The day after: Post-implementation change
effectiveness
A health care case study.
Master Thesis, MSc Business Administration, Change Management, University of Groningen, Faculty of Economics and Business
January 18, 2016
Méral N. Steffens S1869817
Abstract
This research contributes to the field of change management by providing insights to the process of and developments in change effectiveness after planned change implementation and the influence of the middle manager and change recipients’ attitudes. While there is a large amount of research on change effectiveness, research on post-implementation effectiveness is scarce. This concerns the third phase of the three step model of Kurt Lewin which entails three steps: unfreezing, moving, and refreezing. The aim of this study is to clarify the process after implementation in relation to effectiveness, middle manager and change recipients’ attitudes. The analysis made use of a qualitative longitudinal single-case study and used data of two collection moments which were around one year apart. The results show that in this case, refreezing was not fully completed for multiple reasons. Because this phase is not fully completed, stability is not reached and the organization remains at the end of the moving phase. However, whether fully refreezing is preferred for organizations in relation to today’s unstable environment and political forces is questioned. Furthermore, change effectiveness has increased due to more positive individual change recipients’ attitudes and the positive influence of the middle manager. This research provides the field of change management with clarity on post-implementation effectiveness as well as the influence of middle management and change recipients’ attitudes.
Table of Content
1. Introduction ... 4
2. Theoretical background ... 7
2.1 Post-implementation ... 9
2.2 Change effectiveness ... 10
2.3 Change recipients and their attitudes ... 12
2.4 Middle management ... 14
3. Methodology ... 17
3.1 Case context and participants ... 17
3.2 Research design ... 19
3.3 Data collection and interview protocol ... 19
3.4 Analytical strategy ... 21
4. Results ... 24
4.1 Change effectiveness ... 25
4.2 Change recipients’ attitudes ... 29
4.3 Middle manager ... 32
5. Discussion and conclusion ... 36
5.1 Discussion ... 36
5.2 Limitations and further research ... 40
5.3 Conclusion ... 41
References ... 43
Appendixes ... 51
Appendix 1 - Interview protocol first phase ... 51
Appendix 2 - Interview protocol second phase ... 54
1. Introduction
After a change project is implemented, its effectiveness may develop and hence influence organizational effectiveness. This has implications for management when dealing with the post-implementation process, change recipients’ attitudes and middle management approach towards change. However, research on this issue is scarce and organizations rarely evaluate change initiatives post-implementation.
Over the last decades, change is increasingly seen as a critical determinant for organizational success (Ford & Gioia, 2000). Despite the fact that there are several models that claim to be guides to successful organizational change, looking purely at the general outcomes, more than two third of all change initiatives still fail (Beer & Nohria, 2000; Higgs & Rowland, 2005; LaClair & Rao, 2002). According to Choi (2011) as well as Shin, Taylor and Seo (2012), the main reason for failure of change initiatives is the underestimation of the influence of attitudinal and behavioural reactions of the individual on change effectiveness by management. Management, often represented by a change agent, has a large influence on these individual reactions through the interaction process aimed to help the sensemaking process of the change recipients (Bouckenooghe, 2010). However, according to Gill (2003), the leadership approach used is often not appropriate for change implementation. Though the high failure rate is explicitly questioned by Hughes (2011), the question remains whether change initiatives should be implemented differently in general by increasingly taking into account attitudes and change agent approaches. Also, most literature and related research on change management is focussed on preparatory actions and the actual implementation of the change project (Gallagher & Gallagher, 2011). Therefore, the question can be raised whether the high failure rate of change initiatives could be attributed to the absence of post-implementation expertise or general knowledge on the influence of the individual and management during change.
Wieder, 2005; Nicolaou & Bhattacharya, 2008; Yu, 2005). Therefore, the questions remain what long-term ‘refreezing’ entails and what happens after the moving phase of the change process in case the refreezing phase is not fully completed?
The prior discussed issues are not elaborated on much in current literature and many questions concerning the post-implementation phase remain. Therefore, this research tries to increase the understanding of the processes that an organization is faced with after change is implemented. Hence, it aims to provide clarity in the understanding of change effectiveness after implementation as well as influencing concepts as change recipients’ attitudes and middle management. This leads to the following research question:
How does change effectiveness develop after implementation?
To address this research question, this analysis will take a look at the process after change is implemented. In order to do this, a case study at a Large Teaching Hospital (LTH) in The Netherlands is conducted where a large change project took place. The case study will include two data collection moments, both post-implementation. This gives the opportunity to give a clear overview of the underlying mechanisms in the process of the development of post-implementation change effectiveness: the refreezing of Lewin’s three step model. The process will be related to Lewin’s model with a focus on the last step: the refreezing phase. Also, it has the intention to increase theoretical insights into whether Lewin’s three step model is still relevant nowadays. Furthermore, the concepts of change recipients’ attitudes towards change as well as middle management will help in providing understanding on the post-implementation change process. Therefore, the following sub questions will help in answering the main research question:
- How do change recipients’ attitudes influence change effectiveness after implementation?
- What is the effect of the approach of the middle manager on change recipients’ attitudes and hence post-implementation change effectiveness?
2. Theoretical background
“To improve is to change; to be perfect is to change often.”
Winston ChurchillPrime Minister of the United Kingdom 1940-45 & 1951-55.
Change management is one of the most covered topics within organizational science literature (Bouckenooghe, 2011). According to Dopson and Neumann (1998), change is unavoidable when an organization is faced with uncertainty. Change within organizations can take several different forms. On the one hand it can have minor implications for only one division of the organization, called incremental change, on the other hand it can imply significant changes to organizational elements that affect every member of the organization, referred to as radical change. Furthermore, change can be divided into two categories when taking into account whether it is episodic or continuous; is it intermittent or ongoing (Brown & Eisenhardt, 1997; Weick & Quinn, 1999). Another distinction made between different types of change concerns planned and emergent change. Being the opposite of emergent change, planned change is described by Levy (1986), as “deliberately shaped by organization members” (p.5). Regardless of which distinction is made, change has major implications for the organization and hence its effectiveness.
figure 1. His three step model has been the basis for much research leading to many other models needed for the achievement of successful change (Burnes, 2004).
