Case study on Organisational Change

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Introduction
When a firm makes a transition from its present state to some desired or future state is known as
organizational change. The main idea of this case study to present change made at Dorrigo by applying
King et al’s demonstration of the way of applying Kotter’s eight steps to changes in a firm. I presented
the negative positive impact of organizational change in Dorrigo to resident, staff and families.

Main Body
Introduction of the organizational/program change issue
Dorrigo multi-purpose service is a nursing home from Mid North Local health district. Its features are a
small home with 21 beds, 24 hrs 7 weeks registered nursing, secure garden, couple accommodation,
commonwealth subsidy, single rooms with ensuites, and ACFI. The type cares provided by this Dorrigo
multi-purpose service nursing home are palliative care, residential aged care, and non-dedicated respite.
Multipurpose services are present in an acute care setting where competing priorities and minimal
staffing could reinforce an institutional task which is driven aged care culture.

In the health system, organizational change is common. In various health sectors, one of the most
witnessed common change is the long-standing hospital's redevelopment. We know how the staff of
hospital understand organizational change and experience it which indicates the potential of
organizational change. This study aims to explore the experience and understanding of hospital staff in
the organizational change by using hospital redevelopment in Australia. Here in this case study, I am
presenting the experience and understanding of hospital staff and customer in the culture change in
aged care, organizational change to community injustice, and movement of older people residential care
in Aotearoa.

Traditionally long term facilities are been dominated by the medical model which targets on the
hierarchical decision making, efficiency, and illness. The older individuals who are moving into a
residential care setting have disempowerment feelings, loss of control feelings, and helplessness feelings
during the transition to permanent care. The significant aged care reform program is implemented by
the Australian government in 2014, moving towards person-centred or consumer-directed approaches
for caring the old people which provide them greater autonomy, flexibility, and choice over the delivery
of service. This customer directed care move includes four phases. They are:

 Staff centred: employee consult with residents for making decisions

 Provider directed: managements make decisions
 Person directed: on daily basis residents makes a decision
 Person-centred: the basis of decisions is the preference of resident

MPS Dorrigo was privileged for being one of the twenty-five sites selected for participating in the ACI
(Agency for clinical innovation) living well in 2017 MPS Collaborative. Key gaps concluded the role of
resident in their care, homelike environment, leisure lifestyle and activities, and cognitive impairment. It
became evident for improving life quality for those which call culture approach’s broader whole was
required.

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A resident of Dorrigo multi-purpose service nursing home reported boredom and loneliness feeling with
little opportunity for exercising choice or engaging in life outside their clinical requirement. The
Highview model was introduced to overcome the issues of Dorrigo multi-purpose service nursing home.
This model aim was to change the care culture and residents’ empower culture for taking back control of
making decisions, their lives, creating meaningful relation, accepting risk, exercising choice among the
care partners (employees) and care receiver.

Context of the organizational change

Dorrigo multi-purpose service is a nursing home from Mid North Local health district. The type cares
provided by this Dorrigo multi-purpose service nursing home are palliative care, residential aged care,
and non-dedicated respite. Multipurpose services are present in an acute care setting where competing
priorities and minimal staffing could reinforce an institutional task which is driven aged care culture. A
resident of Dorrigo multi-purpose service nursing home reported boredom and loneliness feeling with
little opportunity for exercising choice or engaging in life outside their clinical requirement. The
Highview model was introduced to overcome the issues of Dorrigo multi-purpose service nursing home.
This model aim was to change the care culture and residents’ empower culture for taking back control of
making decisions, their lives, creating meaningful relation, accepting risk, exercising choice among the
care partners (employees) and care receiver.

The older individuals who are moving into a residential care setting have disempowerment feelings, loss
of control feelings, and helplessness feelings during the transition to permanent care. MPS Dorrigo was
privileged for being one of the twenty-five sites selected for participating in the ACI (Agency for clinical
innovation) living well in 2017 MPS Collaborative. Key gaps concluded the role of resident in their care,
homelike environment, leisure lifestyle and activities, and cognitive impairment. It became evident for
improving life quality for those which call culture approach’s broader whole was required.

