Student Workbook-Chapter 4

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SUNY Westchester Community College *

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Management

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Apr 3, 2024

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Chapter 4: Change Management in Health Information Management Learning Objectives  Outline strategic planning in healthcare  Define organizational development in terms of strategic planning  Explain the techniques used to promote change  Identify the stages associated with the adoption of innovation or change  Differentiate between internal and external change agents  Contrast the impact of differing conflict management styles required for managing resistance and conflict associated within change Key Terms Active listening ADKAR model Adoption of innovation Anchoring Bridges’ transition model Change Change agent Change initiatives Change management Collaboration Communication Conflict Conflict management Diffusion of innovation theory Early adopters Early majority Emergent change External change agent Innovation Innovators Input-output process model Internal change agent John Kotter’s change management model Kurt Lewin’s three-stage change management model Laggards Late majority Learning organization Mission statement Negotiation Organizational culture Organizational development (OD)

Phases of grief Planned change Power in negotiation Refreezing Resistance to change Senge’s theory of change Strategic change Strategic planning Thomas Kilmann conflict mode instrument Transitioning Unfreezing Vision statement Work environment scale (WES) Answers to Check Your Understanding Questions Page 74 1. Identify when a health organization initiates development of a new or revised strategic plan. A health organization typically initiates development of a new or revised strategic plan when there is a need to address current or emerging market demands. 2. Explain how strategic planning results in organizational development. Strategic planning guides decision-making and resource allocation, fostering organizational growth, efficiency, and adaptability. 3. Delineate the role of the health information manager in strategic planning and organizational development. Health information managers facilitate strategic planning by disseminating information and supporting the development of health policies and information systems. 4. Differentiate between a mission and vision statement. A mission statement describes the purpose and goals of an organization in the present, while a vision statement outlines its future aspirations and long-term objectives. 5. Differentiate between an internal and external change agent. An internal change agent is an employee of the organization, while an external change agent is an outside consultant or specialist. 6. Outline four strategies employed by change agents to facilitate and mitigate resistance to change. Participation in decision-making, socialization and shared values, culture-based approach, communication, and education. 7. Explain the adoption of innovation or change theory. The adoption of innovation or change theory explains how new ideas, behaviors, technologies, or goods gradually spread through a population, rather than all at once. Page 79 1. Differentiate between planned and emergent change. Planned change is intentional and structured, while emergent change is unpredictable and often unintentional. 2. Outline the three stages of Lewin’s model that are experienced during change. Unfreezing, changing, refreezing.

3. Identify the stages of grief individuals may experience during a change process. Individuals may experience the stages of grief during a change process, including denial, anger, bargaining, depression, and acceptance. 4. Outline the steps of Kotter’s change management model and how these steps can be exhibited an HIM department change initiative. Establish a sense of urgency: Communicate the need for change in HIM processes and technology upgrades to improve efficiency and compliance. Create a guiding coalition: Form a team of key stakeholders including HIM professionals, IT specialists, and department heads to lead the change initiative. Develop a vision and strategy: Define a clear vision for the HIM department's future state, aligning with organizational goals, and devise a strategy to achieve it. Communicate the change vision: Cascade the vision and strategy throughout the department, emphasizing the benefits of the proposed changes and addressing concerns. Empower employees for action: Provide training and resources to HIM staff to equip them with the skills needed to implement the changes effectively. Generate short-term wins: Celebrate early successes in HIM process improvements or technology implementations to maintain momentum and motivate staff. Consolidate gains and produce more change: Embed the changes into daily HIM operations, continually seeking opportunities for improvement. Anchor new approaches in the culture: Foster a culture of continuous improvement within the HIM department, ensuring that the changes become ingrained in organizational norms and practices. Page 80 1. Describe organizational culture and how it can impact an employee’s perception of change. Organizational culture refers to shared values, beliefs, and behaviors within a workplace. It influences an employee's perception of change by shaping attitudes, resilience, and adaptability. 2. Outline how WES can assess a healthcare organization’s culture. WES is a validated measure used to assess healthcare organizational culture by surveying employees within the organization. Page 87 1. Evaluate the role of active listening when communicating change initiatives. Active listening fosters engagement, creates a supportive environment, and enhances communication during change initiatives.

