Change Management in an HIV/AIDS Research Project
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Contents
Executive Summary...................
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Executive Summary
Introduction
Research in...
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felt that the changes directly affected th...
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Follow this order: “Shared Diagnosis 1-RED...
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Acknowledgements
I would like to acknowled...
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Initial Problem/Opportunity Statement
Back...
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which the government could incur. Going th...
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High Level Overview of Deliverables to Spo...
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employees to those changes. This will the...
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An analysis of the RP
The External Enviro...
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New World Health Organization (WHO) recom...
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The new HIV/AIDS Treatment Guidelines whi...
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Liz Mac Dean Dan Coleman
Organization Int...
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Research Question 2
How do employees perc...
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Q9 5 3
Responses to Questions on Motivati...
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Arguing/raising objections 0 0
Agreeing o...
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Introduction of the Changes
The employees...
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they could not complete their tasks becau...
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Sabotaging
Elements of sabotage (4.3%) we...
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Discussion
Spector, B. (2013) recommends ...
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Recommendations
1. Employee of Engagement...
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When employees are called to attend meeti...
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installing enablers of dialogue such as d...
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Organizati
onal design
Process
definitio
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Lessons Learnt
Focus area Low
1 2 3 4
Hig...
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STRUCTURES,
reporting
relationships
,comp...
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References
Spector, B. (2013). Implementi...
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UNAIDS (2015). Implications of the start ...
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6. Are you having any concerns about how ...
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5. How did you feel about your job before...
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Change Management in an HIVAIDS Research Project

  1. 1. Change Management in an HIV/AIDS Research Project 1 Change Management series 01 Change Management in an HIV/AIDS Research Project By Joe Theu Paper made in the Fulfilment of Capstone for the Masters’ degree in Business Administration Aspen University Supervisor Prof. Kevin Chen 18 April 2016
  2. 2. Change Management in an HIV/AIDS Research Project 2 Change Management series 01 Contents Executive Summary....................................................................................................................................3 Acknowledgements .....................................................................................................................................6 Initial Problem/Opportunity Statement....................................................................................................7 Opportunity.................................................................................................................................................7 Scope issues..................................................................................................................................................8 High Level Overview of Deliverables to Sponsor or Project: .................................................................9 Anticipated Sponsor or Project Benefits...................................................................................................9 Introduction.................................................................................................................................................9 Research Question 1 .................................................................................................................................10 An analysis of the RP................................................................................................................................11 The External Environment ..................................................................................................................11 Threats ...............................................................................................................................................11 Opportunities: ...................................................................................................................................12 Stakeholder Analysis ................................................................................................................................13 Research Question 2 .................................................................................................................................15 Methodology..........................................................................................................................................15 Analysis..................................................................................................................................................15 Results....................................................................................................................................................15 Findings: ................................................................................................................................................17 Limitations.............................................................................................................................................20 