Case Study Analysis

Due Date: Sunday, 16 November - submit online

Word Count: 2000 words
30% of Module Grade
Assignment Questions
Work as a team to address the following questions in your analysis, incorporating references to the
relevant literature. Include an introduction and conclusion.

What is your assessment of Morath's leadership of the organisation change process at

Childrens'? Consider the challenges she faced during the transformation process and evaluate her
effectiveness in addressing these challenges.

What change management insights have you gained as a result of this assignment? How do
they relate to your experience/how can they be applied in the workplace?

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Table of Contents

1.0

Introduction.......................................................................................................3

2.0

Organisational change Process.........................................................................4

2.1 Childrens Hospital and Clinics Moraths Change Initiative.........................................4

3.0

Evaluation of Moraths Change Process.........................................................5

3.1 Core Team........................................................................................................ 5

3.2 Change Vision................................................................................................... 6
3.3 Communication of Vision..................................................................................... 6
3.4 Employees empowerment...................................................................................... 7
3.5 Safety initiative Implementation............................................................................. 7
3.6 Was Moraths change process effective....................................................................8

4.0

Transformation Challenges..............................................................................9

4.1 Gaining stakeholder buy-in for a vision, knowing that it would likely take time to show any
measurable results;.................................................................................................. 9
4.2 Building a vision that appealed to all whilst at the same time managing perceived status
differences in the hospital environment;.......................................................................9
4.3 Gaining and maintaining the trust and respect of the workforce..................................10
4.4 Accurately assessing the safety climate in the hospital without impacting on workforce
morale................................................................................................................ 10
4.5 Building a framework for improvement that could be sustained without her direct oversight
......................................................................................................................... 11

5.0

Moraths effectiveness in addressing challenges...........................................11

5.1 Nurturing Psychological Safety at Childrens..........................................................11

5.2 The Trust Dynamic........................................................................................... 12
5.3 Infrastructure and Sustainability..........................................................................14

6.0

Team members Insight....................................................................................14

7.0

Application of Lesson Learned in the Workplace.........................................14

8.0

Conclusion.......................................................................................................14

9.0

Reference.........................................................................................................14

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1.0Introduction
Increasingly organisational change is something which is a necessary undertaking as external
factors such as regulatory changes, technological developments and increased competition
put pressure on organisations to adapt to the challenges that are posed.

Kotter and

Schlesinger (2008) noted that most companies or divisions of major corporations undertake
major change every four or five years.
Leaders of change and transformation in organisations face many obstacles in achieving their
transformation goals. However, according to Kotter and Schlesinger, change strikes fear into
people, it means disturbance of the status quo, vested interests in peoples jobs are
threatened, and it can upset the regular way things are done.
Over the course of this paper there will be an evaluation of the effectiveness of the change
programme that occurred in the structures, systems and culture in Childrens Hospital and
Clinics, and how the new appointed Chief Operating Office Juile Morath spearheaded the
transformation programme. The style of leadership and how resistance to changes were
overcome will also be discussed.
Also there will be an outline of the lessons observed from Julie Moraths transformation
journey of Childrens hospital and the key concepts from the relevant articles that can be
applied to making leading change in Organisations.

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2.0Organisational change Process

Organisation vision and leadership drive successful change, for the change efforts to thrive,
leader must build trust at all levels of the organisation and learn to communicate effectively.
He/She must be cultural and emotional intelligent, and develop cognitive knowledge of the
working surrounding especially when pushing through organisational change to develop a
sense of connection with the employees.
It is when employees and management share common perspectives and expectations of the
company strategic directions, change process becomes an opportunity to redefine employees
commitment to new goals. Nonetheless, the leadership style to facilitate effective change
varies. In one hand, some leaders will adopt autocratic behaviour while others will deploy
democratic or laissez-faire leadership style, even combined difference leadership style to
achieve organisational objective. In another hand, some leader will force change- as the case
of narcissism leader, while other will seek for inclusion and consensus- as the case of
emotional intelligence leader.
In order to have control over the process of change thus minimize the risks of failure, the
change process must be evaluated, well-planned, and carefully implemented. There is no-onesize-fits-all to change strategy, every situation called for different solutions. Transformation
in a company advance through stages, Kotter & Schlesinger (1979) recommended three steps
to successful manage change. 1) Analyse situational factors, 2) Determine the optimal speed
of change, and 3) Consider methods for managing resistance.

