CULTURAL CHANGE MANAGEMENT

Changes are rapid in today's world. Markets are opened and closed, new
technologies for both products and production are developed and more and more
organizations want to compete on the market. Thus, organizations that want to be
competitive have to react quicker and be more flexible. They have continuously to
listen to and anticipate the customer's needs and expectations and be able quickly
to adapt to these new needs and expectations in terms of new products and
processes (Kennerfalk and Klefsj 1995: 194).

Organizational culture can be presented as the glue of the organization, providing

identity and strength. The most difficult aspect of studying organizational culture is
that it is highly subject to interpretation and difficult to measure (Ruigrok and
Achtenhagen 1999: 522). In an organization, where the teamwork for the quality of
service is important, the need for the glue is what those organizations have to focus
on.

The notion of organizational culture gradually arose over the 1970s. There are a
variety of meanings attributed to the concept of organizational culture. However
many authors agree the notion refers to (Ruigrok and Achtenhagen1999: 523):

A set of values, norms, beliefs, meanings, and behaviors at a given point in time
that are shared by people in an organization and can be conveyed to new
members of the organization
about how people should act and/or may improve their performance or solve
problems
that in addition to more formalized systems may serve as an informal coordination
and control mechanism, or glue, at different levels of the organization.

The change in culture helps the organization change also its structure. The cultural
change will work as a lever. As the culture is changed from individualistic to team-
thinking, the function oriented structure will change towards a more process-
oriented structure. The number of decision levels will decrease and the structure will
be flatter. Focus will be more on work flows and processes than on departments and
functions, and the importance of horizontal communication will increase (Saraph
and Sebastian 1993: 76). Recognizing that change is a continuous process has
implications for the way we manage change. No longer is it appropriate to consider
organizational change as a project or event with a beginning and an end- to be
managed, but rather we must consider change management as an ongoing aspect
of the leaders job (Sauser and Sauser 2002: 241).

If we want to learn about how to change culture, we need to understand how it is

created there are six different ways in which culture evolves. Some of these can be
influenced by leaders and some cannot (Cameron, E., 2004, 221):

A general evolution in which the organization naturally adapts to its environment.

 A specific evolution of teams or sub-groups within the organization to their
different environments.

A guided evolution resulting from cultural 'insights' on the part of leaders.

A guided evolution through encouraging teams to learn from each other, and
empowering selected hybrids from sub-cultures that are better adapted to current
realities.

A planned and managed culture change through creation of parallel systems of

steering committees and project-oriented task forces.

A partial or total cultural destruction through new leadership that eliminates the
carriers of the former culture (turnarounds, bankruptcies, etc).

Cultural Change and Quality Culture

Cultural change is increasingly being recognized as an important aspect of total

quality development. However the issue surrounding quality culture has not been
comprehensively studied and as such a structured approach to culture change
remains largely unclear (Adebanjo and Kehoe 1998:275). The staff working directly
interacting with guests have a great importance and effect on the customers to be
the repeat guests as they implement the quality necessities in a voluntary and keen
manner.

There is such a relationship between total quality management and culture that
describes total quality management as the culture of an organization committed to
customer satisfaction through continuous improvement. From this perspective, what
makes total quality management different from other management processes is its
concentrated focus on continuous improvement. This is why we claim that a cultural
transformation from a set of bureaucratic postulates towards a TQM culture must be
carried out through a long-term strategy, clearly formulated and implemented, in
such a way that the change is achieved within an evolutionary process, not within a
revolutionary one. This is so because we are dealing with individual and
organizational behaviors, with all the opposition that a change of this nature tends
to generate

Seven dimensions of quality culture were identified and researched for an

evaluation of cultural problems. These dimensions are indicative of attributes which
total quality practitioners generally agree should be present in organizations whose
culture complements total quality implementation. This model defined by these
dimensions is as follows (Adebanjo and Kehoe 1998: 276-277):

a. Senior management leadership: The commitment of senior managers has been

described as the most important determinant of successful total quality
implementation and its absence is a prime reason why total quality fails. It is clear
that unless senior management is fully committed to, the idea of a real
improvement in quality, exercises leadership and devotes time, energy and
resources to this objective, it would be impossible to motivate the rest of the
organization.

b. Employee involvement and empowerment: Employee involvement as the process

of transforming an organizations culture to utilize the creative energies of all
employees for problem solving and for making improvements.

c. Teamwork: It is argued that teamwork is universally accepted as the vehicle for

change and the organizational mechanism for involving people in quality
improvement.

d. Customer focus: Customers are recognized as the guarantee of the organizations

continued existence and a focus on them is the foundation of the total quality
approach to management. There is a commonly-held notion that all quality efforts
are ultimately directed at the customer.

e. Partnership with suppliers: Many businesses persist in dealing with suppliers on

the basis of price tag while the need is to move to few or single suppliers, based on
a long-term relationship of mutual understanding of needs, loyalty and trust.

f. Effect of chief executive: It has been argued that unless the chief executive takes
the ead in the process of quality improvement, any attempts and improvements
made by individuals and departments will only be transient in nature. It is the chief
executive that should be the focal point providing broad perspectives and vision,
encouragement and recognition.

g. Open corporate culture: It is clear that an open attitude builds trust and is an
essential condition for overcoming people's fears about the quality-related changes
sweeping through the organization.

