used longitudinal approaches to compare outcomes across more sites, the current literature is primarily descriptive and is not designed to offer recommendations that can guide future EHR transitions. Transitioning from one EHR to another constitutes a major organizational change that requires nearly every person in the organization to change how they do their work. Future research should include human factors as well as diverse methodological approaches such as mixed methods and implementation science.