Healthcare Management

Ann Shacklady-Smith

A hospital replaced a notice to outpatients that simply said: 'Wait
here, with a notice that said: 'We promise to see you as soon as we
can. Please take a seat here until a doctor is free.' The print bill
might have risen fractionally, but patient morale soared. (Elliot
1999)

This chapter is written for healthcare managers, who want to learn more about managing change in the workplace. Rather than a prescription or description of change, Collins (1998) encourages a 'thinking practitioner' approach to the subject. His advice is taken and the chapter is written with the aim of helping managers to find their own perspective and approach to the change process. The chapter aims to give managers an appreciation of the context driving change, change-theory frameworks and methods, models of change and managers' roles in change.

As the illusion that there can be a 'stable' environment fades and as organisations are embracing the challenge of thriving in a world of constant change, the impact on organisational change theory and practice has been profound (Watkins and Mohr 2001: xxxi). Charles Handy (1989) speaks of entering an age of 'unreason' where the future is there to be shaped by us and for us, where the only prediction that will hold true is that no predictions will hold true, 'Change is not what it used to be.' The time for new approaches to thinking about and approaching organisational change has clearly arrived.

In the following discussion the established typologies of 'planned' and 'emergent' change are explained and Ackerman's (1997) model is used to show the lack of a clear boundary between them. Transformational change is discussed in reference to the 'emerging paradigm' literature referring to the influence of new science (quantum physics, neurosciences, chaos and complexity theory) in shaping organisational change theory and methods and the challenge it poses to classical scientific versions of change (Watkins and Mohr 2001; Table 22.1).

Three change examples are discussed to illustrate the main themes of

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