Running Head: CONSERVING BLOOD DURING CARDIAC SURGERY AT HUNTINGTON

UNIVERSITY HOSPITAL (A)

Thelma Landeros
Research Paper 5: Conserving Blood During Cardiac Surgery at Huntington University Hospital
(A)
Capstone II - ORG 4361
Rebecca Lynch, Ph.D.
Jun 30, 2019
Conserving Blood During Cardiac Surgery At Huntington University Hospital (A) 2

Dealing with change is important as a future leader in order to adapt personally and

professionally throughout life. The environment within which today’s organizations operate is

becoming increasingly dynamic and competitive where things change all the time at work

(McKee, 2014). These changes happen in an unprecedented pace and are affecting the

workforce. Businesses are affected with several changes, like the marketplace shifts, new

industry standards, or a current event with a company impact were the change cycle can be

applied. This paper will analyze the impact on the organization, the workers, the leadership, and

the customers in the case of conserving blood during cardiac surgery at Huntington University

Hospital (A), how Dr. Frank Young implemented change, discussion on the three lens

framework on organizational processes, and how resistance to change can be managed and

overcome in a context with highly skilled, semi-autonomous professionals.

The Huntington University Hospital (HUH) was the primary teaching hospital for

Huntington University Medical School where Dr. Frank Young wanted to lower the center’s

transfusion rate by leading a blood conservation project (Fernandez, et. al., 2016). In other

words, Dr. Young’s goal was to reduce the hospital’s blood utilization which involved the

medical teams during an operative phase. In today’s organizations, resistance to change can be

managed and overcome in a context with highly skilled semiautonomous professionals (McKee,

2014). This means, that Dr. Young had to convince his cardiac colleagues, over the fact that he

had no influence of the two issues: the conserving blood problem, and how the issue will resolve

as long as the surgeons were willing to change their ways.

One of the primary tasks in a change cycle is to engage employees within the

organization changing process, thus finding ways to overcome resistance, first by letting the staff

become aware of the need for change, and prepare them to share their commitment, and ideas.
Conserving Blood During Cardiac Surgery At Huntington University Hospital (A) 3

Once people join the change processes, then the organization will change in order to meet the

different and ever-changing demands of the world around us. The names of the stages in the

change cycle (Loss, Doubt, Discomfort, Discovery, Understanding, and Integration) indicate the

primary experience of that stage. The point is to progress from stage to stage in order to

eventually integrate the change experience.

Dr. Young implemented change at the HUH involved the six stages of change cycle. The

Change Cycle uses the same colors of a traffic light to signal that the stages mirror the actions we

often take at traffic lights. For example, the red color indicates to stop in order to deal effectively

with the experiences of stages 1 and 2 (Brock, 2008). This means Dr. Young’s new position of

leading a blood conservation project became stage 1 “Loss,” because work-life became different

in the operating room. The issue was that during a cardiac surgery, blood would spill out and into

the surrounding space, where a patient would need a blood transfusion. This explains that if Dr.

Young was not successful in implementing the change, a patient will have a lower chance of

survival. In Stage 2, “Doubt,” deals with the emotions of the skeptics of the blood conservation

project with accusations, and varying levels of mistrust. Another issue for Dr. Young was the

unlikely communication between staff, where the surgeons didn’t want to be disrupted from their

usual routine (Fernandez, et.al, 2016). This means the team was in need for Dr. Youngs’ creative

techniques and guidance in order to support the blood conservation project. Despite a strict

structural separation, recent studies indicate that integration is required in order to successfully

pursue explorative and exploitative activities simultaneously (Gassmann, et.al,.2012).

Moreover, in the following stages 3 and 4, caution is in order, just like in the yellow light

to slow down and stop. This can define how people experience the challenges of motivation and

making choices (Brock, 2008). In stage 3, “Discomfort,” practitioners conducted heart surgeries
Conserving Blood During Cardiac Surgery At Huntington University Hospital (A) 4

at HUH, where the outcomes were unsatisfactory, and incoming patients were on decline

(Fernandez, et.al, 2016). Thus if Dr. Young would be unsuccessful in implementing change, the

patient safety would be at risk. Also, in stage 4 “Discovering,” Youngs’ challenge was to take

the created options and make choices and decisions about the next best steps (Brock, 2008). For

example, using rewards by recognizing employees for making a meaningful contribution to

patient safety. Also, Dr. Young would be unsuccessful in implementing the discovering stage by

not offering incentives in form of motivation to employees. This suggests that members evaluate

membership in high status groups as valuable because it meets their motivation for self-esteem

(Brickson, 2013).

Additionally, in stages 5 and 6 people enable the leader to assimilate the change, just like

a person moves freely at the green light, thus completing the change cycle (Brock, 2008).