From the organizational change in Dorrigo multi-purpose service resident response rate is 57.1% and the
staff response rate is 39.3%. The resident responded that their increase in the right is by 30%, increase
in a positive dining experience is by 47%, an increase in leisure and recreation program satisfaction is
45%. Further, they responded that listen to staff, care and respect of staff towards them are 100% with
their involvement in decision making and satisfaction living in Highview. Further, the staff of this aged
care responded the improvement in the level of wellbeing of a resident by 35%, improvement in the
relationships among families, employee, and resident by 58%, improvement in costuming care by 42%
with an indication of meaningful and purposeful work. The further staff of care firm felt their
contribution to the residents daily quality of life. They also believed that their work also contributes to
Highview mission and vision. With this change, most of the staff of the aged care service home felt
valued and improvement in teamwork cooperation.

Use of critical social work theories/approaches to analyze the organizational change

The organizational change data is accumulated from various sources. Above mentioned change partners
give evaluative and baseline data applied in this study. The criteria for evaluating the relationship among
the care recipient, their family, and care partners quality of life, relation with employee, independence,
mood, respect, and optimism level trust. The second data presented in this study is regarding the MPS

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employee: training effectiveness, quality of life, relationships, mood, care quality, receptiveness to
change, and team effectiveness. It took six months to complete the ACI MPS self-assessment tool. The
instruments of Eden alternative measures the readiness for change and cultural warmth for change
applying a garden analogy. The various terminology like reaping the harvest, tending the garden,
planting the seeds explains the cultural change journey. The organizational change in Dorrigo multi-
purpose service nursing home indicates organizational transformation, and personal level
transformation with environmental and physical changes.

The organizational change of the Dorrigo multi-purpose service nursing home evaluation is performed
by using John Kotter’s steps of a process for successful organizational change. The eight steps of the
John Kotter is compared with the organizational changes made in the Dorrigo multi-purpose service
nursing home and what is their impact on the aged-care services, including their staff, resident, and
other stakeholders.

John Kotter’s steps of a process for successful organizational change

John Kotter has created what has been deemed as the important 8 steps of a process for successful
organizational change. Eight steps process is defined by Kotter, they are:

Step 1

Establish an urgency sense. The Dorrigo MPS evaluates the competitive realities and market. In addition,
the local and discuss crises and other chances. This is the step where a change, catalyst is created.

Step 2

From a powerful coalition: in this step, the Dorrigo MPS assemble the group by applying all his power for
leading the change effort and further develop strategies for gaining that vision.

Step 3

Create the vision: It is when Dorrigo MPS create a vision for helping direct the change effort.

Step 4

Communicating the vision: During this step, it occurs where every channel and vehicle possible for
communicating the vision.

Step 5

Empowering others to perform on the vision: At this point in the process where Dorrigo MPS remove all
obstacles and encourage the taking of risk.

Step 6

Creating and planning for short term wins: The change model of Dorrigo multi-purpose service located
and rewarded the workers which are fully involved in the change.

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Step 7

Consolidate improvements and produce more change: In this step Dorrigo multi-purpose service
pressed more for better successes. In this Dorrigo multi-purpose service become relentless with
initiating change.

Step 8

Institute change: It is the final step of John Kotter's eight-step process. In this step Dorrigo multi-purpose
service articulate the connections among the new behaviours and organizational success, make sure
that they continue it until they become strong enough to replace the previous process.

Eight step model of John Kotter explains the process leader could follow for effectively lead change in
the firm by understanding his eight-step change model is a need for any leader who is serious regarding
implementing change successfully. The organizational change model of Dorrigo multi-purpose service
addressed every step of John Kotter model and it made a successful organizational change. With this
organizational change, there is a rise in the principle of care like respecting rights, involved and
informed, home environment, expertise in aged care, positive dining experience, care planning, etc.
Dorrigo Hostess dinning model is applied as an excellent service by healthcare which attracts LHD visitor
for viewing meal service. In an MPS the Highview Model was evolved, as a caregiving organization which
is based on resident directed practices and values established relationships. This relationship changed
the care culture and language. A human community which embraces the companionship’s elements,
receiving and giving of care (balanced care) and spontaneity and variety daily is excluding boredom,
loneliness, and helplessness by creating a worthful living for residents named as Highview home.