Discussion ..............................................................................................................................................21 Recommendations.....................................................................................................................................22 Conclusion .................................................................................................................................................24 Proposed Change Implementation Plan .................................................................................................24 Lessons Learnt ..........................................................................................................................................26 References...................................................................................................................................................28 Appendix 1.................................................................................................................................................29
  3. 3. Change Management in an HIV/AIDS Research Project 3 Change Management series 01 Executive Summary Introduction Research in the era of the HIV/AIDS epidemic is ever dynamic. Scientists embarking on a journey of a research topic that spans over a period of 3 years can anticipate numerous forces to change their primary objectives along the way. We set out to analyze the effect of such forces on a research project named here-in as RP designed to investigate effectiveness of a mixture of HIV prevention strategies on reducing new infections in rural communities. Methods We used SWOT analysis and stakeholder analysis, questionnaires and group discussions to analyze how these forces affect the RP strategy to change and how research employees perceive the implementation of those changes. Findings We found several forces in the external environment of the RP that influence its strategy of survival. The forces that threatened the RP were the emerging studies on HIV prevention and care, the `new World Health Organization’s (WHO) recommendations on treatment and prevention, new epidemics such as those of the Ebola and Zika viruses and the pressures from the regulatory bodies such as the Data and Safety Monitoring Board(DSMB). Research employees accepted (80%) and viewed the changes as necessary (90%). However, research employees were split on how they perceived the introduction of the changes with half agreeing with the process of introducing them while the other half not. Half the employees (50%)
  4. 4. Change Management in an HIV/AIDS Research Project 4 Change Management series 01 felt that the changes directly affected them while 30% felt that the changes did not directly affect them. Several forms of resistance to change surfaced as described Hultman, K. (2016). Employees made critical and fault finding statements at a rate (23.2%) when compared to (31.9%) positive sentiments about the change. Critical statements included “the changes make staff look in- efficient because of (management’s) poor planning”. Blaming and accusing statements were made at a rate of 13% with statements such as “sometimes we change our plans, we are forced to change our plans…we disappoint patients”. Ridiculing statements such as “work is increasing the money is the same…” were made at a rate of 11.6%. Fear was demonstrated at a rate of 11.6% mainly pertaining to job insecurities. Sabotaging attitudes and those of withholding suggestions and help were evident at the rate of 4.3% and 3% respectively. Employee motivation remained almost the same before and after the changes. 60% of employees remained very motivated before and after the changes while only 20% moved from either being moderately motivated to being either being barely motivated or barely demotivated. Recommendations Research Projects need to analyze their external environment in-order to anticipate and to respond to forces in their environment in-order to design and implement changes that are necessary to make their research objectives viable. Research projects in the HIV/AIDS field such as the RP need to avoid what Spector, B. (2013) calls “change implementation traps”. Implementation traps are defined as “the application of appropriate change tools at inappropriate points in the implementation process”. In general, Spector, B. (2013) cites the following steps in- order to avoid implementation traps and to ensure effective change implementation:
  5. 5. Change Management in an HIV/AIDS Research Project 5 Change Management series 01 Follow this order: “Shared Diagnosis 1-REDISIGN: roles, responsibilities relatioships.2. HELP: training, mentoring, coaching. 3. PEOPLE CHANGE: assessment, promotion, replacement, recruitment.4. SYSTEMS and STRUCTURES: reporting relationships, compensation, information, measurement and control”. Conclusion The RP has several forces in its external environment which influence the viability of its continued existence and ultimately alter its objectives in its quest to remain relevant. The RP responds appropriately to these forces by implementing appropriate change. The RP has successfully implemented its change process with an overall acceptance from its employees. However, the RP has also fallen into “implementation traps” by implementing appropriate tools of change at inappropriate stages. There are areas of improvement where the RP needs to work on next time during implementation of change. These areas of improvement can be perhaps addressed by following the recommendations suggested in this paper and the change implementation plan also suggested in this paper. Lessons learnt from this survey can go a long way in improving change management and acceptance in similar HIV research projects.
  6. 6. Change Management in an HIV/AIDS Research Project 6 Change Management series 01 Acknowledgements I would like to acknowledge all employees, the project coordinator for assisting me to complete this paper. I also thank Onkgopotse Miller for endless support despite trying times. Further thanks go to Yewo Theu for his unconditional support during this analysis. To you I say; you are a Great son! To Vanessa Theu, my wife, I say; you gave me the encouragement to give it a go at the MBA as you did on many other accomplishments. You are not here today to witness this but I say all the glory be given to you. May your soul Rest in Peace!