Figure 1. Lewin’s Three Step Model. Derived from Burnes (2004)
In this analysis, the focus will be mainly on the third step of Lewin’s three step model: the refreezing phase. This third step entails actions to be taken after implementation which will cause the changed situation to be ensured and stabilized in a new equilibrium. This includes integrating and institutionalizing the changed situation so that it leads to changed behaviors and attitudes (Medley & Akan, 2008). Looking at this explanation of the third step of Lewin’s model, a conclusion can be drawn that though a change project has to move through the first two stages, the unfreezing and the moving, the third stage might not be achieved rapidly or, in some cases, not at all. An organization could, before it reached stability, introduce a next change project, and hence remain in the moving phase. Stabilizing the new situation requires cooperation from all parties affected which could be hard to achieve when those parties are hard to convince, of a large size, or scattered across different areas within and outside of the organization.
The main criticism remains whether the stability that this model focuses on in the ‘refreezing’ stage can be seen as a preferred outcome or can ever be achieved since the environment organizations operate in nowadays are becoming more unpredictable and unstable and change is therefore often a continuing process (Garvin, 1993; Pettigrew, 1990). However, according to Burnes (2004), who wrote a complete article trying to prove the critics on Lewin’s three step model wrong, the third step of the model, refreezing, should be explained as “preventing individuals and groups from regressing to their old behaviours” (p993). Hence, while total stability might not been achieved or even preferred, an organization can be seen as having reached a new equilibrium which is stable enough to prevent regression of newly acquired behaviour. Of course, the question remains when an situation can be called ‘stable enough’ and whether this is the same for every organization. Also, if ‘stable enough’ is not universal
among organizations, what are the factors that determine what is ‘stable enough’ for each organization?
2.1 Post-implementation
Because this research focuses mainly on the effectiveness of a change project after it was implemented and compares multiple moments after implementation, it is important to, next to change effectiveness, focus on literature concerning post-implementation effectiveness. However, research on the topic of what happens after change implementation, and especially a longer period after implementation, is scarce. Though this is understandable if taking into account that it becomes harder to identify what outcomes can be linked to the change when there is no comparable situation anymore, post-implementation evaluation remains an important concept. As mentioned before, evaluation of post-implementation effectiveness is beneficial. The post-implementation phase of a change project gives an organization the opportunity to maximizing its effectiveness. According to Abrahamson (2000), ‘business as usual’ is needed after change to reap maximum benefits. During this phase the change is evaluated and unexpected and unintended change outcomes can be reviewed. Therefore, to effectively assess the consequences of a change project, it is important to review the effects of a change project several times after implementation with considerable amount of time between those reviews.
According to research on planned change (Armenakis & Bedeiam, 1999; Balogun & Johnson, 2005; Jian, 2007), no change implementation goes completely according to plan, and hence, the results of the change process consist of both intended and unintended outcomes. Also after the actual implementation, issues might arise that were unexpected and therefore not taken into account when planning the change process. However, ignoring unintended change outcomes might have negative effects on the change program, and hence, the organization (Balogun, 2006). Therefore, management has to take into account issues that unexpectedly arise in order to increase change effectiveness.
for the organization. Next to performance measurement systems, feedback and post-implementation evaluation of the change is needed to analyse organizational performance (Aladwani, 2001). Researching pre- and post-implementation effects of change gives researcher the opportunity to identify intended and unintended change outcomes, and hence, areas that still need improvement.
In his article on reasons why post-implementation reviews are not conducted concerning IT projects, Gwillim, et al. (2005) reveal that, next to time and money, socio-political causes play an important role in the evaluation decision. Though the benefits of post-implementation reviews remain without dispute (Gwillim et al., 2005), organizations have several reasons not to conduct reviews: it is not recognized as necessary or important, organizations are not capable to conduct research it in a right manner, there are concerns about costs, and political or cultural obstacles (Norris, 1996). These political and cultural obstacles are becoming more important in the evaluation decision and can, for instance, entail that the evaluation becomes an instrument with which the power balance within the organization is challenged (Smithson & Hirschheim, 1998). However, when those obstacles are conquered, post-implementation evaluations are showed to result in organizational learning, which in turn results in increased organizational performance (Seddon, Graeser & Willcocks, 2002).
Reviewing change after it has been implemented provides the organization as well as management with opportunities to learn and acquire an important managerial skill (Todnem, 2005). This is supported by the fact that organizational change is interrelated with organizational strategy (Burnes, 2004). Therefore, if an organization can learn from change initiatives and move towards becoming a open learning system, post-implementation reviews can benefit the organization in multiple ways. Open learning systems are, according to Dunphy and Stace (1993), better able to cope with environmental forces and hence more effective at change.
2.2 Change effectiveness
effective change implementation. The difference being that successful change has reached organizational goals, however, effective change results in satisfied and committed, high performing organizational members (Luthans, 1988). Hence, the one does not exclude the other and both effective and successful change are highly preferred. However, since effective change is more comprehensive and increases the chance of accomplishing organizational goals and thus successful change, this research will focus on the effectiveness of change implementation. Hence, change is defined as effective when it resulted in satisfied, committed, and high performing organizational members.
Moreover, there are several factors before, during and after the process of change implementation that have an influence on change effectiveness and consequently organizational effectiveness. Most researchers make a distinction between antecedents, reactions to change, and consequences (Oreg, Vakola & Armenakis, 2011). Also, as Alas (2007) showed, the duration of the change has important implications for the understanding of the change. So, the duration of the process and hence the understanding influences change effectiveness. Therefore, management has an interest in finishing a change project as soon as possible, however, this is not supposed to come at the expense of effective change implementation. Effective implementation can benefit from a careful process whereby taking into account all aspects which is time consuming. Hence, there appears to be a trade off between finishing rapidly and careful and effective implementation.
