You are the new director of the Harpeth Gardens not-for-profit nursing home. Harpeth Gardens is one of 20 elder-care centers managed by Franklin Resident Care Centers. Harpeth Gardens has 56 patients and is completely responsible for their proper hygiene, nutrition, and daily recreation. Many of the patients can move about by themselves, but several require physical assistance for eating, dressing, and moving about the nursing home. During daytime hours, the head of nursing is in charge of the four certified nursing assistants (CNAs) who work on the floors. During the night shift, a registered nurse is on duty, along with three CNAs. The same number of CNAs are on duty over the weekend, and either the head of nursing or the registered nurse is on call.
Several other staff also report to you, including the heads of maintenance, bookkeeping/MIS, and the cafeteria. The on-call physician stops by Harpeth Gardens once a week to check on the residents. You have 26 full- and part-time employees who cover the different tasks and shifts.
During your interviews for the director’s job, you became aware that the previous director ran a very tight ship, insisting that the best way to care for nursing home patients was by following strict rules and procedures. He personally approved almost every decision, including decisions for patient care, despite not having a medical degree. Turnover has been rather high and several beds are empty because of the time required to hire and train new staff. Other elder-care facilities in the area have a waiting list of people wanting to be admitted.
At Harpeth Gardens, the non-nursing offices have little interaction with nurses or each other. Back-office staff people seem to do their work and go home. Overall, Harpeth Gardens seems to you like a dreary place to work. People seem to have forgotten the compassion that is essential for patients and each other working in a health-care environment. You believe that a new strategy and culture are needed to give more responsibility to employees, improve morale, reduce turnover, and fill the empty beds. You have read about concepts for leading organizational change and would like to implement some new ideas to make the culture at Harpeth Gardens more creative, decentralized, and participative. You decide to start with the idea of engaging employees in decision making and encouraging more direct collaboration between departments. If those two ideas work, then you will implement other changes.
Your assignment for this exercise is to decide how you will implement one of the desired changes.
Apply Kotter’s Eight Steps to implement the change within Harpeth Gardens.
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