Don't redesign for disaster

Some tips from an expert

Managing change is never easy - even if you've redesigned by the book, says Michael L. Tushman, PhD. Tushman should know. He's the co-author of Competing By Design: The Power of Organization Architecture (Oxford University Press, 1997, $27.50), as well as Wining Through Innovation: A Practical Guide to Leading Organization Renewal (Harvard Business School Press, 1997, $24.95).

In these books, he examines the barriers to change and addresses how to motivate constructive behavior through case studies of various industries, including health care.

"People are by nature resistant to change, and three basic problems nearly always surface when an organization undergoes significant change," says the professor of business at Columbia University Graduate School of Business in New York. These problems are:

· Power. "People and groups within an organization compete for power, so when the status quo changes, they will engage in political activity if they believe the impending change will make a major shift in their positions of power," he explains.

· Anxiety. "The transition from the current to the future state is threatening because it's a journey to the unknown," he explains. "So whenever employees hear about an impending change, they have many concerns about job security, status, career path. But it all boils down to one thing: 'What does it mean for me?'"

· Organizational control. Redesign, he explains, "disrupts normal activity and undermines routine management control systems." He adds that because most management and control systems are designed to maintain the equilibrium, they are ill-suited to managing periods of change.

Tushman shares with Patient-Focused Care several strategies redesign professionals can use to counteract each of these changes:

1. Clarify the performance gap. "If your hospital is about to get devoured because of the presence of for-profit systems, then you need to communicate that clearly to your employees," he says.

Because it's human nature to resist change, managers have to show employees why "it's in their best interests to let go" of the old ways. This means pointing out the consequences for not changing as well as the benefits of the change, he stresses.

2. Involve employees in the solution. "The most critical step in building support is to get employees involved," he says. "This is the most common flaw we see in failed change efforts - the absence of active participation by people who are expected to become major stakeholders in the future."

3. Make a list of those stakeholders. Then win them over. Tushman strongly recommends constructing a stakeholders' map to "illustrate not only who is likely to take what position but people's relationships to one another and their patterns of influence. Such a diagram can be extremely useful in anticipating successive waves of reaction beyond the first response," he explains.

4. Overcommunicate. "Keep employees posted on the redesign as it occurs. Communi-cate early, clearly, consistently - and then do it again and again," he stresses. "In addition to explaining the reorganization steps and new processes, help people to visualize the end results."

5. Give it time. "In managing transition, you have to allow people to say good-bye, to get angry, to psychologically uncouple from the old way and mourn its passing," he says. "This frees them up to make way for the new system."