The effectiveness of change implementation needs to be seen as a two-sided concept; both the process as well as the outcomes of the change need to be satisfactory to the participants (Burnes & Jackson, 2011). Of course, what is satisfactory is subjective to one’s own opinion and therefore, this research included both the change agent, and the change recipients opinion about the effectiveness of the change to have a bilateral perspective. Since there is not generally agreed on definition of change effectiveness, the definition of organizational effectiveness will be taken and applied to change. This results in change effectiveness as being defined as ‘“a value-based judgement about the performance of an organization” (Quinn & Rohrbauch, 1981, p138) after the implementation of a change project’.
process (Bordia , Hobman, Jones, Gallois & Callan, 2004). Thus, allowing employees to express their opinion decreases uncertainty which is a fact that middle managers can use while guiding change recipients. Furthermore, letting employees express their opinions seems to be obviously related to the interaction process as mentioned before, which also is said to help in the guiding process of middle managers towards the change recipients. This leads to the conclusion that middle managers can influence change recipients’ attitudes as well as the change process and consequently change effectiveness.
2.3 Change recipients and their attitudes
The reaction of change recipients towards change is often seen as one of the main determinants of change effectiveness and thus successful change implementation (Balogun & Johnson, 2005; Oreg et al., 2011). Change recipients, “those who carry out organizational interventions initiated by others” (Bartunek, Rousseau, Rudolph & DePalma, 2006, p182), are often employees at the lower end of the hierarchical chain who have to work with the change. The attitudes of change recipients towards the imposed change has had much attention in research over the past decades, and especially how these attitudes influence the change process. As change implementers want to avoid resistance and pursue cooperation, all possible reactions towards change and how to influence them have been researched intensively in the past (Balogun & Johnson, 2004; 2005; Bouckenooghe, 2010). Some researchers only make a distinction between positive (e.g. supportive) or negative (e.g. resistance) change recipients’ reactions towards change, however, reactions are, according to more in-depth research, a much more complicated concept (Armenakis, Bernerth, Pitts & Walker, 2007).
attitudes as being tridimensional concepts which organizational members express by using three types of explicit reactions: affective, cognitive and behavioural reactions. These three types include individual attitudes to change based on feelings, thoughts and actions respectively.
According to Whelan-Berry, Gordon and Hinings (2003), the majority of the affected employees need to change their behaviors and attitudes to make change happen. However, for change to happen, the change recipients have to become or made aware of the need for change (Armenakis & Bedeiam, 1999; Nadler & Tushman, 1989; Pettigrew, 1987) also called the creation of a sense of urgency by Kotter (1995). Regardless whether change recipients had the power to influence the change initiative or whether it has been imposed on them by top management, change projects can have significant consequences for their job which relates to their way of working, job-related responsibility, position within the organizational hierarchy and hence the amount of satisfaction they get from their work. According to Lines, S enz and Aramburu (2011), change recipients use their own sensemaking capabilities in order to discover what the change will entail for their personal as well as organizational values and goals.
Though most of the research on attitudes towards change is focussed on the individual attitude, the influence of collective attitudes towards change has also been researched by Bouckenooghe (2010) who mentioned that a collective attitude can be seen as a collection of individual attitudes, for instance a team. Attitudes on a collective, organizational or team level are important because groups have a significant influence on individual attitudes (Vakola, 2013). In other words, individual attitudes are partly formed by their social environment (Wood, 2000) and are therefore interrelated. So, while individual attitudes are important, according to Vakola (2013) they cannot be seen separately from collective attitudes. Also, while individual attitudes are influenced by collective attitudes, the reverse is also true. As Rafferty, Jimmieson and Armenakis (2012) stated, by engaging in interaction, individual attitudes influence collective attitudes as well.
have developed change capabilities. One of these capabilities is being able to cope with the uncertainty that comes with change (Stensaker & Meyer, 2011). Also, employees with less experience with change express stronger reactions than experienced employees who were seen as being more passive in expressing their reactions. On the other hand, it has not been proven that experienced employees have a generally more positive response towards change (Smollan, 2006). Moreover, negatively experienced employees may also transfer this negativity into their attitude to the imposed change (Stensaker & Meyer, 2011). Therefore, middle managers have a task at hand to actively select experienced employees with a positive attitude in order to help them spread the word of change. Also, managers have to motivate those employees to actively voice their opinion.
2.4 Middle management
The middle manager is often seen as change agent as well as change recipient (Balogun & Johnson, 2004). The middle manager is seen as the person who guides, directs and facilitates the change and is the first source of information for the change recipients. The middle manager can be seen as being the link between top management and the change recipients (Balogun & Johnson, 2004) since he or she will be the employees’ representative towards the board who instructed the change, though, on the other hand, the board’s representative towards the employees who will have to work with the consequences of the change (Rouleau & Balogun, 2011). In addition to this, Huy (2002) argues that the middle manager should be a person who is positioned in the middle of the organization, has a wide network and has deep knowledge of the organizational culture. However, research suggests that the influence of the middle manager will be moderated by his capabilities. According to Kanter (1982), especially innovative, accustomed to change, and persistent middle managers have the most influence within their organization. These qualities can a middle manager address when he or she guides change recipients through the sense-making process which is done by encouraging interaction between change recipients as well as interacting with change recipients (Balogun & Johnson, 2004).
recipients as well as between change recipients and helps change recipients understand the shift in common understanding within the organization (Balogun, 2006). According to Ford, Ford and D’Amelio (2008), “sensemaking occurs in conversations that involve giving accounts or self-justifying explanations of events and activities” (p364). Therefore, the middle manager guides change recipients in the process of turning new practices into routines and thus new organizational shared values. Hence, neither the middle manager, nor the change recipient can be seen as independently responsible for change effectiveness, both parties are interdependently contributing to newly established organizational values.
