MANAGEMENT

CONCEPTS
Lecture 1. Change and Change Management

The McKinsey consulting group reports data that 70% of all change
management efforts fail.

A 30% success rate is troubling, particularly when considering the
associated costs in the form of loss of competitive position, confidence
of the workforce in leadership, and quality improvements and
anticipated costs reductions. [J Contin Educ Nurs. 2019;50(4):148-149.].


See previous years: 80’, 90’ etc. - exactly the same.

Is everything constantly changing?


Heractlitus

If everything is changing, so the meaning of the words.

So how Heractlitus - and many others - can repeat the
same words believing that they mean exactly the
same?

In other words: do they exclude their own opinion
from their „absolute rule”?

Is everything permanent? And change is an
illusion?


Parmenides

If that’s true, and nothing comes to an
existence, or perishes, where is now
Parmenides and his followers?
Source: Adler M. Aristotle for
Everybody
 Two kinds of motions
(simplify: changes)

Natural

space time quality&quantity- size and shape


Artifical (violent: meaning violate the natural tendency)
 Two kinds of motions
(simplify: changes)
Natural

Artifical (violent:
meaning violate the
natural tendency)
Cooperating with nature (managing changes)
Cooperating with nature (managing changes)
Or… not exactly
So… What is necessary in order
to manage changes?
Aim. Concept of healthy organism (in case of
doctors) – FINAL FORM (end, aim)
Organize/manage the resources towards the
aim.
WISDOM
As simple as
that;)
„They are to be called wise who order things rightly and govern
them well.”
(arrange and handle)
Aristotle

Eg „the art/technique of medicine rules and orders the art of the

chemist because health, with which medicine is concerned, is the
end/AIM of all the medications prepared by the art of the
chemist.”
Aim/END

Lighthouse for a sailor

And even more:

Final form (informing a thing/subject)

Human person can
choose!
 Case study1

Your tasks:
Read carefully.
Answer the following questions:

1. What is a formal aim of existence (that for the sake of which something is made) of a doctor, e.g. surgeon?

2. What is a formal aim of existence (that for the sake of which something is made) of an organization: hospital?

3. Distinguish major persons in the case study and compare their aims with the aim (above).

4. What is an actual aim of the change?

5. In the situation described in the case study: who is an agent of actual aim of the change?

6. What kind of a resistance to change you have noticed?

7. What are „choice options” for cardiothoracic surgeons in this situation?

8. What the CEO have learnt from the „test change”? What he haven’t learnt/understood?
 Individual perspective

Models, techniques, ideas: based on Levin’s 3 steps model

(refreezing, change, freezing).
(see the results: e.g. McKinsey’s analysis)
 Individual perspective
Organization – organon (order, tool)

As many people, as many aims.

Aim (formal) organizes people.

(who decided to achieve it and thus, to cooperate)
 Individual perspective

Change movement:
Natural
Artifical (Violent)

Nature of human being – rational/reasonable choices

 Individual perspective
Case study – doctors

Test change (artificial – failed). The real aim „won” thanks to doctors’
resistance.
However, sometimes someone’s aim „wins”. And starts to inform all of the
members of organization (if they accept it).
Meaning of individual choices.
 Millions of decisions and choices

One of the univ.teachers (Noblist, Herbert Simon) points out that an absence of deliberate centralized planning in
urban development does not necessarily imply an ineffective outcome:

I retain vivid memories of the astonishment and disbelief expressed by students whom I taught - when I pointed to
medieval cities as marvellously patterned systems that had mostly just ‘grown’ in response to myriads of individual
human decisions. To my students a pattern implied a planner in whose mind it had been conceived and by whose
hand it had been implemented. The idea that a city could acquire its pattern as naturally as a snowflake was foreign to
them.

The city of London, for instance, developed spontaneously from early hamlet settlements around three hills: Tothill,
Penton Hill and Tower Hill. Tracks and footpaths wound their way between them, and these gradually became roads
and lanes, encouraging further dwellings to grow up around them so that these clusters of hamlets became villages,
towns and eventually what we now know as London. It is, therefore, the interactional and iterative process of local
actions that feeds urban growth and regeneration. The small, evolving actions of the city’s denizens are what creates
and sustains the complex and organic urban expansion that gives cities their often vivid character, the melange of
smallness and influence making them, at one and the same time, ‘so thrilling and terrifying, so liable to swallow [their]
inhabitants. London, Tokyo, Delhi… pulsate, they groan and sigh and spread their many tendrils.’

Chia and Holt, 2008 (Strategy without design, Cambridge Univ. Press)
So… what is needed for effective change management?

Is the change consistent with the formal aim?