Home' Australian Pharmacist : Australian Pharmacist December 2013 Contents 48 Australian Pharmacist December 2013 I ©Pharmaceutical Society of Australia Ltd.
Continuing Professional Development
SUPPORTING PHARMACY PRACTICE
20--50 (in big organisations) before
progressing beyond. The coalition
becomes the source of urgency and
continues to build momentum around
the need to change. In a pharmacy the
coalition may be the owner, manager and
senior staff members, both pharmacists
and non-pharmacist staff.
3. Develop a vision
A simple and clear vision underpins
and supports the directive plans and
processes given to achieve the change.
A clear vision can easily be communicated
in five minutes or less and receivers
usually get a reaction that signifies both
understanding and interest. If a vision is
blurry, the coalition must work at it until
an effective vision emerges.
4. Communicate the vision
Successful transformations do not happen
unless nearly all the people are willing
to make short term sacrifices. Without
credible, strong and clear communication
with all staff, the hearts and minds of
the ones that matter, who are directly
involved in implementing the change, will
never be captured. Understanding and
support must be available when short
term sacrifices are required i.e. job losses.
5. Address barriers
Obstacles can be the difference between
success and failure. These barriers can
be a person's headspace, organisational
structure, narrow job description etc.
However big or small they are, these
barriers must be confronted and
removed in a fair and consistent fashion
to demonstrate the credibility of the
6. Create short term gains
Real transformation takes time and may
risk losing momentum if there are no
short term goals to achieve and celebrate.
Generally people want to see compelling
evidence within 12--24 months into the
renewal. Creating these short term wins
is an active process where goals and
objectives are clear, with the directives
and performance being achievable and
performance monitored. In pharmacy
staff will look for early results, within
weeks, to maintain their enthusiasm.
7. Build on changes
Until the change sinks deeply into the
culture, declaring victory too soon can
be catastrophic. More often this is due
to the over enthusiasm of the change
initiators and the identified opportunities
for the change resistors to halt any further
changes. Instead of declaring victory,
use the credibility from short term wins
to tackle bigger issues. Identify and
correct systems and structures that are
not consistent with vision; encourage
and promote people and culture that
8. Anchor changes in culture
Long term change becomes permanent
once it is incorporated deep within
the culture. The behaviours and values
espoused and acted on are aligned
with the new state -- 'This is how
things are done'. In pharmacy the staff
and customers will want to see that
management's words and actions align.
Managing change resistance
Throughout Kotter's Eight Step Model,
managing change resistance is usually
feared as it often involves emotional
discomfort and upheaval. This can
become the make or break between
success and failure in the renewal
process. There are points to consider
when assessing how to manage change
1. Diagnosing the resistance
• Self interest -- 'I may lose something of
value,' 'I have too much to lose'.
• Misunderstanding and lack of trust --
'The change will cost me more than I
• Different assessment -- 'I believe that
the change will cost the company more
than the status quo'.
• Low change tolerance -- 'inability to
change or fear of change (even though
I understand the need to change)'.
2. Determining the optimal speed of
• Anticipate intense resistance.
• Have less power than resistors.
• Need information to plan, design and
3. Methods of managing resistance
• Education and communication -- help
people to see the logic of change.
• Participation and involvement --
invite people to contribute to work
• Facilitation and support -- provide
support for the hardships of change.
• Negotiation and agreement -- offer
incentives, negotiate trade-offs.
• Manipulation and co-optation -- covert
attempts at influence, providing
selective information, buy off resistors
to gain support.
• Explicit or implicit coercion -- use of
considerable force on people to accept
change, sometimes resorting to threats
if people do not comply.
Figure 2: Adapted from three factor change model
• Guiding future vision
• Creating a new
model of practice
• Fostering a proactive
• Understanding the
• Intrinsic attributes:
• appraisal of concept
• Support from external
relationships with other
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