Looking at the role of the middle manager from a broader prospective, Balogun (2003) identified four specific roles a middle manager performs within the organization during change implementation, as can be seen in table 1: undertaking personal change, keeping the business going, helping other through change, and implementing changes to departments. The four roles are based on the ‘nature of the activity’, sensemaking or coordination and management, and the ‘orientation’, peers/self or team. According to Balogun (2003), the role of ‘undertaking personal change’ is the informing role for the other roles since the middle manager gives his own interpretation to the change which he consequently will transfer to the change recipients. A middle manager can prove himself as being an asset for the organization during a change project (Floyd & Wooldridge, 1997). Rouleau and Balogun (2011) distinguished in their article between two types of activities that middle managers can enact to guide the sensemaking process of change recipients: “performing the conversation and setting the scene” (p.953).
Table 1. Roles Middle Manager. Derived from Balogun (2003)
According to Balogun (2006), middle management can, deliberately or not, cause unintended change outcomes because they have to go though the sensemaking process themselves and interpret the intentions of top management. If a difference exists between top management
Nature of activity
Sensemaking Coordination and management
Orientation
Peers/self Undertaking personal change
Keeping the business going Team Helping others through
change
intentions and middle management interpretation, this might have considerable consequences for the eventual change implementation and effectiveness since it is the middle manager than helps change recipients directly with the sensemaking process.
3. Methodology
The case that was used for this analysis entailed a comprehensive change project at a Large Teaching Hospital (LTH). This change project was particularly relevant in answering the research question of this analysis because the project affected a large amount of employees, the influence of the project on the hospital was substantial and it was possible to have two data collection moments after the implementation. Those two data collection moments gave this analysis an advantage because it gave a clear overview of the current situation as well as developments after the actual implementation. Also, the opportunity was present to interview employees of different hierarchical positions and different departments within the hospital which was convenient for discovering differences in the perceptions of the change consequences.
3.1 Case context and participants
The Large Teaching Hospital (LTH) is a hospital located in the Netherlands has a substantial influence on local society. Like most organizations, it was severely affected by the latest financial crisis. As part of an overarching cost reduction plan, it had to save up to €25 million. The board of directors set up a cost reduction plan for the hospital. This plan had to reduce employee costs with roughly €6,5 million. The board of directors decided that, to cope with the consequences of the recent financial crisis, several cost reductions had to be made, one of them concerning the medical administration department. Therefore, a project was initiated which had to lead to a cutback of employees of around 30%. The employees affected had to be released or placed elsewhere within the organization. However, a local newspaper stated in 2012 that the project had run into some trouble during execution. The cost reduction project caused job uncertainty for a large number of administrative employees, even for some who had been with the organization for decades.
to improve, standardize and digitalize the work processes of the administrative staff. This resulted in the disappearance of the so-called ‘typkamer’, typing room, which meant that not the administration employees but the doctors themselves had to compose letters to patients. Also, the planning concerning which administration employee would work for which hospital department had to become flexible and the work process had to be standardized and digitalized as much as possible. To do this, ICT solutions would be installed to support the staff in their daily tasks. These ICT solutions included among other things speech recognition software, an electronic patient registration system and an electronic patient dossier (EPD).
Figure 2. Timeline project
3.2 Research design
Since the aim of this research is to try to understand an underlying process, qualitative research will be appropriate (Garcia & Gluesing, 2013). Qualitative research gives the researcher the opportunity to gather explanatory information and delve into and get acquainted with what lies beyond the actions of participants (Corbin & Strauss, 2015). This research consisted of a single case study however research was conducted using two data collection moments which were separated by a time interval of around one year: October 2014 and November 2015. Hence, it will be a longitudinal single-case study that is used to evaluate effectiveness of an intervention (Yin, 2003), in this case the change within the medical administration department of the hospital.
3.2.1 Quality criteria
Reliability and validity are important quality criteria when it comes to doing good quality research. Firstly, reliability is achieved when same outcomes can be assured in duplicated research because the results are independent of the research characteristics (Yin, 1999). Second, validity is guarded by an assessment of the results and how they are generated. After coding the first interview, the codes were checked by the supervisor, which resulted in increased reliability and validity (Van Aken, Berends & Van der Bij, 2012). The adjusted codes were used in the coding process for the remaining interviews. To assure respondent reliability, interview participants were selected from different departments of the hospital as well as different functions. Furthermore, this analysis includes a detailed description of how the research and its analysis are conducted in the methodology section.
Moreover, bias because of interpretation of the researcher is called researcher bias (Yin, 2013). This is avoided by discussing the method and interpretation of the results multiple times during the process with the supervisor and fellow master students of the University of Groningen. Also, objectivity, which represents an objective view of the research (Yin, 2003), is guarded by using the same guideline for every interview.
3.3 Data collection and interview protocol
consent of the interviewees. The interviews took place at the office of the interviewee to assure that they felt comfortable, lasted from 45 to 65 minutes each and were transcribed afterwards.
The interview was semi-structured to give the interviewer the opportunity to dive into unexpected though relevant issues (Van der Velde, Jansen, & Anderson, 2004). The interview protocol used during the first data collection moment in October 2014 was based on literature related to the concepts important for this analysis: change effectiveness, change recipients’ attitudes, and middle management. The interview protocol was split into two types: one with specific questions for the middle manager and one with specific questions for the change recipients. For instance, the middle manager was asked: “To what extent did you change your approach to this change project to accommodate those affected by the change?”, and the change recipients were asked: “What was your opinion about what the change agent wanted to achieve with this change?”. Furthermore, change effectiveness was analysed by asking questions related to the satisfaction with the process and the outcomes (Burnes & Jackson, 2011). Also, change recipients’ attitudes were asked for by focussing on the reactions towards the change. The translated interview protocols can be found in Appendix 1.