During stage 5, the “understanding” mode, we find ourselves wanting to take in as much

newness, as much information, as we can absorb, both at work and outside work by becoming

confident and productive. Dr. Young became confident and productive by suggesting techniques

that medical teams could employ to bring down the use of blood products (Fernandez,

et.al,.2016). However, if Dr. Young would fail in implementing the change in stage 5, the

challenge to understanding executive leadership becomes in two ways. First, by identifying

effective leadership behavior in the context of the organizational turbulence stirred up in the

change process. Secondly, distinguishing that behavior from any preconceived theories of

effective leadership held either by the executive leader or the researcher (Bastien, 1991). Finally,

in stage 6 “integration,” a leader may experience empathy and often are able to assist to other

staff members who may not be as far along in the process. Dr. Young had supporters of the

project which included hospital administrators, nurses, perfusion staff, cardiologists, and surgical
Conserving Blood During Cardiac Surgery At Huntington University Hospital (A) 5

colleagues which understood that the project goal was the best idea for patients (Fernandez, et.al,

2016). Likewise, if Dr. Young would be unsuccessful in implementing change in this stage, he

would have not kept flexible through uncertainty, or incompetent to move closer to his larger

work and life goals. It is essential to generate internal support by communicating successes

within the hospital, physicians and staff members to initiate a project (Dückers, et.al, 2011). At

the start of change cycle in the blood conservation project, Dr. Young determined how much

support or training was needed and who would provide it. Enthusiasts of the blood conservation

project confirmed the relevance of organizational support and approaches to reutilize knowledge

and experience techniques looking at quality outcomes in relation to costs.

The three lenses are strategic lens, political, and cultural lenses in the organizational

processes and they provide new insights into managerial behavior. Organizational processes,

“repetitive patterns of interdependent action carried out by multiple actors", can vary

substantially. For example, the process of convincing surgeons and the medical teams to make

changes to their surgical routines in healthcare is clearly different from surgery following the

blood conservation project (Fernandez, et.al, 2016). In order to understand these differences,

surgeons use simple frameworks to classify their processes. Text- and management handbooks

for process management speak of primary versus secondary activities or core, management, and

support processes. These frameworks are widely adopted in practice (Brocke, et.al., 2018).

In conclusion, the change cycle model works for people up and down an organization and

it is meant for anyone who works, manages, supervises, or leads. This by meeting people where

their emotions are (Brock, 2018). These changes happen in an unprecedented pace and are

affecting the workforce. Businesses are affected with several changes, like the marketplace

shifts, new industry standards, or a current event with a company impact were the change cycle
Conserving Blood During Cardiac Surgery At Huntington University Hospital (A) 6

can be applied. It is essential in todays’ organizations, to reinvent new kinds of leadership

approaches, and improve existing processes. This to create new possibilities for companies and

its employees not just to be more effective, but also, more fulfilling for their members.
Conserving Blood During Cardiac Surgery At Huntington University Hospital (A) 7

References
Brickson, S. L. (2013). Athletes, Best Friends, and Social Activists: An Integrative Model
Accounting for the Role of Identity in Organizational Identification. Organization
Science, 24(1), 226–245. https://doi.org/10.1287/orsc.1110.0730
Dückers, M. L. A., Wagner, C., Vos, L., & Groenewegen, P. P. (2011). Understanding
organizational development, sustainability, and diffusion of innovations within hospitals
participating in a multilevel quality collaborative. Implementation Science, 6(1), 18–27.
https://doi.org/10.1186/1748-5908-6-18
Fernandez, R., Mangi A., Reavis, C. (2016). MIT Management Sloan School: Conserving Blood
During Cardiac Surgery at Huntngton University Hospital (A). Retrieved from
https://mitsloan.mit.edu/LearningEdge/Leadership/ConservingBloodDuringCardiacSurge
ryA/Pages/default.aspx
Gassmann, O., Widenmayer, B., & Zeschky, M. (2012). Implementing radical innovation in the
business: the role of transition modes in large firms. R&D Management, 42(2), 120–132.
https://doi.org/10.1111/j.1467-9310.2011.00670
Manz, C., Bastien, D., & Hostager, T. (1991). Executive Leadership During Organizational
Change: A Bi-Cycle Model. Human Resource Planning, 14(4), 275–287. Retrieved from
https://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=7702082&site=eds-
live&scope=site
McKee, A. (2014). Workplace Essentials: Creativity, Innovation, and a Spirit of
Entrepreneurship. In A. McKee, Management A Focus On Leaders Second Edition (pp.
216-217). Saddle River: Pearson Education Inc.
Salerno, A., & Brock, L. (2008). The Change Cycle: How People Can Survive and Thrive in
Organizational Change (Vol. 1st ed). San Francisco: Berrett-Koehler Publishers.
Retrieved from https://search-ebscohost-com.ezproxy.southtexascollege.edu/login.
aspx?direct=true&db=nlebk&AN=260671&site=eds-live&scope=site

Zelt, S., Recker, J., Schmiedel, T., & vom Brocke, J. (2018). Development and validation of an
instrument to measure and manage organizational process variety. PLoS ONE, 13(10), 1–
25. https://doi-org.ezproxy.southtexascollege.edu/10.1371/journal.pone.0206198