TEAMWORK

If you succeed in any kind of team activity then you know how important it is that
each team member sees the big picture and not just their own part. Anytime one
doesnt know how his/her work fits in with that of the team then the quality and
effectiveness of both the team member and the entire team suffers. Basketball is a
perfect example. Each player in any given position knows their assignment and how
it develops into a play. The better grasp each team member has of the big picture
and overall goals, the greater their potential to work together as a team (Maxwell
2009). Together-Everyone-Achieves-More, (TEAM). Incorporating team-building
measures to change organizational culture are exactly the type of reformation
needed to address corrections suffering staff moral and performance issues. True, it
is a difficult and complex proposition to shift an entire organizational paradigm.
However, avoiding a task simply because it is difficult or never been done before is
taking the path of least resistance. This is especially true if the end result is higher
efficiency in the expenditure of our human and economic assets. Transforming
organizational culture long entrenched in antiquated policy and systematic
ineffectiveness is the biggest obstacle of change. Its time to think out of the box
and explore What Works and apply those techniques to corrections. Nothing
limits achievement like small thinking; Nothing expands possibilities like unleashed
thinking (William Arthur Ward).

Teamwork is performing work by a team for a common purpose. It encourages

collaboration from all levels of the organization and as such unleashes untapped
thinking potential. In this environment, managers and employees come to
understand the value of cooperation in planning, decision making and problem
solving. A team culture fosters a participatory atmosphere that encourages staff to
make suggestions to improve operations and efficiency knowing that their ideas will
be received with open minds. The focus is on contributions and solicitation of input.
This type of motivation taps into the synergy of the workforce. Such motivation
provides positive reinforcement that increases job satisfaction stemming from a
challenging job experience (FEMA/USFA/NFA, 2000). Consequently, employee
empowerment promotes ownership of agency performance that equates to more
dedicated corrections professional. According to Heathfield, to achieve a successful
team environment, several actions must occur,

Administrators communicate the clear expectations that teamwork and

collaboration are expected. No one individual owns the work.

Administrators demonstrate leadership in teamwork in interaction with each

other and the rest of the organization, even when things are going wrong.

Department members talk about and identify the value of team. This is easily
facilitated in annual cycle training programs or development seminars. If
team value is effectively discussed, it becomes organizational philosophy.

Teamwork must be rewarded and recognized.

Abraham Lincoln once said, A house divided against itself cannot stand. Therefore
a facility void of teamwork cannot successfully achieve its goals as an organization.
When team-building is not promoted division occurs. When division takes control of
a facility an us and them culture prevails and each is viewed by the other as the
enemy. With division we work against ourselves and fail to optimize our efforts. For
example, division between labor and management, union representation and
management, groups within the rank and file and even between facility
administrators of differing political ideologies. Such division in many departments
has been a catalyst for mediocrity. Division can cripple a facilitys productivity and
efficiency potential. A correctional facility overcome with division can be prolific in
adversarial relationships. The mission of corrections gets blurred and our obligation
to maintain public confidence lost. Personality conflicts and power positioning
becomes business as usual. Efficient governance in corrections is replaced with
counter productive dissension. Big picture thinking and innovative ideas are easily
dismissed as ridiculous or without due consideration. It is this lack of teamwork that
has prohibited corrections from achieving high performance in public safety and
stymied performance excellence in human resource management.

Team-building on the other hand capitalizes on the strengths of each staff member
and highlights their talents or areas of expertise. The focus is on bringing
employees together to concentrate in concert on organizational goals. The overall
objective is collaboration, not competition. A team enriched environment creates a
sense of ownership of agency mission and therefore staff feels they have value to
the organization. It opens many avenues of creative input and feedback for
management. A win win situation results. The impact on staff commitment to their
profession and their employer is positive. Seeking help from staff members who
posses expertise in a specific area is a sign of strength, not weakness. The result
will be a more dedicated staff who takes pride in what they do because they know
they legitimately contribute to the department. When everyone feels valued, the
level of effort and focus increases, leading to a more productive organization.
Moreover, when people see that their advice is valued, they look more closely for
ways to improve and seek to give more advice, which creates a positive domino
effect ( Liff, 2007).