As second data collection moment, November 2015 was chosen since this was more than a year after the first data collection moment which gave the change recipients the chance to get acquainted with the new situation. The same persons, one middle manager and four change recipients, were interviewed in order to discover relevant changes over the last year. The interviews took place in the same setting as during the first data collection moment and lasted from 50 to 60 minutes each. Afterwards, the interviews were transcribed which resulted in a total of more than 45.000 words of raw data.
to the management of last year was: “In your opinion, what has been the influence of the middle manager was over the last year? Please explain”. Also, extra questions regarding important issues that appeared during the first data collection moment were added, for example increased work pressure and lacking ICT support. A question asked concerning the increased work pressure was: “In the interviews of last year, an issue that arose was the work pressure, what is your opinion about that now?”. The translated interview protocols that were used for the interviews during the second data collection moment can be found in Appendix 2.
3.4 Analytical strategy
After the data was collected, the analysis took take place. First, the data was accurately read to become familiar with it. Next, the data of each of the two collection moments was coded. The main part of data analysis consisted of labelling quotations in the data by using codes; the coding process. The research made use of a hybrid approach of deductive and inductive coding (Fereday & Muir-Cochrane, 2006). First, deductive coding was used. Change effectiveness was analysed using the satisfaction with the change process as well as the satisfaction with the change outcomes (Burnes & Jackson, 2011). Since individual change recipients’ attitudes are seen as a tridimensional concept of reactions by several authors (Bouckenooghe, 2010; Elizur & Guttman, 1976; Oreg et al. 2011), individual attitudes were analysed by using the three types of explicit reactions proposed by Oreg et al. (2011): cognitive, affective and behavioural reactions. Furthermore, collective attitudes, as stressed by Vakola (2013), were looked at by asking about colleagues’ opinions as well as the general opinion of the affected employees. Furthermore, the analysis of the influence of the middle manager was divided into the four roles that a middle manager fulfils within the organization as according to Balogun (2003): ‘undertaking personal change’, ‘keeping the business going’, ‘implementing change to departments’, and ‘helping others through the change’. This last role was made more specific by dividing it into two types of activities ‘performing the conversation’ and ‘setting the scene’ (Rouleau and Balogun, 2011, p953).
Higher level concept Codes Source Change recipient’s attitudes
Individual attitudes Cognitive attitude Deductive, Oreg et al.
(2011) Affective attitude
Behavioral attitude
Collective attitudes Vakola (2013)
Change effectiveness
Satisfaction with the change process
Deductive, Burnes and Jackson
(2011) Satisfaction with the
change content Anticipated effectiveness development Inductive Roles of the middle manager Undertaking personal change Deductive, Balogun (2003) Keeping the business
going
Implementing change to departments Helping others through
the change Performing conversation Deductive, Rouleau and Balogun (2011) Setting the scene
Shaping change terms
Inductive
4. Results
Now relevant literature and the methodology of this analysis have been discussed, the focus can shift to the findings within the data. The large amount of raw data collected at two different moments in time presented an opportunity for this research to provide clarity concerning the post-implementation process of a change project including the important concepts that play a role.
During the coding process, it became apparent that, looking at change effectiveness, there was a large difference between the process and the outcomes since the satisfaction with the process was extremely low though the satisfaction with the outcomes was average and increased over time. Also, while the dissatisfaction with the process had a negative influence on the satisfaction with the outcomes in October 2014, this had disappeared by November 2015. Furthermore, change recipients’ attitudes towards the change seem to have gone through a positive development though the collective attitude towards the change lagged behind and remained mainly negative. Looking at the middle manager, his approach towards the change recipients has changed over time. During the first data collection moment he was more focussed on explaining the change and individual guidance while during the second data collection moment his approach had switched to a general approach focussed on the day-to-day business.
4.1 Change effectiveness
October 2014. When looking at the change effectiveness during the first data collection
moment, barely any administrative employee appeared to be satisfied with the process where the assessments, communication and the timespan of the project were the main issues. First of all, the assessments were seen by the administrative staff as well as the middle manager as an inadequate instrument to select capable employees. For example, it was expressed that employees who are currently struggling with their new job related tasks had a high score on the assessment. The assessment was not seen as the right instrument for its purpose. Also, some of the departments had been practising while other departments had not which was expressed as being unfair by the change recipients: “I do not feel like it happened in a fair way. Then you will see differences. If some managers practice and others do not”. Second, the employees of the medical administration department experienced the communication as being insufficient and contradicting, as an employee declared: “We were actually not informed about what was going to happen”. Third, the total length of the process appeared to be too long, as an employee expressed: “I feel like it took 2 years, and that is just too long. It caused a lot of disturbance”. Participants that were not involved in the assessments, like the doctors, expressed dissatisfaction with the process based on lack of control and minimal say in the matter.
Furthermore, the satisfaction with the outcomes in October 2014 differed per person as well as per change goal. The outcomes so far seem to be acceptable for the change recipients. For instance, a participant said: “Though it goes slowly and we had to take a lot of hurdles, I do see advantages. I think we can work efficiently”. On the other hand, a number of change goals have not been achieved yet, one of them being the implementation of supporting ICT. Those ICT solutions are expected to have a positive effect on the work processes and hence change effectiveness is anticipated to increase after installation. Next to ICT, the goal of improving the work processes has not been achieved: “Not all the goals have been achieved. If you are talking about process improvements that has not been achieved”. A conclusion can be drawn that, though not dissatisfied, improvements are needed.
between the satisfaction with the process and the satisfaction with the outcomes. While the satisfaction with the process is mainly negative, the satisfaction with the outcome differs per person and per change goal.
