title: Gaining and maintaining commitment to large-scale change in healthcare organizations.
abstract: Healthcare administrators have sought to improve the quality of healthcare services by using organizational change as a lever. Unfortunately, evaluations of organizational change efforts in areas such as total quality management (TQM), continuous quality improvement (CQI), and organizational restructuring have indicated that these change programmes have not fulfilled their promise in improving service delivery. Furthermore, there are no easy answers as to why so many large-scale change programmes are unsuccessful. The aim of this analysis is to provide insights into practices that may be utilized to improve the chances of successful change management. It is proposed that in order to effect change, implementers must first gain commitment to the change. This is done by ensuring organizational readiness for change, surfacing dissatisfaction with the present state, communicating a clear vision of the proposed change, promoting participation in the change effort, and developing a clear and consistent communication plan. However gaining commitment is not enough. Many change programmes have been initially perceived as being successful but long-term success has been elusive. Therefore, maintaining commitment during the uncertainty associated with the transition period is imperative. This can be done by successfully managing the transition using action steps such as consolidating change using feedback mechanisms and making the change a permanent part of the organization's culture.
authors.affiliation: Department of Health and Behavior and Administration, University of North Carolina at Charlotte, USA.
authors.forename: L
authors.initials: L
authors.lastname: Narine
authors.forename: D D
authors.initials: DD
authors.lastname: Persaud
mesh_terms: D017598:Efficiency, Organizational; D006298:Health Services Administration / Q000592:standards*; D006302:Health Services Research; D015279:Organizational Culture; D009936:Organizational Innovation; D009937:Organizational Objectives; D010558:Personnel Loyalty; D017749:Total Quality Management; D014481:United States