  7. 7. Change Management in an HIV/AIDS Research Project 7 Change Management series 01 Initial Problem/Opportunity Statement Background The Research Project (RP) study is designed to test the hypothesis that applying prevention measures in unison to neighborhoods will cost-effectively reduce new HIV infections in those neighborhoods. This project is implemented by the Ministry of Health, local partners and the international partners. The Problem The RP has implemented and continues to implement changes to its project so as to align the project to the current developments in the field of HIV/AIDS management. These changes have been to adopt the “test and treat” strategy that the World Health Organization (WHO) is recommending for all countries. The outdated protocol which the project currently uses relies on immunological staging (a form of differentiated criteria) to determine the eligibility of HIV positive people on ART treatment. This call for change has arisen upon the findings of the Temprano and most recently the START study that found that delayed ART initiation led to more deaths compared to initiating ART at CD4 counts equal or greater than 500. It no longer makes sense to continue a research project that uses the outdated protocol to pursue its research goals or questions. The findings of a research of that kind would be irrelevant. This situation necessitates change. Opportunity While change is desired, it is not easy to implement large scale change to the whole country without creating other problems. As a result of this realization, the RP could be used as a pilot project to launch these changes in a “phased-out” approach rather than in the “big-bang” approach. In a “big bang” approach, there is considerable risk
  8. 8. Change Management in an HIV/AIDS Research Project 8 Change Management series 01 which the government could incur. Going through the “phased-out” approach through the RP would minimize that risk. The risks arise in that some of these changes not only affect the management of the epidemic but also the people managing the disease. When change is introduced, a lot of things can be affected from patient care to staff management. “It is not unusual for changes to raise project costs by 50% and sometimes even more”, according to Stare, A. (2011). Cost, scope and schedule are usually affected during change therefore, it is crucial to pay attention to how changes are implemented. An opportunity exists within the RP to conduct an analysis of the change management process that comes with this change introduction within the RP project. This will also provide a better opportunity of learning to other HIV/AIDS organizations who are affected by these inevitable changes that come as a result of external forces including the evolving research world at large. Scope issues – In Scope  The project will analyze the perception by employees of the processes so far used in introduction of change in the RP organization.  The impact on human resources such as acceptance or resistance to change, job satisfaction or motivation. Out of Scope  The project will not analyze change in costs, scope, and schedule as this is beyond the sponsor’s approval  The project will not analyze in detail, the RP’s change plan.
  9. 9. Change Management in an HIV/AIDS Research Project 9 Change Management series 01 High Level Overview of Deliverables to Sponsor or Project:  Deliverable 1: Provide a report on changes in employee motivation.  Deliverable 2: Provide a report on degree of acceptance or resistance, forms of resistance, causes and possible steps and possible solutions to employee resistance.  Deliverable 3: Produce a suggested change management template. Sponsor Assistance Needed 1. Interview of employees and management 2. Access to non-confidential study documents Anticipated Sponsor or Project Benefits 1. The sponsor will have an insight into the shortfalls and strengths from the way change is implemented in the organization and possible ways on how change implementation could be improved. 2. The sponsor will benefit from the lessons learnt that will be captured through this project. Introduction In-order to examine change management at the RP, an internal and external analysis will need to be conducted. We will conduct a qualitative analysis of the organization’s change processes in response to the external environment. We will also conduct an internal and external analysis of the organization broadly. The focus will be specifically on how the RP responds to triggers of change and implements change solutions to the organization. We specifically look at the employees’ perception of the steps taken to introduce change and therefore we will zone in at the reaction of
  10. 10. Change Management in an HIV/AIDS Research Project 10 Change Management series 01 employees to those changes. This will therefore lead us to a focus on the acceptance or resistance to the changes. Possible ways to mitigate the forms of resistance will be explored by searching literature. In-order to understand the root causes of this problems that will be elicited at the RP, we will use group discussions, questionnaires and literature review. Both qualitative and quantitative data analysis techniques will be utilized to fully understand the issues around the introduction of change in the organization. In analyzing quantitative data, statistical methods will be used to make meaning of the data. When analyzing data through the use qualitative analysis, content analysis will be used to gain meaning of the themes that are arising from the data. Content analysis is as described by Libweb (2016) “a procedure for the categorization of verbal or behavioral data, for purposes of classification, summarization and tabulation.” We will analyze data at two levels using this method: The basic level will be a description of the data in the way that it has been said without making an attempt to create meaning. The second level of the analysis will be the higher level where an interpretation of the responses will be gained through inference. This will be achieved through coding and classification of data so as to elicit the significant messages. Research Question 1 What are the forces that influence research projects to change their primary objectives?