Change goal General satisfaction about achievement Staff reduction of 30%
Universalizing work processes Digitalizing work processes - Disappearance ‘typing room’ - Installing supporting ICT
✓
✗
✓
✗
Table 4. Achievement satisfaction phase 1
November 2015. From the data collected during the second moment, November 2015, a
conclusion can be drawn that the overall opinion about the change process is still negative. When looking back at the process, multiple issues arise that should have been done differently. These are the same issues as expressed in October 2014. Furthermore, at this moment in time, the attitude towards the process seems to be more focussed on the upcoming changes. Here, a difference in occupied hierarchical position can be noticed. While executing employees are still focussed on the negative influences of the past process, the management employees of the medical administration department are already focussed on the upcoming changes and how these changes can be implemented in a better way; the management is trying to learn from the past experiences. As one management employee mentioned: “I think we have learned a lot on how it can also be done.”
the change gave them: “I have gotten more understanding of the process and everything around it. For me personally, that is really nice”. This opinion was shared by the middle manager: “I think that the employees who are capable are functioning at a higher level right now. There are people who take more responsibility and work more independent”. On the other hand, the dissatisfaction with the process, more specifically the assessment method, also has its consequences on the satisfaction with the outcomes. Because the assessment method has been described as inadequate to select capable employees, the satisfaction concerning the current employees is not optimal. As one of the participants expressed concerns about this: “There are still employees that are actually not competent”. Here, the negativity concerning the process has a spill over effect on the satisfaction with the outcomes. This entails that, when the process would have gone differently, the change outcomes would be so different that the satisfaction would have been higher. In this case, when an instrument was chosen that was seen as more adequate to select the capable employees, this would have resulted in more satisfaction with the change outcomes.
Table 5. Achievement satisfaction phase 2.
Out of the data appears another inductively developed concept that is not covered by the concepts of process satisfaction and outcome satisfaction though which can be linked to change effectiveness: ‘anticipated effectiveness development’. The awareness of the effect of the promised ICT solutions on working processes appears to be become higher; it was mentioned more often in November 2015 than October 2014. Moreover, these issues are included in the concept of ‘anticipated effectiveness development’, which entails the developments that are expected in the future to increase the effectiveness of the change project.
Change goal General satisfaction about achievement Staff reduction of 30%
Universalizing work processes Digitalizing work processes - Disappearance ‘typing room’ - Installing supporting ICT
✓
Goal abandoned, partly achieved. ✓
Comparison. Satisfaction with the process has not changed and is still negative. Almost no
change recipients said something positive about the process of the change and the more important reasons for this are for the administrative employees, as established before, the assessment, communication and the time span of the project. For the other employees it concerned the lack of control and say in the matter. Since the process has ended, this satisfaction is not likely to change anymore, neither for the better nor for the worse. However, as appeared during the second phase, management employees are trying to learn from negative aspects of the process to prevent issues from happening once again during a next project.
While important supporting ICT is still not implemented, satisfaction with the outcomes of the change has increased over time. Unexpected change outcomes have resulted in a more positive view of the change, which in turn resulted in more satisfaction with the outcomes. For instance, one participant mentioned during the first interview in October 2014: “Organizationally, I am not positive … I think it is a deterioration” while during the second interview in November 2015, the same participant expressed: “I think we cached up .. I am satisfied”. So, while the change was already implemented at the moment of the first data collection, the effectiveness developed over the year after implementation. There are several reasons for the increase in satisfaction with the change outcomes. First of all, it seems that the acceptation of the necessity of the change has increased the satisfaction with the outcomes Second, the unexpected change outcomes like personal development have positively influenced the satisfaction with the outcomes. Furthermore, it appeared that the dissatisfaction with the process had a negative influence on the satisfaction with the outcomes during the first data collection moment. Since the process has finished and time went by, this influence seems to decrease and hence the influence of the process on the satisfaction with the outcomes become less and less.
during the second data collection moment four out of five participants mentioned the anticipated developments concerning ICT. For instance, one participant said during the second data collection moment: “The EPD will be coming, as well as the speech recognition. Those things will be coming and will be implemented that will make the work processes better, more easy”, another participant mentioned: “We are moving towards an EPD and the pressure for supporting ICT is increasing”. Therefore, an additional effectiveness concept has inductively been developed: ‘anticipated effectiveness development’.
During the second data collection moment, the satisfaction with the change outcomes has increased compared to the first data collection moment. What stands out here is that while the change recipients and the middle manager have done everything in their power to make the change work, promises made by the hospital have not been lived up to. As mentioned before, none of the supporting ICT has been installed though these were clearly terms of the change project before it was implemented. Therefore, the satisfaction has increased due to the own efforts of the change recipients as well as the middle manager and all credits for increasing the change effectiveness should go to the change recipients and the middle manager. Furthermore, to increase the change effectiveness even more, the parties responsible for the supporting ICT have to live up to their promises.
4.2 Change recipients’ attitudes
October 2014. What can be seen when looking at the individual attitudes expressed is that
there is still much instability and insecurity in October 2014. The change recipients expressed a passive, wait-and-see attitude: “I felt like; ‘we will see’”. One change recipient mentioned; “That is how we acted, ‘just let it all happen, we cannot do anything about it’”. This attitude towards the change appeared to be based on the satisfaction with the process at that moment. As explained before, the satisfaction concerning the process was fairly low which resulted in the change recipients having low expectations of the change outcomes. Since those expectations were low, the change recipients also did not seem to care about investing it the change outcomes to positively influence them.
that. They actually do not want to change. I do not see any change in that … I do not see any movement”. This negativity and resistance was strong and immune to efforts to change it, as one participant expressed it was almost like the resistant change recipients “determined their vision and dug themselves in”.
Furthermore, there appears to be a remarkable difference between the individual attitude and the collective attitude. While most participants seem to have a passive individual attitude of wait-and-see, the collective attitude towards the change is more active and shows more resistance. When asked about the collective attitude and the attitude of their colleagues, most participants focused on the negativity, resistance and disturbance that the project caused: “It is still a change that is felt as not being a pleasant one”. However, when asked about their individual attitude, most change recipients responded with a passive, wait-and-see attitude. For instance, there was one change recipient who expressed his/her own opinion as: “I saw that it was a necessary step … I did not have that much problems with it”, however when asked about his/her colleagues, he/she expressed: “There was a lot of resistance… there were a lot of emotions … I mainly heard negative things”. This difference between individual passiveness and collective active resistance is remarkable.