2.1 Childrens Hospital and Clinics Moraths Change Initiative

Edmondson et al. (2001) tell us how Julie Morath a newly employed Chief Operation Officer
(COO) at Childrens Hospital and Clinics in Minneapolis implement a successful patient
safety initiative. The change process approaches she deployed to quench resistances, and the
major transformation challenges she faced in the process of implementing patient safety
initiatives in the Childrens.
Crisis is the trigger of change initiative in the childrens hospital, it a reactive change rather
than proactive change that threat childrens hospital survival. Overdose of morphine
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administered to Matthew is one case out of many cases of medical errors in the childrens
hospital. According to Morath 98,000 people died annually from medical errors nationally.
Patient safety and quality improvement in childrens hospital is the number one priority of
Morath, she would not want the patients to perceive childrens as unsafe in her watch.
Though, culture cannot change overnight. To orchestrate change successfully in the childrens,
is an ultimate test for Morath, because it takes time to plan, nurture and alter how people think,
feel, and behave.
Argumentatively, it is noteworthy to highlight that Julie Morath has never led a wide
organisational transformation initiative or implement a continuous improvement program in a
large organisational setting. Therefore, we could argue that her people management experience
is minimum. After all, she was hired because she was an excellent manager and an expert on
patient safety. Prior to this appointment she was a manager not a leader, to make change happen
you need to be both a manager and a leader. Now, Morath has a senior leadership position at
childrens and a burning desire to implement patient safety initiation. Which raise the question
of how effective is Moraths change process at the Childrens.

3.0Evaluation of Moraths Change Process

Starting a change program requires cooperation of many people, the top-management backing
and employees buy-in are critical to make the transformation happens. Morath has the backing
of the company CEO and the hospital Medical Director. In fact, the patient safety initiative is a
brainchild of the CEO who identified the need to change the hospital safety policy and
procedures. Morath was hired by the Childrens CEO based on her experience on the subject of
patient safety to change the system and make the transformation happen.

3.1 Core Team

Moraths kick started the change process by assemble the team of key influential, and highly
respected people, dedicated to provide superior patient care in the Childrens hospital to play
lead role in the patient safety initiative. However, what we dont know is the extent of the team
members share commitment to the patient safety initiative and the level of the individual team
member desire to effect change in their area of expertise. The selection criteria she used to
select the patient safety team is questionable. When selecting change process team members,
Katzenbach et al. (2012) suggested enlisting those people who have track record of
motivating their team effectively. In a radical top-down change approaches as in the case of
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childrens Hospital, top-management team make decisions and impose the change on
employees.

3.2 Change Vision

To drive a wide organisational change you need to have a vision to direct the change efforts.
Moraths envision of the childrens Hospital from the onset is to create a hospital centred
around patient safety and quality improvement. A hospital that focus on patient comfort and
safety, a place where patient safety is the problem of everyone in the hospital. It is not just the
responsibility of the frontline people, but also owned by administrators who interact with the
system daily. According to Edmondson et al. (2001) Morath wants to create a culture where the
concept of do no harm was explicit rather than implicit. The work of many authors in the
field of organisational change identified the need to create change vision to have the picture of
the desire future state.
To put the vision on a wheel within the few months in the job, Morath decided to do three
things. 1) Present the vision to the employees- she understands that employees buy-in is
critical to ensure the transformation success. 2) Gather vital information through the focus
group to know more about patient safety issues at the children- Morath used the focus group to
promote psychology safety, to encouraged people to speak up without fear. 3) Develop the
strategic plan for the initiative- it is the inputs for defining how the future state will be.