  11. 11. Change Management in an HIV/AIDS Research Project 11 Change Management series 01 An analysis of the RP The External Environment Threats The external environment of a project such as the RP that is an HIV/AIDS research endeavor, is filled up with a lot of dynamic changes. The goal of a study that sets out at the beginning may not be the same goal that the project pursues in the end. There are a lot of other research projects taking place in the quest to curb the HIV/AIDS epidemic. The findings and outcomes of each project has the potential to influence how any organization involved in the prevention, treatment and care of the disease operates. This means that organizations working on HIV/AIDS research themselves have a higher chance of being influenced by other studies. Such is the situation for the RP. Below is an examination of the threats that the RP faces in its external environment. The Research Environment. Emerging studies The emerging studies in the field of research, in particular, the Temprano study, as cited by WHO (2015) indicate that if people infected with HIV/AIDS are started on treatment sooner, they survive more than their counter parts who are started on treatment only when their CD4 drops below 350. The other study, the START study, as cited by NIH (2015) also indicates that when people are started on treatment early enough, the chance for them to spread the virus to others is reduced. These emerging studies have affected this major strategy of the RP which was among the preventative measures it is testing in combination with other lesser strategies. This question is no longer useful as the other big studies have already proved this to be correct and therefore, the need for the RP study’s existence is almost zero. This means that the RP needs to change its primary goal if needs to exist. This is the major threat to the RP.
  12. 12. Change Management in an HIV/AIDS Research Project 12 Change Management series 01 New World Health Organization (WHO) recommendations to “test and treat” The World Health Organization (WHO) has recommended that countries embark on a policy of “test and treat”. This means that patients should not wait for their immunity to go down before they can be started on treatment. This is largely due to the findings from the other studies which have shown that it is largely beneficial for people infected with HIV and their communities if people infected with HIV are put on treatment universally. This has meant that the issue of when people start treatment when they are infected with HIV is no longer a research issue but is a policy one. This is a threat that the RP also needs to deal with. New Epidemics The emergence of new epidemics such as those of the Ebola virus and the Zika virus are major threats that threaten the diversion of donor funds from initiatives combating the HIV/AIDS epidemic. The RP needs to prove to donors that its continued existence adds more value than when it is stopped. The Data and Safety Monitoring Board The Data and Safety Monitoring Board is a body which oversees all the health research worldwide and monitors the relevance of research especially in terms of safety of the participants and the viability of the data that comes out of the research. The board reserves the right to cancel any study that it deems to be pursuing a cause that is no longer useful for the research community and the health world. At any point, the RP could be stopped by this body. Opportunities: The HIV/AIDS Treatment Guidelines
  13. 13. Change Management in an HIV/AIDS Research Project 13 Change Management series 01 The new HIV/AIDS Treatment Guidelines which emphasize immediate treatment of people who tested positive. The RP is already conducting massive HIV testing campaigns in the communities. This places the RP in the right position to be a leader from whom other organizations can learn in implementing their own programs in working with large numbers of people being put on treatment from RP study sites. This may make the policy makers to want to maintain the RP to act as a lead in the introduction of this new treatment policy. Renewed political commitment to the fight against HIV/AIDS The political situation in the world at large as well as in the country under study specifically has seen renewed vigor to the fight against HIV/AIDS since the advances made towards curbing the epidemic have become apparent. A trend has become apparent that the incidence of HIV is decreasing in the most hit countries as well as in the whole world at large. As a result of this, there is a palpable general feeling among political leaders to do more in this fight which at first seemed insurmountable. This presents the RP with the opportunity to get financial support necessary for its continued existence. In summary, the RP needs to modify its strategy and goals so as to be in line with the trends in its environment. The trends in its environment present it with threats which it needs to overcome using its internal strengths as well as capitalizing on the opportunities the external environment present. These opportunities are the New HIV/AIDS guidelines and the renewed political will in the fight against HIV/AIDS. Stakeholder Analysis
  14. 14. Change Management in an HIV/AIDS Research Project 14 Change Management series 01 Liz Mac Dean Dan Coleman Organization International Partner Local Partner Min of Health Sponsor partner Regulatory body Role on project Project Lead partner Lead local partner Director General Lead sponsor regulator Unique facts Very particular with meeting deadlines Very open and mature leadership, experienced in the local health system Custodian of the health system of the country/well versed in research statistics and public health. Very busy at this very high position Major stakeholder very friendly and excellent listening skills Very busy approves large amounts of research work and proposals in the country/works with few staff, has challenges meeting deadlines because of this Level of interest Very high Very high Very high Very high low Level of influence high medium Very high Very high Very high Suggestions on managing relationship Must have weekly meetings with her Can have monthly meetings with him Must be updated about the study monthly Do not have direct contact but must go through Lisa regularly for close and regular contact Must have a cordial relationship so that our work can be prioritised on his desk