November 2015. The individual attitude towards the change shows to be positive during the
second data collection moment. The change recipients understand why the change was necessary: “In my opinion; I understand the goal and I understand why it needed to happen”. The necessity of the change has sunk in even more and the passive, wait-and-see attitude turned into acceptance of the changed situation. Also, the positive individual consequences as well as the personal development of the change had an influence on the individual attitude. For example, one of the participant used the opportunity brought by the project to switch to another ward where the tasks of the medical department were different and personally better suited: “Because of multiple reasons, this spot became available and I thought that I liked to do this so I switched”.
change is expressed: “There has been a lot of complaining about the situation”. The negativity is derived from the fact that, while the necessity of the change is accepted, the process still bothers the majority of the employees of the medical administration department. This negativity is still present however less actively expressed as the change recipients have accepted the situation and moved on, as expressed: “There is a sort of acquiescence with the whole thing”.
Based on the findings of the individual attitude compared to the collective attitude, again a difference is worth mentioning. While the individual attitude is mainly positive, the collective attitude was said to be less positive by the participants. Also, while the individual attitude became more positive over the last year, there was no shift in negativity of the collective attitude. However, the acceptance of the new situation has caused the negativity to be more passive, the employees shifted their efforts towards making the new situation work and were less concerned with actively expressing their opinion.
Comparison. What becomes obvious after comparing the data from the first and second phase
is that the individual attitudes of the change recipients have become much more positive; from a wait-and-see attitude to a positive, accepting and understanding attitude towards the change project. Personal developments have positively changed their attitudes towards the change. Also, releasing resistance and letting go of the negativity that the change process provoked resulted in an acceptance of the current situation. Next to that, the understanding of the change necessity has developed over the year, which helped the change recipients in their efforts towards pursuing the goals of the project together.
negativity, it is not expressed as actively anymore which can entail that is it beginning to fade away as a result of the acceptance of the new situation.
When comparing the individual attitude with the collective attitude, there can be seen that while the individual attitude has changed for the better, the collective attitude has remained nearly the same. Hence, the difference between the positive individual attitude and the negative collective attitude has become greater. Likewise, it seems that the negative influence of the dissatisfaction with the process has a greater effect on the collective attitude than it does on the individual attitude. When asked about this, the participants mentioned that collectively, there are still feelings of dissatisfaction. However, it would be expected that the collective attitude would follow the same developments as the individual attitude since they are interrelated. Hence, one of the explanations for the difference, which can be found in the data, might be the fact that the communication among change recipients about the change project has decreased, as a result of the acceptance of the situation. This was expressed by one of the change recipients: “There are other things that we can devote our energy on. So, at one point we did not talk much about this anymore”. Therefore, change recipients, the participants, are less aware of the current collective attitude while they do still remember the negativity of the collective attitudes when there was still more communication.
4.3 Middle manager
October 2014. What becomes clear is that the middle manager, in this case, adapted his
As expressed by the change recipients, the middle manager tried to influence the attitudes of the change recipients towards the change by providing insights into the necessity of the change, listing to arguments and concerns of the change recipients and finally guiding them through the change. Out of the four roles that Balogun (2003) identified, the middle manager in this case mainly focussed on ‘helping others through the change’, which he did both by ‘performing conversation’ and ‘setting the scene’ (Rouleau & Balogun, 2011). As explained by one of the change recipients, the middle manager did not distance himself from his employees but tried to built a personal relationship: “He planned a lot of meetings … He fits his approach to what we can offer … He really understands his employees … He is very compassionate and he really tries to think along”. Furthermore, he combined the role of ‘helping others through the change’ with the role of ‘implementing changes to departments’, this appeared from what one of the change recipients said: “He has been the first manager who actually accomplished some changes, I think that is really clever”.
Furthermore, though the middle manager was appointed by the board of directors to execute the change, his commitment to his employees showed because he tried to do everything in his ability to help them through the change. This also showed in his efforts to keep as much people on board as possible. So, even though the middle manager was appointed to execute the change, he was able to influence the change terms slightly. Though the middle manager was appointed to execute the change, he used his position to slightly influence some of the terms of the change. This resulted in some employees being allowed to do the assessment more than once and also other employees who failed the assessment were being helped to see whether it was possible to stay with the medical administration department. As one change recipient expressed: “He tried to keep people who actually did not pass the assessment”, even though everyone who failed the assessment had to be replaced or let go according to the change terms as set by the board of directors. According to another change recipients, this even entailed that some employees who failed the assessment, were allowed to do the assessment once again: “There has been someone who was allowed to redo the assessment”. A middle manager can influence the terms of the change project by going against the original plans of top management, in this case the board of directors.
November 2015. In the data of this data collection moment, the middle manager is, next to
and its necessity as good as possible, the approach of the middle manager became more imposing. Understanding that not everyone agreed with the change though also focussing on the job that had to be achieved. His approach was less understanding and explaining though more focused on the change that had to be done. The nature of the activities shifted from ‘sensemaking’ to ‘coordination and management’ (Balogun, 2003). Looking at the four roles that Balogun (2003) identified, the middle manager is mostly performing the role of ‘keeping the business going’. This shift in role was noticed by one of the employees: “From a understanding change agent who has an eye for all the changes that needed to take place, to a more directing, distant one. A bit like; this is it and that is what you will have to work with”. Furthermore, as the collected data showed, the inductively developed concept of the middle manager being able to shape the terms of the change also appeared. Since the board of directors and the middle manager have different views as a result of their different hierarchical positions within the organization, this leads to a difference in opinion on how to accomplish organizational goals. In this case, this led to the middle manager expressing disagreement concerning one of the change terms: “That is a strange way and I am not going to agree with it. I moved heaven and earth … and it is probably going to happen my way”. Here, the concept of ‘shaping change terms’, another role the middle manager can fulfil within the organization, appears again.
Comparison. The approach of the middle manager with respect to the change recipients has
The influence of the middle manager on the change recipients’ attitudes appears to have been positive. As the participants expressed, the middle manager made a clear shift in his approach towards the change recipients. Where he was first trying to explain the change and individually ‘performing conversation’ (Rouleau and Balogun, 2011), later he focussed more on a collective approach and on actually implementing the changes. During this first approach he gave the recipients the possibility to express their opinions, which gave him the possibility to explain the situation. Next, he focussed on individual resistance though collectively on achieving the change goals. In the end, the change recipients expressed that they respected the approach of the middle manager and, also, that the middle manager was the first to accomplish any change, as expressed by one of the participants: “He was the first manager who has been able to accomplish any changes and that is clever of him”.