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2. Explain two differences between negotiating change initiatives and collaborating within change initiatives. Negotiation involves formal discussions between parties, while collaboration implies working together towards a common goal. Negotiation focuses on reaching agreements, whereas collaboration emphasizes joint decision- making and problem-solving. 3. Discuss the advantages and disadvantages of the five conflict management styles. Avoidance:  Advantage: Maintains relationships.  Disadvantage: Conflicts remain unresolved. Accommodating:  Advantage: Preserves harmony.  Disadvantage: May lead to resentment or exploitation. Competing:  Advantage: Quick resolution.  Disadvantage: Damages relationships and teamwork. Compromising:  Advantage: Speedy resolution.  Disadvantage: Potential for unsatisfactory outcomes and unresolved issues. Collaborating:  Advantage: Effective problem-solving and relationship-building.  Disadvantage: Time-consuming and requires high levels of trust and communication. 4. Create a plan for approaching a critical conversation that needs to take place as a result of conflict. Gather facts and clarify objectives, understand the other person's perspective, express concerns calmly and directly, find mutually acceptable solutions, schedule a follow-up to ensure resolution. Answers to End-of-Chapter Questions 1. Following a strategic planning retreat, the University Hospital board of trustees wrote this: “University Hospital exists to bring quality healthcare to the surrounding community and region and to educate future healthcare providers.” This is an example of what kind of statement? a. Mission b. Value c. Vision d. Strategic

2. The HIM department at Memorial Hospital will install CAC next month. Meetings were held with all coders so they had input into the process and could address any concerns. HIM managers are working together to ensure the process is as smooth as possible. This is an example of what kind of change? a. Emergent b. Open-ended c. Planned d. Strategic 3. Emily, one of the coders at Memorial Hospital, has refused to attend any meetings on the CAC project, and when the other coders bring up the topic she quickly changes the subject saying she is sure it will never happen. Emily demonstrates what step in the grief process? a. Acceptance b. Bargaining c. Denial d. Depression 4. University Hospital made the decision to allow coders to code remotely from home. As preparations are made, some of the coders who were originally in favor of the idea are now reluctant to leave their workstations. This change phase is called: a. Changing b. Refreezing c. Transition d. Unfreezing 5. During remote coding implementation at University Hospital, the problem of how to keep a sense of community among the coders surfaced. The coders decided to create a group for themselves on a popular social media website to keep in touch. This change phase is called: a. Beginning b. Freezing c. Transition d. Unfreezing 6. Which of the following behaviors is an early indicator of resistance to change that an employee might exhibit when presented with a new project? a. Asking repeated questions during a department meeting about the new project b. Missing planning meetings to determine the implementation schedule for the new project c. Reading industry articles on the new project to gain knowledge prior to installation d. Volunteering to be on an implementation committee for the new project 7. Dr. Jones is the first physician in the practice to adopt the e-prescribing application. He says he likes to try out new technologies and to be a role model for other physicians. Dr. Jones is at what step in the innovation adoption life cycle? a. Early adopter

b. Early majority c. Laggard d. Late majority 8. Caroline is an evening shift manager in the HIM department. When employees are arguing among themselves, she often delays intervening in the hopes that they will work out their problems and she will not have to get involved. Caroline exhibits which conflict style? a. Accommodating b. Avoiding c. Collaborating d. Compromising 9. Jacob is the assistant department head in the HIM department. When the director offers her opinion on how to handle a disciplinary problem, Jacob usually acts on her advice even if he disagrees with it. Jacob exhibits which conflict style? a. Accommodating b. Avoiding c. Collaborating d. Compromising 10. Which of the following items on Abigail’s to do list is most likely to require a critical conversation? a. Ask Thomas to act as a coach for the new scanning clerk scheduled to start next week b. Meet with the director for a discussion on whether I should consider going back to school for my master’s degree c. Tell Patricia she has been selected for promotion to lead transcriptionist to fill the vacancy left when Sara retired d. Place Daniel on probation due to continuing problems with decreasing coding productivity and coding accuracy

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Student Workbook-Chapter 4

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