Organizational Change for Services Integration in Public Human Service Organizations: Experiences in Seven Counties

By Packard, Thomas; Patti, Rino et al. | Journal of Health and Human Services Administration, Spring 2012 | Go to article overview

Organizational Change for Services Integration in Public Human Service Organizations: Experiences in Seven Counties


Packard, Thomas, Patti, Rino, Daly, Donna, Tucker-Tatlow, Jennifer, Journal of Health and Human Services Administration


Ensure Top Management Support and Commitment

In the structurally integrated counties, the department heads were mentioned by 69 percent of respondents as prime movers for the change. A priority for leaders in the more successful change projects was building an executive level core action system committed to the changes sought and willing to spend personal energy and professional capital to achieve them. Sometimes this involved bringing into the team new persons with energy and commitment, but it also involved seeking the participation of the team in planning and implementation and in most cases the building of trust and mutual understanding among executive team members if these were not already present. Commenting upon the importance of creating a collaborative culture among leaders, one respondent said "moving chairs around is not as important as having the right people in the chairs." The philosophy and attitude of individual workers and managers were seen as key variables, more important than structural arrangements.

In several counties, the commitment to and support for the changes sought were reflected in the creation of offices placed high in the hierarchy whose primary function was to facilitate integration and/or collaboration. There appeared to be a decided advantage to having a highly placed instrumentality for facilitating integration and/or collaborative arrangements.

In non-integrated counties, the counterpart to building the executive team was forging alliances with other agency executives. A similar process of building trust and mutual understanding is necessary in these kinds of collaborations. Successful collaboration seemed very dependent upon the mutual perception that the interests of all the agencies were being served, that none would exploit the collaborative to achieve unfair advantage, and that all partners understood the limitations and vulnerabilities of the others. In one county, the fact that the directors of social services and other departments already had effective and trusting working relationships was seen as valuable in getting staff committed to the new or enhanced collaborative agreements.

Successfully pursuing a strategy of structural reorganization or one of interagency collaboration, depended on the ability of leadership to "market" (as several respondents put it) the change efforts to the Board of Supervisors, key community constituencies such as various other agencies and consumer groups, agency management, and front line staff, especially those with strong professional identifications such as mental health staff.

The experiences of these counties, reflected in interviews with management staff, suggest strongly that successfully marketing core values requires a committed executive team. In most counties studied, a committed executive staff made it possible for the director to convey a constant and consistent message out to community and inward to staff and to receive feedback that could be helpful in implementing plans. In one county that experienced initial resistance to integration, respondents observed that the agency prime mover spent little time trying to articulate the vision, receive input, and get others on board. It was only through later efforts at the middle management level that collaboration began to take hold.

Where marketing with staff and community was not effectively done,

it was at least partly due to the director's inability or failure to mobilize the executive team around the ideas and strategies. This, in turn, undermined efforts to build agency wide consensus, slowed implementation of the reorganization and may have, in one or two cases, jeopardized the entire change effort. One county had to replace a visionary director with an interim director who had a different and less dynamic leadership style. This change may have affected the strategies that had been in place to build commitment. The temporary loss of "visionary" leadership was cited by half of the respondents in this county as critical.

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Organizational Change for Services Integration in Public Human Service Organizations: Experiences in Seven Counties
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