3.3 Communication of Vision

A clear communication is the bedrock of change process success. Morath used different modes
of communication to reach the childrens employees. Morath communicates her vision of
patient safety through presentation to seek consensus and support among employees. The
message of change she was selling did not initially resonated with the staffs, her opening sound
as a warning to the employees to improve service quality rather than as an appeal to see change
as an opportunity to provide exceptional service to the patients. Morath herself realised that her
early presentation create scepticism among staffs. Although, during other numerous
presentation, she changed the tune of the message, to highlight and reiterate the need for
change.
Morath knew that culture of blame and finger pointing prevent childrens employees from open
up. She creates forum and focus group to encourage people to speak up openly about error
without fear. She knew that talking more openly promote psychology safety, and facilitates
open information sharing and communication. The forum and focus group help to build
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awareness of patient safety and produce wealth of information about the progress of the
initiative. For example, the focus group helps one of the neonatal intensive care nurse to
become a key participant in the initiative.

3.4 Employees empowerment

Moraths approach to change process encourage inclusion and participation. Employees
involvement and commitment to change is important from the onset to make the change work.
Smollan (2006) suggests that organisation that introduce change need to gain the
hearts and minds of their members if the change is to be successful. Change is

characterised by certainty and uncertainty, and it also involve risk and control. To curb
resistance, she sought out employees at all level of the hospital- key influencers in their field. In
an attempt to rally for support of every employees. She creates a forum to reach to those staffs
at childrens Hospital that cannot shape change but have responsibility in shaping the
consequence of change in their working area in the hospital. Change involves learning new
things and new way of doing things, Morath knew that to make the change work employees
must have the skill required to make the desire change. She institutionalised learning and
training in the childrens by invite national speakers to give mini courses on safety.
Morath focuses was not just to implement safety initiative but to also create a learning
organisation that can adapt to change. In sustaining the change gained, it is important to
unlearn the past culture Morath intended to change, and to develop a culture that value
creativity and encourage innovation to be able to produce new ideas when Morath is long
time gone.

3.5 Safety initiative Implementation

Morath culture of openness was nurtured through deployment of Patient Safety Dialogues,
Blameless Reporting, a common language, and Disclosure Policy. Moraths new policy bring
employees, management, and patients together to share critical information on safety and
discuss a common issues affecting them. A sense of togetherness grow in the childrens
hospital as the result of the open culture propel by the safety initiative. Employees are able to
discuss medical errors, learn from each other mistakes, and make suggestion on possible
improvement. Management discuss misdiagnosis or medical errors with the patients without
fear of legal implications. For example, the parent of the teenage boy who died of aggressive
cancer due to medical misdiagnosis did not received apology under the old disclosure policy,

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the old culture cultivate dishonest and lies. Under new complete disclosure regime, the
Childrens CEO apologised and offer assistance to the family.
To effectively implement the new initiative, Morath put in place several structures and
processes to implement the safety initiative- include patient safety reporting and new process
for examining serious accidents. Morath appoint steering committee which she chair herself
to oversee the safety initiative project. The committee make critical decision in regard to the
direction of the safety initiative project. Moraths behaviour exhibits consensus decisionmaking affiliated to democratic leadership style. For example, to gain buy-in of the doctors and
nurses, she seeks suggestions and gather ideas from the medical director, and she will take no
action without approval of patient safety committee. Morath behaviours facilitate psychology
safety as we have seen. However, it does not mean that the steering committee are not suffering
from groupthink. For example, the Patient safety steering committee consist of various
committed and dedicated people of different professional background. For the fact that Morath
Chair the steering committee, there might be a desire for conformity among committee
members which might threat long time sustainability of safety initiative.
Morath dedicates reengineering of the Childrens hospital medication administration system
to the pharmaceutical director with no prior knowledge of continuous improvement with the
goal of zero defects. A focus leader is aware of how their subordinates see them and
understand what others need from them. For the pharmaceutical director to thrive in this
improvement project, he will need to embark on learning trail. Morath provides the support,
motivation and encouragement and acts as a teacher, coach, and mentor to the project lead to
ensure the goal is achieved in parallel with the safety initiative plan.

