Jonathan P. DeShazo, Laishy Williams-Carlson, & Rich Pollack

 Jonathan P. DeShazo, MPH PhD, Assistant Professor, Virginia Commonwealth University, Richmond, Virginia  Laishy Williams-Carlson, Vice President and CIO, Bon Secours Health System Inc. Richmond, Virginia  Rich Pollack, MS, Vice President and CIO, Virginia Commonwealth University Health System, Richmond, Virginia

 In this session, students will learn to Describe several types of organizational change Identify theories of motivation Develop reward systems that support change Measure and analyze change

All great changes are preceded by chaos. Deepak Chopra

 Incremental  Step-shift  Radical  Fundamental

 A series of small to medium size changes  Changes are relatively easy and low risk  A continuous improvement process may be ongoing incremental changes Examples are six sigma and LEAN  What are the advantages and disadvantages of incremental change?

 A significantly sized change that does not deviate from organizational norms or existing goals  Can be an acute focus and change in one aspect of the organization  Typical change in HIT adoption  Examples: growing an existing service delivery line, adopting an EHR, etc.

 Preserves organization and core values but significantly changes business  An example may be changing to an ACO model

 Effectively creating a new organization in a different business  Very rare  Change is significant enough that all IT is likely to be affected

 Emotional stages of change  Management theories of motivation  Incentives  Rewards

 Think about how these may manifest in HIT adoption: Denial Resistance Exploration Commitment Armenakis, A. A., & Bedeian, A. G. (1999). Organizational Change: A Review of Theory and Research in the 1990s. Journal of Management, 25(3), doi: /

 Scientific Management Theory Rewards workers for increases efficiency and productivity Assumes people are motivated to work more efficiently and that they should be paid by the quality of work they perform.  McGregor’s Theory X Managers view employees as unmotivated and disliking work Their job is to control and direct employees Shanks, N. (Ed.). (2007). Management and Motivation. Sudbury MA: Jones and Bartlett.

 Ouchi’s Theory Z Employees who are committed to the organization are motivated to increase efficiency and productivity Managers reward using additional responsibility, promotions, long term employment, etc. Shanks, N. (Ed.). (2007). Management and Motivation. Sudbury MA: Jones and Bartlett.

 Create a sense of urgency  Form a powerful coalition  Create a vision for change  Communicate the vision  Remove obstacles  Create short term wins  Build on the change  Anchor changes in culture

 No single theory explains everything  Think about the underlying focus of these theories for motivating your employees Expectancy Goal setting Performance Feedback Equity Satisfaction Commitment Shanks, N. (Ed.). (2007). Management and Motivation. Sudbury MA: Jones and Bartlett.

 Money  Benefits  Flexible schedules  Praise and feedback  Promotions  Educational opportunities  Strong leadership  Supervision of others  Change in status (title or responsibilities ) Shanks, N. (Ed.). (2007). Management and Motivation. Sudbury MA: Jones and Bartlett.

 Healthy relationships  Meaningful work  Competence  Choice within organization or projects  Nurturing culture  Inspirational people Shanks, N. (Ed.). (2007). Management and Motivation. Sudbury MA: Jones and Bartlett.

 Assume everyone is only motivated by extrinsic factors or (less frequently) only intrinsic factors  Some people are just not motivated  People are mostly motivated by money  One-size-fits-all reward or recognition programs  Motivational people are born that way Shanks, N. (Ed.). (2007). Management and Motivation. Sudbury MA: Jones and Bartlett.

 Training & knowledge  Technical infrastructure, configuration, and support  Re-engineered workflows

 In this session, we discussed The various types of organizational change How to motivate people Elements of reward systems that support change Factors by which change is measured and analyzed