BackgroundFacilitation is a powerful approach to support practice change. The purpose of this study is to better understand the facilitation roles exercised by both external facilitators and interprofessional facilitation teams to foster the implementation of change. Building on Dogherty et al.’s taxonomy of facilitation activities, this study uses an organizational development lens to identify and analyze facilitation roles. It includes a concise definition of what interprofessional facilitation teams actually do, thus expanding our limited knowledge of teams that act as change agents. We also investigate the facilitation dynamics between change actors.MethodsWe carried out a qualitative analysis of a 1-year process of practice change implementation. We studied four family medicine groups, in which we constituted interprofessional facilitation teams. Each team was supported by one external facilitator and included at least one family physician, one case manager nurse, and health professionals located on or off the family medicine group’s site (one pharmacist, plus at least one nutritionist, kinesiologist, or psychologist). We collected our data through focus group interviews with the four teams, individual interviews with the two external facilitators, and case audit documentation. We analyzed both predetermined (as per Dogherty et al., 2012) and emerging facilitation roles, as well as facilitation dynamics.ResultsA non-linear framework of facilitation roles emerged from our data, based on four fields of expertise: change management, project management, meeting management, and group/interpersonal dynamics. We identified 72 facilitation roles, grouped into two categories: “implementation-oriented” and “support-oriented.” Each category was subdivided into themes (n = 6; n = 5) for clearer understanding (e.g., legitimation of change/project, management of effective meetings). Finally, an examination of facilitation dynamics revealed eight relational ties occurring within and/or between groups of actors.ConclusionsFacilitation is an approach used by appointed individuals, which teams can also foster, to build capacity and support practice change. Increased understanding of facilitation roles constitutes an asset in training practitioners such as organizational development experts, consultants, facilitators, and facilitation teams. It also helps decision makers become aware of the multiple roles and dynamics involved and the key competencies needed to recruit facilitators and members of interprofessional facilitation teams.Electronic supplementary materialThe online version of this article (doi:10.1186/s13012-016-0458-7) contains supplementary material, which is available to authorized users.
It is generally believed that individuals are predisposed to organizational change and have a natural tendency to react in the same way, regardless of the change. This study deals with this popular belief by determining the level of discomfort experienced by 321 employees of the same organization who were simultaneously confronted with three organizational changes: a structural reorganization, a relocation of the workplace, and a technological change. The overall results reveal that each change creates a distinct level of discomfort. However, at an individual level, these results overshadow the presence of two patterns of discomfort with change: a dispositional pattern for almost a quarter (23%) of respondents, for whom the level of discomfort remains identical regardless of the change, and a situational pattern, prevalent among 77% of respondents, for whom the level of discomfort differs from one change to the next. In addition, regardless of the occupational group considered, the proportion of respondents who show a situational pattern of discomfort with change is always much higher than the proportion of individuals who have a dispositional pattern of discomfort. These results bring an important clarification to popular beliefs by showing that although certain individuals have a tendency to react to change in a stable manner (dispositional pattern), this pattern is prevalent only among a minority of employees. For the majority, the situational pattern predominates.
International audiencePurpose Two complementary objectives are addressed in this article. First, several studies are introduced based on the assumption that organizational change is now excessive. We propose an operational definition to change excessiveness, and we assess whether it is a generalized phenomenon at a societal level. Second, these studies are habitually mobilizing coping theories to address their purpose. However, an integrated model of coping, including appraisals and coping reactions toward change is still to be tested. Thus, our assessment is anchored in an application of the Stimulus-Response Theory of Coping. Design/methodology/approach A quantitative study is conducted by administering questionnaires to a nation-wide representative sample (n = 1002). Anderson and Gerbing (1991) two-step approach is used to validate the study and tests its hypothesized model. Change excessiveness is measured in order to observe if it’s a generalized phenomenon in the working population. Its effects on coping are modelled through the fully mediated Stimulus-Response Theory of Coping (SRTC). Therefore, our hypothetical model predicted that the relationships between the perception of excessive change contexts and negative coping reactions is fully mediated by negative appraisals toward change contexts. Findings Perceptions of excessive change is a normally distributed and a statistically centralized phenomenon. As hypothesized, an SEM test of the SRTC shows a full mediation effect of negative appraisal between change intensity and negative coping to change. Originality/value This article empirically tests a nation-wide sample where organizational change may be too excessive for individuals' positive coping. It is the first to generalize the observation of change excessiveness as perceived by employees to a nation-wide level. Moreover, it addresses the gap between change excessiveness and coping theories in modelling the Stimulus-Response Theory of Coping through its three components: event, appraisals, and coping reactions. Finally, it presents managerial discussions toward the strategic necessity for organizational change and its potential "too-much-of-a-good-thing" effect
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