3.6 Was Moraths change process effective

Morath creates appealing future picture of the patient safety initiative, she motivates people
to follow her vision, and clearly communicate the type of changes she envisages for
childrens to all the employees from management to the frontline staffs. She involves team
members by communicating the need for change as early as possible, helping them to
understand what the change will means for them. Morath engaged and involved the
employees from the onset to ensure they are committed to the safety initiative. She
establishes structures, processes, and change policies to effect the initiative. Morath formed
cross-functional core team and put steering committee in place to ensure the project become
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reality. She ingrained safety DNA in the childrens, and to sustain the gain, she hired someone
with similar background to ensure the initiative stay on track.
The work of Kotter & Schlesinger (1979) suggested that to lead transformation successfully,
the change agent must determine how much resistance and the kind of resistance that can
possibly inhibit changes. Morath did not carry out situational factors analysis that would have
help her to understand the nature of resistance, what can hinder the initiative and how to deal
with the resistance that will hamper change in the childrens. For example, people concerns
regarding accountability, disclosure and legal issues, and resources allocation wound have been
identified from the onset of the initiative.
Cultural scanning of the childrens in the beginning of the safety initiative would have benefits
Morath significantly to identify prevalent culture in the hospital she can aligned with the safety
initiative strategy. Katzenbach & Kronley (2012) said project initiative strategys
effectiveness depends on cultural alignment. Morath did not observed the prevalent behaviour
in the childrens before embarked on a change, is the project success a mere fluke. Although,
the patient safety initiative was considered a success but not without challenges that would
have undermine the initiative.

4.0 Transformation Challenges

4.1 Gaining stakeholder buy-in for a vision, knowing that it would likely take time
to show any measurable results;
Hospitals are fast paced, highly complex environments with multiple stakeholders. Aligning the
interests of this complex stakeholder group without damaging key stakeholder relationships
would have been a significant challenge for Morlath. In hospitals, staff are constantly
competing with a hectic schedule and for the most part want to avoid taking time out from their
patients. In Tucker and Edmondsons study of hospital nursing care processes, they observed
that nine out of ten nurses stayed on over 45mins after their shift had finished, without extra
pay, to ensure their patients needs were addressed appropriately. Given that Morath was new to
not only the role but also the hospital, she would have been under pressure to effect change in a
timely manner and to evidence that any time diverted from patient care was beneficial and
quantifiable. If Morath could not do so she would run the risk of losing credibility and
subsequently the support of workforce and key influencers.

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4.2 Building a vision that appealed to all whilst at the same time managing
perceived status differences in the hospital environment;
In Tucker and Edmondsons article Why Hospitals Dont Learn from Failures they refer to the
relatively low status of nurses as front-line employees. To successfully effect change Morath
would need to secure active involvement and commitment, not just from nurses, but from the
whole spectrum of hospital employees and stakeholders from porters to consultants, to patients,
to patient families. To achieve this Morath would need to identify and dispel any perceived
status differences, nurture psychological safety and create an environment which encouraged
open, frank and honest discussion whilst at the same time protecting people from blame or
finger pointing. A delicate balance to strike and one in which one false move could jeopardise
the entire initiative.

4.3 Gaining and maintaining the trust and respect of the workforce
As outlined above, Morath was new to the role and the hospital. In Hurleys article The
Decision to Trust he sets out some pretty stark statistics in his opening paragraph Roughly
half of all managers dont trust their leaders, 310 out of 450 executives surveyed by Hurley
agreed with the statement I just dont know who to trust anymore and lastly, in a survey of
800, 4 out of 5 had only some or hardly any confidence in the people running major
corporations
Gersick (1991) distinguished between incremental and radical change and observed that
radical change produced more emotional reaction. It also generated more negative and intense
emotions. The change which Morath was proposing was not incremental but radical and
therefore, should Morath be unsuccessful in gaining the trust of workforce and other
stakeholders it would all but preclude her from successfully delivering on the Patient Safety
agenda at Childrens.

4.4 Accurately assessing the safety climate in the hospital without impacting on
workforce morale
In why Hospitals Dont Learn From Failures, Tucker and Edmondson introduce us to three
interesting concepts; Individual vigilance, first order problem solving and second order
problem solving they also observed that in instances where a nurse encountered a problem in
their course of duties, they were more likely to ask for help from someone who was socially
close as opposed others who might perhaps be better equipped to correct the problem.
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Before Morath could address any of the problems or opportunities within the hospital she
would first need to get visibility of them to enable proactive assessment of system weaknesses,
close calls and unsafe conditions. Morath would need to guide people away from first order
problem solving activites which could potentially obscure the existence of problems thus
preventing reform.
Morath wanted to talk openly about problems, mistakes, near misses and other potentially
contentious issues however, the approach she would take in doing so would need to be well
considered and thought out to mitigate the risk of workforce demotivation and the evolution of
environment characterised by low levels of trust.

