Decision that will impact every member of every team

Respond to A.S. post

A.S Post

The organization that I currently work in has recently made a very important decision that will impact every member of every team. Avow is a not-for-profit hospice and palliative care organization that maintains a culture of empathy while embracing any change that will positively impact patient care. This summer we will implement a new software program called Home Care Home Base that will replace our current electronic health record (EHR) that has been used for over 10 years. The fact that we have utilized an EHR makes us pioneers of sorts. In our industry there are many organizations that have never used such a tool and within the healthcare community, physicians, hospitals and other delivery venues are still struggling to implement EHRs for the first time. Ten years ago choices were few as the EHR concept was new, options were limited. Organizations were not yet savvy at using technology and in some respects the cost of using a tool that wasnt necessary or required by regulation was prohibitive. As a result, Avow engaged in satisficing and adopted a program, called Suncoast, that was the best choice at the time (McShane & Von Glinow, 2013). For a while Suncoast seemed to adequately meet our needs organizationally, but as our industry changed, the technology seemed to be a step behind other innovations. Eventually we determined that it was no longer meeting our needs and was not on pace to add updates or adapt for the long haul. These factors prompted us to seek other alternatives and consider making a change.

Decision structure during this process was extremely high. People from many departments and levels of our organizational hierarchy were involved. Front line users such as social workers, chaplains, nurses, home health aides, billing representatives, managers, and directors weighed in on deficits the current system had that negatively impacted productivity. They engaged in creating wish lists that included the features that their ideal software system would contain. IT and compliance staff evaluated the hardware components to determine how we would need to adapt current security policies to ensure patient privacy protection. The finance department carefully considered how the purchase of this software would fit into our budget as this change would not only require the initial costs of implementation but affect long term routine maintenance costs. Senior Management solicited input from all of these parties and carefully prepared a case presentation for the Board of Directors who ultimately granted their seal of approval to move forward by a unanimous affirmative vote.

Source of decision knowledge was also very high in this process. As previously stated, input was gathered from many different disciplines and levels within the organization. We engaged in a thorough due diligence process that included online and in person demonstrations, sales presentations, and even a site visit to another organization currently using Home Care Home Base. Information was received by numerous people in a variety of formats. The site visit allowed us to receive unbiased information as we observed how an organization similar to ours used the system. We heard their positive and negative feedback, and never divulged our own reasons for considering a change. By the time our case presentation was being made for the board we were certain that we were recommending a superior product and had gathered substantial and convincing evidence to prove it.

Decision commitment is currently high but only time will tell if it stays that way. With so many individuals involved in the group decision there should be few opportunities to place blame on a single individual if the decision is later determined to have been a bad one. We are all personally invested in the success of the implementation process because each of us played a role in decision participation.

It is my hope that risk of conflict is low related to this decision. Change itself is often a cause of conflict. Staff will be drawn outside of their comfort zones in order to adapt to new procedures related to the change. They will initially be slowed down by having to learn new ways of doing things they have done the same way for many years. As an organization we are trying very hard to anticipate potential conflicts and plan ways to dissolve anxiety and frustration.

At our last all staff meeting there was a joint presentation by one of our clinical leaders and the IT Director to share the implementation time frames and generate some excitement about new hardware devices we hope to roll out soon. Following this segment of the meeting we played a short video clip that summarized the book Who Moved My Cheese? (Johnson, 1998). Our goal is to continue engaging staff throughout the implementation process to ensure sustained buy-in to the decision. Continued communication will be a key factor.

I am very pleased with the level of employee involvement that was achieved in making this difficult and important decision. The EHR is at the center of everything we do to care for our patients. The tool will support so many essential activities of our daily roles and directly impact employee and customer satisfaction. It must allow us to meet compliance requirements with state and federal agencies. The EHR must be efficient and user friendly allowing staff to spend more time with patients. It will streamline documentation to remove redundancies and improve billing performance.

Our organization has high hopes for the new EHR, Home Care Home Base. We hope that the high level of employee involvement that was achieved during the decision making process will ensure a successful implementation so that we may enjoy using the program for many years to come.


Johnson, S. (1998). Who moved my cheese?. New York: G.P. Putnam’s Sons.

Johnson, S. (1998). Who moved my cheese? [Video file]. Retrieved from;_ylt=As5D_UXD.4zX3HknMMpxVL2bvZx4?fr=yfp-t-901-s&toggle=1&cop=mss&ei=UTF-8&p=who%20moved%20my%20cheese%20video

McShane, S.L. & Von Glinow, M.A. (2013) Organizational behavior: emerging knowledge. global reality. New York, NY. McGraw-Hill.

Respond to A.S. post

Changes in an organization are inevitable due to the frequent changes in the environment. Advancement of technology and increasing need for efficiency plays a significant role in embracing change.

Steps taken by the facility in the A.S post are adequate and appropriate in change management. The high employee involvement in the decision making to replace electronic health record with Home Care Home Base is critical. This averts any conflicts, as all the stakeholders remain accountable for the decisions that they make. It is also a sign of unity and cooperation among the employees which is essential to ensuring achievement of the organization objectives.

When implementing change it is also prudent to understand the benefits and the challenges of the new change or products (McShane & Von Glinow, 2013). The organization carried out adequate research through surveys and interviews on the operations of the system. They went an extra mile to approach organizations that had already implemented the system and equipped themselves with the knowledge of how the system works. This therefore, contributed to their informed choice. The costs of financing the project was also brought to the fore and deliberated. Any change adopted need to be within the resources in the organization. The organization must re-evaluate itself and assess whether they have the capability to finance the system or not. These issues should be considered in the decision-making process to ensure that the process goes on smoothly.

 I therefore believe that the hospital has an appropriate change management strategy which has enabled it to adopt change without having or experiencing conflicts. This is proved through its previous change strategies and the current change it hopes to implement. This is proof that change is something that can be embraced by the organization if there is appropriate planning and implementation.


McShane S., & Von Glinow, M. (2013). Organizational behavior: Emerging knowledge in          global reality. 6 ed. New York. McGraw Hill/Irwin.

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