  15. 15. Change Management in an HIV/AIDS Research Project 15 Change Management series 01 Research Question 2 How do employees perceive introduction of Change in HIV/AIDS Research Projects like the RP? Methodology Thirteen conveniently selected employees were involved in the study. Ten of the thirteen were given the questionnaires to provide responses. Three employees were requested to participate in a group discussion using the questionnaire as a guide. The questionnaire had two sections, one on acceptance and resistance of change and the other had questions on employee motivation. Five of the questions required discreet answers of either Yes or No while the rest could take any amount and form of text entries. Analysis The discreet responses were quantified using simple mathematics to calculate percentages. The texts were coded into themes according to a table cited by Hultman, K (2016) as representing forms of resistance and the number of texts falling into the categories of the themes was quantified and calculated into percentages. Results Discreet questions on acceptance and resistance Question Yes NO Q1 8 0 Q4 9 0 Q5 5 5 Q6 4 4
  16. 16. Change Management in an HIV/AIDS Research Project 16 Change Management series 01 Q9 5 3 Responses to Questions on Motivation Motivated Demotivated Question Very moderately barely very moderately barely Q4(After change) 6 1 1 0 0 1 Q5(Before change) 6 3 0 0 0 0 Theme analysis and coding adopted from Hultman, K (2016) Theme Frequency Percentage Critical/fault finding 16 23.2 Ridiculing 8 11.6 Using facts selectively 0 0 Appear to fear 8 11.6 Blaming/accusing 9 13.0 Distorting facts 0 0 Sabotaging 3 4.3 Intimidating /threatening 0 0 Starting rumor 0 0
  17. 17. Change Management in an HIV/AIDS Research Project 17 Change Management series 01 Arguing/raising objections 0 0 Agreeing only verbally 1 1.5 Failing to implement 0 0 Procrastinating 0 0 Feigning ignorance 0 0 Withholding information, suggestions 2 3 Standing by watching things fail 0 0 Positive attributes 22 31.9 Total 69 100 Findings: Acceptance of Change Majority of the employees (80%) welcomed the changes introduced in the project so far while the 20% were non-committal in their responses. Employees accepted and embraced the change which the saw as the right way-forward not only for the project but also as the right approach towards the management of HIV/AIDS. Necessity of Change The majority of the participants (90%) believed that the changes were necessary with the 10% being non-committal.
  18. 18. Change Management in an HIV/AIDS Research Project 18 Change Management series 01 Introduction of the Changes The employees were split on how the perceived the introduction of the changes with 50% believing that the changes were introduced in the right manner and the other 50% believing that they were not. Effect of the change on Employees Half (50%) of the employees indicated that the changes directly involved them while 30% of employees believed that the changes did not directly affect them. 20% were non- committal in their responses. Description of Acceptance and Resistance to Change The types of resistance described by Holman, K. (2016) listed in the table 1 below were used as themes that emerged in the analysis. The following were the findings according to each theme in each category. Positive Attitudes towards Change Overall, there were 31.9% positive reactions towards changes implemented in the project. Such statements as “‘test and treat’ (the change theme) will bring in more lost patients” “test and treat will make us earn more certificates because we will be trained”. Critical and Fault Finding Critical and fault finding themes emerged as the next highest category of reactions at 23.2%. The predominant statements were statements such as “the changes make staff look in- efficient because of (management’s) poor planning”. Staff were critical of management’s apparent lack of proper planning or sudden notices of changes or plans. Staff feel that at times,
  19. 19. Change Management in an HIV/AIDS Research Project 19 Change Management series 01 they could not complete their tasks because of these frequent sudden changes. Staff complained of not being involved in the process of change introduction and given not to have been given a chance to contribute: “they were not done in the right manner, they are done fast, people were not given a chance”. Blaming and Accusing At times staff were blaming or accusing (13%) in their reactions to change. They blamed the management for putting them in awkward situations. “Sometimes we end up borrowing money to go for abrupt workshops…they will just say I want you here in the morning”. Other reactions were “the changes were harsh”. There was “too much movement of staff”. Sometimes we change our plans, we are forced to change our plans…we disappoint patients (for example those who come) for blood collection. Ridiculing There were some ridiculing reactions towards the changes at a rate of 11.6% with some statements such as “do the public know about this (change) yet?” “Our posts are being advertised…it is tea time to go”. “Work is increasing, the money is the same”. Fear Staff expressed fears at a rate of 11.6%. The fears were related to the loss of their jobs or insecurities. They were not sure whether the project was going to continue for long or whether their posts were going to be kept. They also feared that their workload was going to increase. Some statements showing fear were “(we are) seeing other people losing their jobs…anytime it is... time to go”. “These changes affect me because they affect my job…it may be decided (for the project) to be stopped”.