4.5 Building a framework for improvement that could be sustained without her
direct oversight
Morath obviously had a vision for the hospital which a less successful leader may have tried to
push through without effective communication or collaboration Morath would need to avoid
the possibility of becoming blinkered and actively take the time to stop and listen to others
around her. She would need to build a framework for improvement which could be sustained
without her direct involvement and an organisation which placed a strong emphasis on
organisational learning.

5.0 Moraths effectiveness in addressing challenges.

As outlined above, Morath faced many challenges during the transformation at Childrens, any
or all of them could have pushed the patient care agenda completely off course and could have
resulted in reputational damage for both the hospital and Morath as a leader. The stakes were
particularly high and so nothing could be left to chance.

5.1 Nurturing Psychological Safety at Childrens

From the case study, it is clear that from the very outset Morath was already aware of and
addressing some of the challenges she would face. As early as the interview stage Morath was
adopting practices to enable her to build trust and nurture psychological safety, she met and
talked with employees about her vision of patient safety and had carefully crafted
conversations about her vision of patient safety with, as she describes it people who would
have to be on board with the initiative. This evidences an acknowledgement by Morath that
she would need to gain the trust of the workforce and put in the spade work to align the entire
workforce behind the vision of Patient Safety at Childrens.
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Morath was acutely aware that refining and implementing the vision would require active
engagement and involvement from not just the management team and directors but also front
like workers, as a result she communicated openly with the workforce and placed regular
emphasis on the value of their contribution irrespective of perceived status, which in turn,
created a psychologically safe environment where people felt appreciated and therefore were
more open to contributing to discussions and offering up their own personal experiences of
patient safety at Childrens.

5.2 The Trust Dynamic

Leadership is most difficult when a situation is changing or perceived as unstable in some way.
The appointment of a new Chief Operating Officer in itself, would have most likely been
perceived as a radical organisational change and in such, would have caused the workforce to,
as Smollan (2006) describes it undertake an analysis of the perceived favourability of the
outcomes of the change for themselves, for others and for the organisation.
Smollan (2006) also details three other assessments which are regularly undertaken by those in
change environments; an assessment of the perceived justice of the change, an assessment of
the scale of the change and an assessment of the speed and timing of the change. These,
coupled with the assessment of the favourability of the change would largely dictate the
cognitive responses to the change in terms of the relative positivity or negativity of same.
Morath demonstrated a high level of emotional intelligence during the transformation process.
She would need to balance competing demands whilst at the same time not compromising the
initiative. Her studies had helped Morath understand that employee/workforce responses could
potential alter aspects of the change process. In the context of the considerations Smollan
(2006) refers to, the scale of the change at Childrens was inevitably going to be large, the speed
and timing of the change would need to be prompt to maintain momentum and so Morath
seemed to appreciate that the two key areas she would need to hone in on were the perceived
justice of the change and the favourability of the change.
The perceived justice of the change

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In the case study, Brock Nelson commented that one of the major challenges faced by hospitals
is aligning upper management and front line workers. Morath would have been conscious that
she would have been perceived as the former. Morath addressed this challenge in three ways;
1.) She almost instantly secured support from the Medical Director, Dr Terry Harte. As
the Medical Director, doctor Harte would have had direct access to front line
workers and was a trusted and respected figure amongst them. Enlisting the help of
doctor Harte and other key influencers at this early stage would have helped to
address one potentially limiting factor which Morath faced i.e. her perceived
trustworthiness amongst the workforce relative to her newness to the hospital and
the position and her limited interactions with the workforce in the early stages of
the transformation.
2.) Morath ran a series of presentations and workshops with frontline workers. These
presentations would in many instances, be Moraths first introduction to many
frontline workers and so this would have been a crucial juncture in the
transformation in terms of securing support for the initiative. First impressions
count!
During these workshops Morath placed emphasis not on Patient Safety at Childrens
or issues with same, but instead on complex systems and patient safety in the
broader sense, in particular, patient safety in the context of Medical Accident Data
prepared by Harvard following studies throughout the whole of the US.
3.) Morath made herself available. Once the presentations and focus groups were
concluded, Morath did not return to her office and shut the door. In the article
Morath describes how her office became a confessional. She presented
information and data, put forward ideas and then invited and encouraged feedback
from those involved. Moraths openness to receipt of feedback and communication
in general was empowering frontline workers bridge the divides between upper
management and frontline workers to focus on a common commitment i.e. patient
safety.
In terms of the workforces assessment of the perceived justice of the change, these three
steps taken by Morath highlighted a number of key traits of her leadership which would have
helped to secure support for the initiative amongst the workforce i.e.;
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A passion for patient safety