5. Discussion and conclusion
The aim of this research was to provide clarity concerning developments of post-implementation change effectiveness. Therefore, the main research question was: How does change effectiveness develop after implementation? Now the results of this research have been discussed, some outcomes surprise more than others. By relating those outcomes to current views in literature, they can be theoretically positioned and suggestions for further research will be given. Also, managerial implications as well as implications for the organization of this research are explained. After this, the conclusions of this research are presented.
5.1 Discussion
One of the surprising outcomes of the cross-phase analysis is the fact that while the supporting ICT solutions are still not implemented, effectiveness has increased mainly because of the positive individual attitude of the employees. Their acceptance has increased and employees that showed a considerable amount of resistance at first now show acceptance and try to make the best out of the current situation. One explanation for this can be the positive though unexpected change outcomes that were described by the participants, for example personal development. Another explanation could be the approach of the middle manager. His approach was focussed on explaining and guiding the change recipients, which was experienced as positive by the change recipients. When looking at related literature, the positive relation could explain this as the researchers Coch and French (1948) found between satisfaction and productivity of change recipients and participation even if this entailed participation by representation. The middle manager was able to fulfil this role of representing the employees, among other things by shaping the terms of the change. Hence, though the board of directors has not lived up to promises, the satisfaction with the outcomes increased due to the positive individual attitude of the employees.
also not seem to be the case when looking at the individual attitude, which positively evolved, and the collective attitude that remained negative throughout the year. Hence, the conclusion can be drawn that, though individual and collective attitudes are related, they do not always evolve synchronously. This raises the question whether individual and collective attitudes are as interrelated as suggested by research and what causes the differences in attitudes that are observed in this research. One explanation given in the results section is that at one point the change recipients refrained from discussing the change project and are therefore less aware of the collective attitude at this moment. Another explanation could be the approach of the middle manager. According to Penava and ehi (2014), if the change agent, in this case the middle manager, has an individual approach instead of focussing on the collective, this has a positive influence on individual change attitudes and the individual will then display less resistant behaviour. However, the middle manager could not have been able to focus individually on every change recipient. This could explain the difference in collective and individual attitude. Further research is necessary to determine what caused the difference between individual and collective attitude.
Moreover, three out of the four roles for middle manager within an organization that Balogun (2003) identified become clear from the data. However, one role, ‘undertaking personal change’, rarely appeared in the data. This was an informing role to execute the other roles according to Balogun (2003). The absence of this role can be explained by the fact that the middle manager in this case was not part of the organization before the change. Since he was appointed during the first phase of the change project, his personal development concerning the change was of less relevance since he was not part of the organization before the change and he did not have to become familiar with a different organizational situation.
because they don’t experience the change as necessary (Bouckenooghe, 2010). Moreover, when the promised ICT solutions are implemented, this will cause the situation to become unstable even more since the employees have to get acquainted with and adapted to the new ICT. Therefore, the conclusion can be drawn that, as long as the ICT solutions are not implemented and the collective attitude remains negative, the ‘refreezing’ phase has not been fully completed at the administration department.
When an organization does not fully ‘refreeze’, it does not reach stability or a sort of equilibrium, the question remains whether Lewin’s three-step model could be applied at all and if so, which step is applicable to the organization at this moment. Looking at the organization, the ‘refreezing’ also will not likely happen in the coming future since a new project is being refined at the moment. This can be linked to the view of Orlikowski (1996), Brown and Eisenhardt (1997) and Smith (2006) that change nowadays should be seen as a constant and continuing process formed by political and environmental forces. Also, this was mentioned by one of the participants who reflected on the amount of changes he/she as well as the organization had to cope with lately: “It has been a tsunami of changes the last couple of years. You used to be able to retire without any major changes happening however lately it seems to be really turbulent”. Organizational environments as well as the increasing pace of change do not seem to give organizations the possibility to achieve a sort of equilibrium these days. Therefore, a conclusion can be drawn that, at the moment, the third step of Lewin’s model is not appropriate as well as not desired at the hospital. It is not appropriate because the situation is not quasi-stable. Also, this is not desired because the next change project is approaching which will cause new instability and uncertainty thus efforts to stabilize the current situation will be overturned. Therefore, the advice is to focus on the new change project while the situation is still instable so that further changes are not seen as that disrupting.
actually moving but also not refreezing at the moment, the organization appears to be in an in-between phase. Lewin’s model does not specify such a phase, which gives the opportunity to suggest an extra step that will be defined as the cooling-down step. This new cooling-down phase is more relevant nowadays because organizations experience change as being more rapid than it was before and therefore organizations might implement the next change before a quasi-stable situation has been reached. Moreover, putting a cooling-down phase between the moving and refreezing steps gives the organization an opportunity to postpone the refreezing until multiple changes, movements, have been completed. Then, new changes will not be experienced as disrupting the new stable situation. Thus, this step can be explained as a short period of time in which the organization recovers from change though a quasi-stable situation is not desired temporarily since parts of the change project are still being installed or are anticipated to be installed shortly or a completely new change project is expected soon. This phase can be seen as a possible step between the current second step and third step, which entails that the refreezing phase, could become the fourth step. However, after cooling down it would also be possible to change again and therefore go back to the second step, moving. So, after the cooling-down phase, the organization has two options. It can choose to go back to the second step and implement other changes or it can choose to refreeze when a stable situation is preferred. Moreover, during this stage the organization has to take in mind that the members should not fall back into old behaviour. Looking at the case study used for this research, a conclusion can be drawn that since refreezing is not desired at the moment and a next change is upcoming, the organization can be said to be cooling down at the moment, preparing for the next movement. This entails that the organization is not currently moving though also not refreezing; the organization is cooling down.
