Success Factors for Strategic Change Initiatives: A Qualitative Study of Healthcare Administrators' Perspectives/PRACTITIONER APPLICATION

By Kash, Bita Arbab; Spaulding, Aaron et al. | Journal of Healthcare Management, January/February 2014 | Go to article overview

Success Factors for Strategic Change Initiatives: A Qualitative Study of Healthcare Administrators' Perspectives/PRACTITIONER APPLICATION


Kash, Bita Arbab, Spaulding, Aaron, Johnson, Christopher E., Gamm, Larry, Hulefeld, Michael F., Journal of Healthcare Management


EXECUTIVE SUMMARY

Success factors related to the implementation of change initiatives are well documented and discussed in the management literature, but they are seldom studied in healthcare organizations engaged in multiple strategic change initiatives. The purpose of this study was to identify key success factors related to implementation of change initiatives based on rich qualitative data gathered from health leader interviews at two large health systems implementing multiple change initiatives.

In-depth personal interviews with 61 healthcare leaders in the two large systems were conducted and inductive qualitative analysis was employed to identify success factors associated with 13 change initiatives. Results from this analysis were compared to success factors identified in the literature, and generalizations were drawn that add significantly to the management literature, especially to that in the healthcare sector.

Ten specific success factors were identified for the implementation of change initiatives. The top three success factors were (1) culture and values, (2) business processes, and (3) people and engagement. Two of the identified success factors are unique to the healthcare sector and not found in the literature on change models: service quality and client satisfaction (ranked fourth of 10) and access to information (ranked ninth).

Results demonstrate the importance of human resource functions, alignment of culture and values with change, and business processes that facilitate effective communication and access to information to achieve many change initiatives. The responses also suggest opportunities for leaders of healthcare organizations to more formally recognize the degree to which various change initiatives are dependent on one another.

For more information about the concepts in this article, contact Dr. Kash at bakash@srph.tamhsc.edu.

INTRODUCTION

Strategic change capabilities have become a primary focus as hospitals and healthcare systems attempt to perpetually improve and position themselves in a competitive market characterized by continuous regulatory changes and opportunities for reorganization and growth. Yet few empirical studies focusing on success factors for effective organizational change have been conducted in hospitals or healthcare settings (Rosacker, Zuckweiler, & Buelow, 2010).

The present study draws on management literature and examples of the successful implementation of strategic change initiatives in healthcare to further improve our understanding of how to plan for and implement such an initiative. The purpose of this study was to explore and identify specific change initiative success factors as depicted by healthcare leaders' assessments of change efforts in their health systems. Success factors available in the management literature are identified and contrasted to responses gathered from more than 60 administrators at two large healthcare systems engaged in multiple change initiatives.

Prior research attempted to evaluate how strategic change initiatives are implemented (Edmondson, Bohmer, & Pisano, 2001), how leaders promote organizational successes (Bass & Riggio, 2006), and how culture affects organizational performance (Pfeffer & Veiga, 1999). Many of these strategies have even been categorized and summarized according to the organizational change theories applied (Van de Ven & Poole, 1995). However, variation frequently occurs within and across systems in innovative program success (Armutlu, Foley, Surette, Belzile, & McCusker, 2008; Hosier & Nadle, 2000; Manzo et al., 2005; Silow-Carroll, Alteras, & Meyer, 2007), and it may be that variations in success are related to an organization's ability to acquire and use new knowledge to ensure successful initiatives (Kash, Spaulding, Gamm, & Johnson, 2013).

Healthcare strategic change initiatives research primarily focuses on outcomes that measure only one dimension of success at one level of the organization (Vest & Gamm, 2009). …

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