In corrections we are public servants. As such, we are all charged with a matter of
public trust. Our public mandate is to provide the most efficient and effective
system of incarceration possible. This involves the safeguarding and prudent
management of public assets both human and fiscal. We must begin the process of
examining our accomplishments in these areas and as a branch of criminal justice.
The time is now to think differently about our commitment to our profession and our
responsibility to nurture public confidence. Lets take it to the next level and stop
wasting valuable resources and start capitalizing on what we already posses. Team-
building concepts, if implemented wisely will begin the transformational steps to
reach high performance and achieve tangible operational and economic benefits.

DRIVE (Define, Review, Identify, Verify, Execute) MODEL

DRIVE is a commonly used tool and approach in process improvement. This

approach helps us analyze the problem from different angles. Its meaning is as
follows:

Define
Define the scope of the problem and the criteria by which success will be measured
and agree on the deliverables and the success factors.

Review

Review the current situation, understand the background, identify and collect
information, include performance metrics, identify problem areas, improvements,
and "low-hanging fruits."

Identify

Identify improvements or solutions for the problem as well as necessary changes to

gain and sustain the improvements.

Verify

Verify that the improvements will bring about benefits that meet the defined
success criteria, prioritise and pilot the improvements.

Execute

Execute the implementation of the solutions and improvements; plan a review;

gather feedback and review.
Using Key Driver Models To Focus Quality Improvement Plans

Key driver models are roadmaps to particular outcomes that help focus the work of
a facilitation program, as well as the work of individual facilitators and facilitation
teams at the practice level. Key drivers define the pathway to a desired
transformation. Key driver models graphically display the strategies and activities
needed to achieve goals and aims of the practice improvement effort (DeWalt, et
al., 2010).

acilitation programs typically use two levels of key driver models:

One at the programmatic level that outlines the facilitation programs overarching
goals and underlying model for change, and

One at the practice level, which tailors the programmatic model to the needs and
priorities of individual practices.

Program-level and practice-level key driver models include:

Desired outcomes for the practice improvement effort,

Big changes or key drivers that are most likely to accomplish these goals, and

Specific changes or action items that must occur to produce the desired big
changes.

Example of a Key Driver Model

Figure 14.1 shows a program-level key driver model for improving diabetic and
asthmatic patient outcomes based on the Care Model (see Module 16). This key
driver model was developed for the Improving Performance in Practice Initiative
funded by the Robert Wood Johnson Foundation and provided by Dr. Darren DeWalt.

The far left column shows specific QI goals. The middle column contains the
organizational and care processes thought to improve care and patient outcomes.
These key drivers function as a menu from which practices can choose the
approaches they will use to achieve their goals. The far right column contains the
change concepts or action items/steps to implement a particular key driver.

Designing a Key Driver Model With a Practice

You should work with the practice to develop a practice-level key driver model that
links to the outcomes identified by the practice and targeted by the facilitation
intervention. The practices QI plan should be based on the practice-level key driver
model to reflect the change concepts included in the model. If your program has a
predefined key driver model for the intervention, you should review the prescribed
model with the practices QI team and work with them to identify the drivers and
change concepts they want to implement first, second, and third. You should also
ask the practice to identify what other items not currently represented on the key
driver model they are interested in changing, and make these additions accordingly.

If your facilitation program does not have a key driver model for the change work
the practice wants to do, consult the guide Developing and Running a Primary Care
Practice Facilitation Program (Knox, et al., 2011). You will find guidance on creating
a key driver model, including a couple of samples showing different forms key driver
models can take.

A first step in developing a key driver model is to choose goals that are clearly
defined. Goals and outcomes should be SMART:

Specific,
Measurable,
Attainable/Achievable,
Relevant, and
Time bound (IOM).

When defining its change goals, the practice should include numeric targets.
Distinguish between goals that will be accomplished during the period you are
facilitating (if its time limited) and longer term goals. They should be based on the
results of the practice assessment and focus on the areas needing improvement.

As you work with the practice on developing its practice-level key driver model,
point out materials and resources to support the improvement activities and tasks
associated with each key driver. For example, the Integrating Chronic Care and
Business Strategies in the Safety Net Toolkit (AHRQ, 2008) contains many tools
useful to practices implementing the Care Model. You will need to familiarize
yourself with resources that you can use to support these changes in the practice.

As part of developing this plan, you will also need to help the practice establish an
inventory of the resources, assets, and personnel talents that currently exist in their
practice and can be leveraged to support Care Model implementation and its
associated key drivers and change concepts.