Research the strategies, approaches, programs and/or policies

The Highview model was introduced to overcome the issues of Dorrigo multi-purpose service nursing
home. This model aim was to change the care culture and residents’ empower culture for taking back
control of making decisions, their lives, creating meaningful relation, accepting risk, exercising choice
among the care partners (employees) and care receiver. Introducing a new care model and changing a
workplace culture in an established one needs a multifactorial approach for successfully embed change.
The relationships among grow people and empower by engaging minds and hearts that inspires cultural
transformation. In MPS Dorrigo the strategies applied for engaging the minds and hearts of families,
employee, residents and the community is established. It includes:

 Workshops and education

 Bi-monthly employee, family gathering, resident for co-designing a new aged care model.
 Essential of care methodology for action and feedback audit outcomes
 Plan or act or study or do improvement cycles
 Daily facility-wide safety huddles
 Resident directed environmental changes
 Ideas board

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  Environmental changes which id directed by resident
 Daily facility with wide safety huddles
 Act of kindness
 Aged care as a specialty
 Devolved decision-making for residents and their care partners

Other changes for stakeholders are:

 ACI is living well in Dorrigo multi-purpose service nursing home collaborative 2017.
 My choice hostess, my food dining model for service point of meal selection and input of
resident into menu Alzheimer insights into the experience of the hospital in dementia, the trial
of an experimental training package
 Cultural change philosophy of Eden Alternative is based on ten principles, which empowers
caretakers for transforming traditional institutional aged care service into a human community
where life is worth full in living and boredom, loneliness, and helplessness are eliminated.
 A project of memories in reflection photography captures the resident’s younger image is a
reflection of the mirror. Knowing the life story of a person builds relationships among care
partners and resident as a meaningful relationship.
 Staffing model’s collaborative review for creating a specialist and dedicated workforce for
enabling the practice and values of a person who is based on relationship.
 Workshops of a productive team and MNCLHD positive for building team capacity and enacting
core values.

Above mentioned change data of change is accumulated from various sources. Above mentioned
change partners give evaluative and baseline data applied in this study. The criteria for evaluating the
relationship among the care recipient, their family, and care partners quality of life, relation with
employee, independence, mood, respect, and optimism level trust. The second data presented in this
study is regarding the MPS employee: training effectiveness, quality of life, relationships, mood, care
quality, receptiveness to change, and team effectiveness. It took six months to complete the ACI MPS
self-assessment tool. The instruments of Eden alternative measures the readiness for change and
cultural warmth for change applying a garden analogy. The various terminology like reaping the harvest,
tending the garden, planting the seeds explains the cultural change journey. The organizational change
in Dorrigo multi-purpose service nursing home indicates organizational transformation, and personal
level transformation with environmental and physical changes.

Introducing a new care model and changing a workplace culture in an established one needs a
multifactorial approach for successfully embed change. The relationships among grow people and
empower by engaging minds and hearts that inspires cultural transformation. In MPS Dorrigo the
strategies applied for engaging the minds and hearts of families, employee, residents and the
community is established. It includes Workshops and education, bi-monthly employee, family gathering,
resident for co-designing a new aged care model, essential of care methodology for action and feedback
audit outcomes, plan or act or study or do improvement cycles, daily facility-wide safety huddles, etc.
With this organizational change, there is a rise in the principle of care like respecting rights, involved and

6
informed, home environment, expertise in aged care, positive dining experience, care planning, etc.
Dorrigo Hostess dinning model is applied as an excellent service by healthcare which attracts LHD visitor
for viewing meal service. In an MPS the Highview Model was evolved, as a caregiving organization which
is based on resident directed practices and values established relationships. This relationship changed
the care culture and language. A human community which embraces the companionship’s elements,
receiving and giving of care (balanced care) and spontaneity and variety daily is excluding boredom,
loneliness, and helplessness by creating a worthful living for residents named as Highview home.

The existing gaps in the current strategies

When organizational change takes place it is essential to evaluate and monitor the outcome of change. If
change is not evaluated it would be difficult for leader or mangers for locating how well they managed
the process of organizational change as well as aiding in assisting manager for understanding where the
future improvements might be needed. All change types require evaluation by managers and leader.
The only gap which I viewed in the organizational change model is an improvement in a home
environment. Only 9% of the increase is responded by the resident on it. Hence, strategies to overcome
it should be introduced and applied.

Conclusion
Organizational change is essential for the organization for maintaining a competitive edge. The change
implementation process is very complex and it includes all firm’s aspects. Change in the subject and
inevitable for various variable attributing the failure and success of the change process. Change is
something which is either embraced or endured. By understanding the components and strategies of
change, effective leaders have a better view of the change initiative implication. With this organizational
change, there is a rise in the principle of care like respecting rights. In an MPS the Highview Model was
evolved, as caregiving organization which is based on resident directed practices and values established
relationships. This relationship changed the care culture and language. A human community which
embraces the companionship’s elements, receiving and giving of care (balanced care) and spontaneity
and variety daily is excluding boredom, loneliness, and helplessness by creating a worthful living for
residents named as Highview home.