HIM 685 Module 6 Change Theory Short Paper Example

From Mailroom to Monitor: Choosing a Change Model for Longleaf's Release-of-Information Team

[Student Name]

Southern New Hampshire University

HIM 685: Advanced Topics in HIM II

Module Six Short Paper

[Instructor Name]

[Date]

The organization, setting and figures below are a composite written as a model document. No real employer, client, colleague or patient is described.

From Mailroom to Monitor: Choosing a Change Model for Longleaf's Release-of-Information Team

Change models are often cited and rarely used. A paper may name Lewin or Kotter and then describe a plan that would have looked the same without them. A useful model should tell a leader what to do next and what to check before moving on. This paper tests three models against that standard for a specific change at the composite Longleaf hospital: moving the seven-person release-of-information team from mailing and faxing records to managing requests that increasingly arrive and are answered through the statewide exchange.

The Change

Requests arrive at a rate of roughly 2,300 a month. Most come from other providers, insurers and patients, and most are answered by printing, copying and mailing or faxing records. Once Longleaf's discharge summaries and lab results are available through the exchange, many provider requests will be answered automatically, and the team's work will shift toward checking unmatched patients, handling restricted records, answering requests the exchange cannot meet and auditing what was disclosed. No positions will be cut, but every job will change. Several team members have more than fifteen years in their roles, and rumors about layoffs began the week the board approved the exchange.

Lewin: Unfreeze, Change, Refreeze

Lewin (1947) described group behavior as held in a balance of forces and change as a process of loosening the existing balance, moving to a new one and stabilizing it. The model's strength is its insight that old habits are held in place by forces, some of which a leader can weaken, and that a new practice must be deliberately stabilized or it will slide back. For Longleaf, the forces holding the mail and fax process in place include familiarity, pride in careful work and fear about jobs. The model is less helpful about what to do on a given week; it describes stages more than steps.

Kotter: Eight Steps

Kotter (1995) drew on transformation efforts in many companies to argue that change fails when leaders skip steps, and he proposed a sequence: establish a sense of urgency, form a powerful guiding coalition, create a vision, communicate it, empower others to act by removing obstacles, plan for and create short-term wins, consolidate improvements and institutionalize new approaches. The model's strength is that it is a sequence of actions a leader can schedule. Its weaknesses are that it was written for large corporate transformations and that urgency, if pressed too hard, can feed the fears already present in a small team.

Weiner: Readiness

Weiner (2009) described organizational readiness as two things held in common across a group: wanting the change, which he called commitment, and believing the group can deliver it, which he called change efficacy. In his account, people are most ready when they think the change worth making and trust that they have the know-how, tools and time to pull it off. The theory does not prescribe steps, but it supplies two questions a leader can ask before each move: does the team want this, and does it believe it can do it? At Longleaf today, the honest answers are no and no.

Choosing and Combining

The paper chooses Kotter's sequence as the backbone of the plan, because it can be scheduled and assigned, and uses Weiner's two questions as a check before moving from one step to the next. Lewin's insight about forces informs the urgency and obstacle-removal steps. Urgency will be framed carefully: the case for change is that patients and clinicians across the state will soon expect Longleaf's records in minutes rather than days, not that the team's jobs are at risk. The guiding coalition will include two respected team members, not only managers. Before moving from communication to action, the director will ask the team, in a short anonymous survey, whether the change seems worthwhile and whether they feel able to learn the new tasks, and will not move on until most answer yes to both.

What Could Go Wrong

The chosen approach has its own risks. A guiding group that includes team members can be seen by others as a group of favorites, so membership will rotate after six months and every meeting summary will be shared with the whole team. Kotter's emphasis on short-term wins can tempt a leader to declare victory early; the first win will be reported as a beginning, not an end, and the old mail and fax process stays available until the exchange has carried its share for a full quarter. Readiness surveys can be gamed if people fear that honest answers will be held against them, which is why they will be anonymous and why the director will report the results back to the team in full, including the unflattering ones. Finally, the exchange's own performance is outside Longleaf's control. If the exchange is slow or unreliable during the first months, the team's belief in the change will fall, so the director will agree on service expectations with the exchange in advance and share its performance reports openly.

The First Ninety Days

Applied to the first ninety days, the approach produces specific actions. In weeks one and two, the director meets the team, states plainly that no positions will be cut, explains why the change matters to patients and invites two senior specialists to join the guiding group. In weeks three to six, the group maps every type of request the team handles and identifies which the exchange will absorb and which will remain, so each person can see their future work. In weeks seven to ten, two specialists learn match checking and query watching from the exchange's own staff, the obstacle of an unreliable document server is escalated to IT and the readiness survey is repeated. By week twelve, the team aims for a visible short-term win: the first month in which a measurable share of provider requests is answered through the exchange, celebrated with the team and reported to leadership.

Conclusion

Each model contributes something. Lewin explains why the old process persists, Kotter supplies the sequence of actions and Weiner offers a check on whether the team is ready for the next step. Combined, they produce a plan that is specific enough to schedule and humble enough to pause when the people involved are not ready. Milestone Two will extend this approach into the full change management and implementation plan.

References

Kotter, J. P. (1995). Leading change: Why transformation efforts fail. Harvard Business Review, 73(2), 59-67.

Lewin, K. (1947). Frontiers in group dynamics: Concept, method and reality in social science; social equilibria and social change. Human Relations, 1(1), 5-41. https://doi.org/10.1177/001872674700100103

Weiner, B. J. (2009). A theory of organizational readiness for change. Implementation Science, 4, Article 67. https://doi.org/10.1186/1748-5908-4-67