  20. 20. Change Management in an HIV/AIDS Research Project 20 Change Management series 01 Sabotaging Elements of sabotage (4.3%) were also present. Most of this represented looking for other jobs and then quitting as soon as opportunity presents itself meaning that the project would go with a vacant post. “If we find a stable position outside, we will quit”. Withholding information/suggestions/help/support The reaction of withholding either information, suggestions, help or support accounted for 3% of the reactions. “We just do what you have been told to and (we) accommodate (it) but we (only) meet their needs not our needs or patient’s needs”. Employee Motivation Employee motivation after the changes remained almost the same as before the change. 60% of the employees felt very motivated with their job before and after the change. However, 20% of the employees moved from either being very motivated or moderately motivated to being either being barely motivated (10%) or barely demotivated (10%). Limitations The sample size may not be representative of the employees for two reasons: 1.The sample size of 13 employees might not be representative of the full contingent of protocol 3 implementing staff. The convenient sampling method may cause bias in the findings. Statistical tests of significance have not been used to examine the differences observed. The investigator is part of the team and their bias cannot be eliminated both from the participants and from the investigator’s perspectives.
  21. 21. Change Management in an HIV/AIDS Research Project 21 Change Management series 01 Discussion Spector, B. (2013) recommends four steps that start with shared diagnosis in implementing change and cautions against what are called “implementation traps” in the roadmap to change implementation. The “implementation traps” are defined as the application of appropriate change tools at inappropriate points in the implementation process. Texts from the findings such as “seeing our colleagues lose their jobs” and then “test and treat will make us earn more certificates because we will be trained” suggest that structures were changed first and positions lost before training was conducted which means structures were changed before training for behavior change was effected. This has the problem of substituting refreezing with unfreezing. Here, employees are still attached to the old social behaviors which may then cause resistance. By skipping the process of shared diagnosis, which as opportunity for building commitment and harvesting from the knowledge that is rooted deeply and diversely within the staffs, managers fall into another implementation trap and may be implementing out of touch strategies. As advanced by Spector, B. (2013), retrenching employees as observed above without giving them an opportunity to be trained on the new change processes may be seen as unfair, arbitrary and may reduce trust as well as commitment. In general, Spector, B. (2013) cites the following steps in-order to avoid implementation traps and to ensure effective change implementation: Follow this order: “Shared Diagnosis 1-REDISIGN: roles, responsibilities relatioships.2. HELP: training, mentoring, coaching. 3. PEOPLE CHANGE: assessment, promotion, replacement, recruitment.4. SYSTEMS and STRUCTURES: reporting relationships, compensation, information, measurement and control”.
