Accomplishing Change in Treatment Strategies

A change management perspective on the introduction of music therapy to interprofessional teams

“…These studies indicate that organisational change is not always viewed favourably by healthcare workers, especially when change is understood as increased work. It has been proposed that healthcare practices are firmly entrenched and that healthcare organisations are hesitant to adopt change (Deegan et al, 2004;Dulaney and Stanley, 2005). This view is supported by research into the effects of introducing clinical directorates (CDs), new management structures intended to bring together clinical and organisational aspects of care (Braithwaite et al, 2005;Braithwaite, 2006a, b).…”

“…In his view, forces such as values, past experiences, money, and time can create or limit the possibility for change (Cartwright, 1951). Successful change may depend on the presence of driving forces, such as motivation to change, or require the removal of restraining forces, such as limited funding or resources in the case of a healthcare setting (Dulaney and Stanley, 2005). Lewin presented change as a three-step process.…”

“…They recommended that researchers interested in change sustainability should be "sensitive to context, complexity, ambiguity, uncertainty, competing stakeholders and to the range of potential interlocking influences". While it may not be possible to identify the dominant factors leading to change sustainability, studies of hospital organisations have typically emphasised cultural and contextual influences on organisational change (Braithwaite et al, 2005;Dulaney and Stanley, 2005;Viitanen and Piirainen, 2003). Published strategies for achieving organisational change include identifying opportunities for change, communicating and collaborating with others, and appointing change agents.…”

Presidential Address

“…Goals of the US Department of Health and Human Services include that by 2016, 50% of Medicare payments will be tied to quality through alternative payment models, and by 2018, 90% of remaining fee-for-service reimbursement will be tied to quality. 6 Approximately 50% of hospitalized patients in the United States are covered through CMS, and this will increase as our population ages. 7 This is planned change.…”

“…Health care costs in the United States have risen faster than any other country, but our life expectancy has not kept pace with these costs. 6 In the 2000s, new models have been rolled out in which hospitals/PCPs are no longer reimbursed based on services alone but also on outcomes. Further changes in reimbursement include the development of accountable care organizations and a reimbursement model for "bundled care," meaning payment goes to a health care system including physicians, hospitals, and other members of the health care team as one payment instead of individually.…”