Change initiatives such as that taking place at Victoria Hospital are often met with enormous resistance from staff in many different specialties and at many different levels of the organization. The case in point - that of Victoria Hospital - reflects a real-world example of how a change initiative based on an assessment of needs and a decision to restructure the strategic focus of the organization can be managed. The initiative involved restructuring the case management process and team initiatives of the institution as well as improving the communication channels (flattening the hierarchy and establishing meaningful linkages between internal actors). Many care providers are establishing interdisciplinary teams that bring together the varied expertise of different actors in the care delivery system.
A five step process for the diffusion of this innovative strategy can be identified. The first step is acquiring knowledge regarding the needed change, followed by persuading significant actors to recognize the need and the proposed solution. Driving the change initiative are the following: 1) a shortage of professional staffing; 2) escalating costs associated with care delivery; 3) a growing patient population; 3) the need to provide case management oversight of the activities of different caregivers.
Resistance to innovative strategies or processes is commonplace in most work environments and may be particularly strong among members of professional communities. Similarly, medical caregivers are often highly sensitive to such issues as the limits of their autonomy and can be reluctant to share decision-making. It is possible that professionals accustomed to delivering care more autonomously might have been reluctant to "abdicate," so to speak, some of their responsibilities .
Using an empirical-rational strategy, an action plan has been developed to facilitate the development of interdisciplinary teams in which ca...