  22. 22. Change Management in an HIV/AIDS Research Project 22 Change Management series 01 Recommendations 1. Employee of Engagement and Training The lost opportunity of engagement should now be utilized by making sure employees are engaged and trained about the changes. If possible, each training should be certified as the employees seem to seek career advancement benefits from the change process. Employees want to see these changes translate into visible benefits for patients. It would be useful to quantify the impact of the changes on the quality of care of patients and communicate this to staff regularly. Employees need to be involved when planning activities and further changes. They need to be assured that interruptions in their work will not be accounted for in assessing their efficiency. In-order to do this, care need to be taken to ensure that when events are planned, employees are asked to specify how the change affects their work. The stakeholders who are crucial in making sure that this recommendation is successful are the training coordinators who are based at the international partner. These are under the control of Liz according to the stakeholder analysis. Liz can influence the training coordinators and make sure that they not only the employees but also issue them with meaningful certificates which they can use to further their career prospects. The hindering factor is that certifications require organization on the part of training coordinators who need more time and resources to print certificates and to acquire accreditations. However, it is possible that the international partner’s management could allocate the trainers more resources and time to achieve this. 2. Improve Employee Welfare
  23. 23. Change Management in an HIV/AIDS Research Project 23 Change Management series 01 When employees are called to attend meetings at places outside their work stations, logistics need to be put in place to facilitate the ease with which they conduct their duties. This will prevent them from blaming the job for the debts they at times incur for such arrangements. These arrangements involve accommodation, transportation and food. The enabling factor for this recommendation is the HR department of employees. The stakeholders that can influence this are the PS of the Ministry of Health. The PS can ensure that policies are put in place whereby every employee is well cared for during trainings outside their duty stations. This policy can be made at the highest level and can be made as a requirement for all workers working in the health field. The hindering factors are the unavailability of funds. The mitigating factors are allowing the communication plan described in the table above to be implemented. 3. Improve Clarity on job security The process of retrenchment has to be explained explaining the criteria well in-advance if there are to be retrenchments. A human face has to be seen handling the welfare of employees who have been retrenched so that employees still on the job may be reassured that their welfare is at the heart of the organization. This may not necessarily need monetary assistance. Activities such as employee counseling and support and job references may help. Again the enabling factor is the international partner’s management which can influence the HR department in implementing this resolution. 4. Employee Involvement/ Install enablers of dialogue The organizational silence that persists that candid feedback and open shared dialogue is to be avoided in the organization should be removed. Some steps that can be followed to this are
  24. 24. Change Management in an HIV/AIDS Research Project 24 Change Management series 01 installing enablers of dialogue such as doing away with executive parking and cafeteria tables, putting the rest of the staff on the same payment scheme rather differentiating others, and using casual communication such as use of first names. The enabling factors of this are the use of the MOH PS to create such an environment which will be act as an example for the other stakeholders. Conclusion The RP has several forces in its external environment which influence the viability of its continued existence and ultimately alter its objectives in its quest to remain relevant. The RP responds appropriately to these forces by implementing appropriate change. The RP has successfully implemented its change process with an overall acceptance from its employees. However, the RP has also fallen into “implementation traps” by implementing appropriate tools of change at inappropriate stages. There are areas of improvement where the RP needs to work on next time during implementation of change. These areas of improvement can be perhaps addressed by following the recommendations suggested in this paper and the change implementation plan also suggested in this paper. Lessons learnt from this survey can go a long way in improving change management and acceptance in similar HIV research projects. Proposed Change Implementation Plan Month 1 Month 2 Month 3 Month 4 Month 5 Month 6 Leadership alignment Vision worksho ps mission Change agent booklet Change agents Alignment workshop Individu al coaching