Strong communication and active listening skills
An acceptance that she did not have all the answers
A respect for and acknowledgment of the value of the voice of frontline worker

The perceived favourability of the change

To successfully transform processes in Childrens, Morath needed to foster organisation
learning.

Frontline employees are best placed to help organisations learn by identifying

problems and opportunities during the course of their duties. One risk to be addressed was the
potential for frontline employee disengagement or worse, resistance based on a skewed
perception of the favourability of the change. As outlined above, Morath had already
emphasised that the focus was on organisational learning and improvement through open
discussion however, she went one step further by introducing the concepts of blameless
reporting and words to work by.
In the case study, union leader and Nurse Linda Hamilton describes how once blameless
reporting was introduced the emphasis shifted from who did it to what happened next. This
change in practice is likely to have been perceived as favourable for frontline workers and
would have been a key enabler for employee engagement.

5.3 Infrastructure and Sustainability

From the very outset Morath was keen to put systems and infrastructure in place which would
sustain the programme long after she had moved on to other areas. In Moraths words, she
wanted to make sure there was enough DNA in the organisation around the issue of patient
safety so that the initiative would survive without my direct involvement
Morath built an infrastructure and strategy based on people, reporting and empowerment. She
brought a passion to the initiative which inevitably, if intentionally was passed on to other who
expressed an interest in the area of patient safety. Morath also built a knowledge base of patient
safety information which was fashioned into patient safety course material which employees
could complete for continuing education credits. Morath empowered people from a top down
position up to the point at which they could empower themselves and then put structures such
as the patient safety committee in place to ensure the initiative remained on track.

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What is your assessment of Morath's leadership of the organisation change process at Childrens'?
Consider the challenges she faced during the transformation process and evaluate her effectiveness in
addressing these challenges.

What change management insights have you gained as a result of this assignment? How do
they relate to your experience/how can they be applied in the workplace?

6.0Team members Insight

Morath patient safety initiative success is a lesson for managers leading a wide transformational
change initiative in their organisations. The case study gives us a real insight into change
initiative in the childrens hospital, demystify the change process and highlights the key drivers
of change the managers can use to effect change successfully and get better result.
6.1

Employees Involvement

It is an important message for change agents embarking on organisational transformation

journey that people are the key drivers of change. People and only people alone that effect
change, involving employees in a change initiative, empower them to make decisions,
encourage psychology safety provides opportunity for continuous process improvement in a
company. When an organisation tapped into the creative and innovative knowledge of their
people, ideas flow to rejuvenate the company. Employees involvement is critical for change to
be successful, it is the difference between productivity improvement and the possible demise of
the company.
Without doubt, it demonstrates involving employees in decision making has significant effects
on employees motivation, and motivation comes within a person, employees develop such
motivation when they feel that their efforts are valued which show they are doing something
worthwhile for the company growth. For example, Safety Action Teams created by clinical
nurse specialist to discuss medication safety issues is as a result of childrens hospital
empowering employees and involving them in change initiative.
6.2

Effective Communication

You will be amazed to know the level of support you we get from your employees, if you
choose the right words to clearly communicate the message of change in a way that it resonates
with them. Effective communication of change initiative vision to employees reduce the
number of resistance. Moraths childrens Hospital case study shows that effect communication
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is vital for successful implementation of change initiative. Communication is an engagement

tool to stir employees in buy-in into your vision.
In terms of the transformation programme at Childrens there are a number of things which
stand out about Julie Moraths approach and leadership;
6.3

Planning and patience

We know that on average approximately 75% of transformation initiatives are unsuccessful.

