title: Explaining the success or failure of quality improvement initiatives in long-term care organizations from a dynamic perspective.
abstract: The purpose of this study was to better understand why change initiatives succeed or fail in long-term care organizations. Four case studies from Québec, Canada were contrasted retrospectively. A constipation and restraints program succeeded, while an incontinence and falls program failed. Successful programs were distinguished by the use of a change strategy that combined "let-it happen," "help-it happen," and "make-it happen" interventions to create senses of urgency, solidarity, intensity, and accumulation. These four active ingredients of the successful change strategies propelled their respective change processes forward to completion. This paper provides concrete examples of successful and unsuccessful combinations of "let-it happen," "help-it happen," and "make-it happen" change management interventions. Change managers (CM) can draw upon these examples to best tailor and energize change management strategies in their own organizations.
authors.affiliation: Université de Sherbrooke, Sherbrooke, QC, Canada francis.etheridge@usherbrooke.ca.
authors.forename: Francis
authors.initials: F
authors.lastname: Etheridge
authors.affiliation: Université de Sherbrooke, Sherbrooke, QC, Canada.
authors.forename: Yves
authors.initials: Y
authors.lastname: Couturier
authors.affiliation: École nationale d'administration publique, Montréal, QC, Canada.
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Denis
authors.affiliation: Donald Berman Maimonides Geriatric Centre and Jewish Eldercare, Montréal, QC Canada.
authors.forename: Lucie
authors.initials: L
authors.lastname: Tremblay
authors.affiliation: Université de Montréal, Montréal, QC Canada.
authors.forename: Cara
authors.initials: C
authors.lastname: Tannenbaum
mesh_terms: D006801:Humans; D008134:Long-Term Care / Q000458:organization & administration* / Q000639:trends; D015279:Organizational Culture; D009936:Organizational Innovation; D058996:Quality Improvement; D011792:Quebec; D017749:Total Quality Management
keywords: change dynamics; change management; innovative care program; long-term care