  25. 25. Change Management in an HIV/AIDS Research Project 25 Change Management series 01 Organizati onal design Process definitio n Process definition Chart finalization/r oles specifics Chart finalization/r oles specifics Process training/empl oyee mentoring Transitio n phase Individual developme nt Cultural training Cultural training Cultural training Role training Cultural identity Mission, vision disseminat ion workshops Communicat ion program Communicat ion program Communicati on program Team building Company day Team objective workshops High performance teams workshops Global Team workshops Global Team worksho ps Employee motivation Employ ee satisfacti on survey Project member recognitio n Project member recognition Employee satisfaction survey Individual Cafeteria program Satisfact ion survey
  26. 26. Change Management in an HIV/AIDS Research Project 26 Change Management series 01 Lessons Learnt Focus area Low 1 2 3 4 High 5 Successes shortcomings Recommended solutions Change Introduction x Changes necessary Manner abrupt- non-engaging Shared diagnosis(unfreeze) Change implementation x Implementation steps not in- order Follow this order 1-REDISIGN roles, responsibilities relatioships.2. HELP training, mentoring, coaching. 3. PEOPLE CHANGE assessment, promotion, replacement, recruitment.4. SYSTEMS and
  27. 27. Change Management in an HIV/AIDS Research Project 27 Change Management series 01 STRUCTURES, reporting relationships ,compensation, information ,measurement and control Employee Welfare x Work hygiene factors not conducive Attend to hygiene factors of job security, work environment and work conditions Employee Motivation x Motivation maintained No specific program for employee motivation Address employee motivational factors-recognition and mastery, reward routine non-cognition jobs with appropriate financial compensation
  28. 28. Change Management in an HIV/AIDS Research Project 28 Change Management series 01 References Spector, B. (2013). Implementing Organizational Change. 3rd edition. Pearson. Boston Christensen et al (2016). Research Methods, Design and Analysis. 3rd Edition. Pearson. Boston. RP (2016). The CP Protocol. Unpublished Notes Stare, A. (2011). Reducing Negative Impact of Project Changes with Risk and Change Management. Retrieved from http://search.proquest.com/pqcentral/docview/913401431/3398DAC60FC84E23PQ/6?ac countid=34574 Hultman, K. (2003). Managing Resistance to Change. Retrieved from http://www.academia.edu/595772/Managing_Resistance_to_Change Sundaram, A. (2015). Resistance and types of resistance to change. Retrieved from http://www.slideshare.net/AjithSundaram1/resistance-and-types-of-resistance-to-change Libweb (2016). Analyzing Qualitative Research Data. Retrieved from http://libweb.surrey.ac.uk/library/skills/Introduction%20to%20Research%20and%20Man aging Stare, A. (2011). Reducing Negative Impact of Project Changes with Risk and Change Management. Retrieved from http://search.proquest.com/pqcentral/docview/913401431/3398DAC60FC84E23PQ/6?ac countid=34574
  29. 29. Change Management in an HIV/AIDS Research Project 29 Change Management series 01 UNAIDS (2015). Implications of the start study data questions and answers. Retrieved from http://www.unaids.org/sites/default/files/media_asset/2015_Implications_of_the_START _study_data_en.pdf MOH (2016). 2016 Treatment Guidelines. Unpublished document. NIH (2015). QUESTIONS AND ANSWERS The START HIV Treatment Study. Retrieved from https://www.niaid.nih.gov/news/QA/Pages/STARTqa.aspx WHO (2015). WHO welcomes new evidence on the use of antiretroviral for prevention and treatment of HIV infection. Retrieved from http://www.who.int/hiv/mediacentre/news/croi2015-arvnews/en/ Appendix 1 Questionnaire on change 1. Do you welcome the changes that have been introduced into the project? 2. Which changes do you particularly like? 3. Which changes do you not like? 4. Do you believe that the changes were necessary? 5. Do you believe that the changes were introduced in the right manner?
  30. 30. Change Management in an HIV/AIDS Research Project 30 Change Management series 01 6. Are you having any concerns about how the changes were introduced? 7. How did you respond to the changes you did not like? 8. How do you plan to keep responding to these changes? 9. Do the changes directly affect you? 10. How do you think these changes affect you Questionnaire on Employee Motivation 1. What do you like about your job with the CP? 2. What is it that stands in your way to do your job perfectly? 3. Has anything changed with your job that motivates or demotivates you to perform your duties? 4. How do you feel about your job? 1. Very motivated. 2. Moderately motivated. 3. Barely motivated. 4. Very Demotivated. 6. Moderately demotivated. 7. Barely demotivated.
  31. 31. Change Management in an HIV/AIDS Research Project 31 Change Management series 01 5. How did you feel about your job before the changes you mentioned above? 1. Very motivated. 2. Moderately motivated. 3. Barely motivated. 4. Very Demotivated. 6. Moderately demotivated. 7. Barely demotivated.
  32. 32. Change Management in an HIV/AIDS Research Project 32 Change Management series 01
  33. 33. Change Management in an HIV/AIDS Research Project 33 Change Management series 01
  34. 34. Change Management in an HIV/AIDS Research Project 34 Change Management series 01

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