We also know that as a newly appointed COO, it was important that Julie Morath establish
legitimacy as a leader promptly. It was interesting in this article to see the patience she
showed in allowing sufficient time to put in, as she describes it, the spade work. All too
often we have heard of change managers falling on their swords as a result of a failure to
create relationships and communicate effectively with key stakeholders and in particular, front
line workers. As noted earlier Julie Moraths planning commenced during the interview
process when she began to meet with Childrens employees. By the time she would present
the information on Medical errors from Harvard, Morath had a well-developed and informed
view of the organisation from a structural perspective and was also aware of dynamics such as
relationships, anxiety levels, moments that matter in patient care etc. This period of planning
was essential in that it afforded Morath time to develop appropriate corporate goals and also
to ensure that they were set with the right tone and values in mind.
6.4

Self-awareness and self-regulation

Many transformation efforts fail due to a lack of self-awareness on the part of the change
leader. Daniel Goleman identified self-awareness as one of the keystones of emotional
intelligence. During change processes, in particular radical change, emotions run high and so
one would imagine it is even more important that change managers are self-aware. Morath
put structures in place to ensure that the strategic agenda was formulated on the basis of
collaboration and consultation with all relevant stakeholders. Morath also put in place the
Patient Safety Steering Committee through which all proposals were essentially stress tested.
One can imagine that the transformation period at childrens was an exciting time and one
during which it would have been very easy for Morath to have slipped in to a authoritative
leadership style, I believe she displayed a keen sense of self-disciple in ensuring this did not
transpire.

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7.0Application of Lesson Learned in the Workplace

Since receiving this assignment I have seen first-hand how poor communication and a lack of
consultation around changes in the workplace can impact on change programmes. A couple of weeks
ago a member of our senior management team decided to alter a particular process within a particular
section. Although he had the best of intentions at heart, unfortunately he came up against significant
resistance from those working on the front line. Having read the case study and other articles provided
I met with the manager and talked about the Childrens case study and the approaches adopted by
Morath during the transformation process. I explained that I felt the resistance may have been down
to the fact that front line workers felt removed from the decision making process around the change
and that this may have led them to question the motives behind the change. I talked about Julie
Moraths presentations and subsequent workshops and the emphasis she had placed on the
involvement of frontline employees.
This particular manager was open to the feedback I provided and agreed that whilst the change was
proposed with the benefit of the workforce in mind, it could perhaps have been approached
differently.
We agreed to run a brainstorming workshop with all relevant staff in the section. At the outset of the
meeting the Manager presented some information on the climate we were operating in and
convincingly apologised for the oversight on his part of not talking to frontline workers when
contemplating a change in process. Thankfully the brainstorming session was successful with
everyone contributing in a highly interactive session. What was interesting was that the final solution
proposed by the frontline workers was not too dissimilar to that which had been initially circulated. I
think this highlights peoples desire to have a say in decisions that are made which will impact their
environment. It was a valuable lesson learned for the Manager and for I.
The readings have given us a fantastic insight into the emotions and behaviours the prospect of
change can trigger. The key thing I will take from this assignment is an appreciation for the
importance of a psychologically safe environment and intensive and ongoing communication during
all stages of transformation efforts.

8.0Conclusion
9.0Reference
Edmondson, A. C., Roberto, M., & Tucker, A.L (2001)"Children's Hospital and Clinics
(A)." Harvard Business School Case 302-050. (Revised September 2007.)
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Kotter, J. P. (2007) "Leading Change. Why transformation efforts fail", Harvard Business
Review, pp 92-107
Kotter, J. P., & Schlesinger, L. A. (1979). Choosing strategies for change. Harvard Business
Review. (PP. pp-106).
Katzenbach, J. R., Steffen, I., & Kronley, C. (2012). Cultural change that sticks. Harvard
business review, 90(7), 8.
Hurley, R. F. (2006). The decision to trust. Harvard Business Review, 84(9), 55-62.
Smollan, R. K. (2006). Minds, hearts and deeds: cognitive, affective and behavioural
responses to change. Journal of Change Management, 6(2), 143-158.
Tucker, A. L., & Edmondson, A. C. (2003). Why hospitals dont learn from
failures. California management review, 45(2), 55-72.

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Lukmon Sumola
Walter Molloy