Home' Australian Pharmacist : Australian Pharmacist December 2013 Contents Australian Pharmacist December 2013 I © Pharmaceutical Society of Australia Ltd.
SUPPORTING PHARMACY PRACTICE
1. Which of the following statement is
a) According to the findings from
the PAMS program, pharmacists’
readiness to change is considered
fairly high despite the relative lack
of understanding and experience in
b) In general, the key important
factors needed to facilitate change
management are supporting
remuneration mechanisms, inter‐
professional relationships with
key stakeholders and a change
management framework that
facilitates change implementation.
c) The process of change management
is never straight forward. It is dynamic
and emergent in nature.
d) In general, community pharmacy does
not need to embrace change because
the security of pharmacy’s future
landscape ensures sustainability and
2. Which of the following statement is
a) Lewin’s model has 3 stages that cannot
be interchanged because of the rigid,
non‐fluid nature of transactional
b) The Refreeze stage of Lewin’s model
should signal a complete stop, which
marks the very end of the change
c) Both Lewin’s and Kotter’s change
models highlight the objectives and
imperatives for change facilitators
at different stages, ensuring clear
understanding and focus in the midst
of managing complexity and the
emotional upheaval of change.
d) The unfreezing stage is always the
least time consuming stage due to the
urgency to deliver quick wins to create
momentum for the next stage.
3. According to Kotter’s 8 Step Model:
a) More than 50% of management
must be convinced before forming a
powerful coalition that will drive the
b) A successful vision is easily
communicated in less than 5 minutes
and it must be clear, concise, create
a buy‐in from all layers of the
organisation and be supported with
c) One of the biggest challenges comes
from addressing change barriers –
and most of these would come from
changing the behaviour of people.
d) All of the above are true.
4. When managing change resistance,
it is important to:
a) Understand and diagnose the nature
of the resistance, determine how fast
or slow the change needs to happen
and then use an appropriate mix of
methods to manage the resistance.
b) Spend the required time to create
a genuine buy‐in, involvement and
commitment through communication,
negotiation and participation, to
secure sustainable change.
c) Use only one single method to address
the situation or the current stage of
d) A and B are both correct.
e) A, B and C are all correct.
Criticism and implications
Kotter’s Eight Step Model is an excellent
starting point for managers to implement
changes and the application of this model
is likely to improve the chance of success.
However there are some considerations
and contextual variables that need to be
accounted for in view of adapting the
model accordingly. Much of the change
management research suggests that
it is far more constructive to combine
Kotter’s framework with some of the
other leading change models such as
emergent, contingency or choice models
Despite the complex, unpredictable
and non‐linear nature of change,
Kotter’s framework encompasses the
entire change process adequately.
It systematically outlines a step by step
change process and addresses how to
manage change resistance and steps to
promote change initiators. Ultimately
Kotter determines that the core problems
people face with the eight steps are never
due to ‘strategy, structure, culture of
systems’ but rather about ‘changing the
behaviour of people’. The model certainly
highlights the importance of behavioural
change, which underpins the momentum
behind the transformational process.
Community pharmacy change initiatives
could benefit by adapting and utilising
Kotter’s model as a pre‐implementation
checklist and a post‐implementation
learning and reflective exercise. As
mentioned above, Kotter’s model is
best incorporated with emergent and
contingency theories and models,
such as Kotter’s new dual operating
systems.9 With strong readiness to
change, growing remuneration channels
through pharmacy professional services,
and a collaborative and shared vision
throughout the pharmacy stakeholders
(suppliers, pharmaceutical companies,
customers, professional bodies);
community pharmacies are at the
precipice of a transformational process to
ensure viability and sustainability.
1. Feletto E, Saini B , Lui G. Practice change in community
pharmacy: using change-management principles when
implementing a pharmacy asthma management service in
NSW, Australia. International Journal of Pharmacy Practice.
2. Emerton LM, LeKay KS , Saini B, et al. Experiences of community
pharmacy involved in the delivery of a specialist asthma
service in Australia. BMC Health Services Research. 2012;12:164.
3. Lewin K. Field theory in social science; selected theoretical
papers. DC, ed. New York: Harper and Row; 1951.
4. Lewin K. Frontiers in group dynamics: Concept, method and
reality in social science: social equilibria and social change.
Human Relations. 1947;1:5–41 .
5. Kanter RM, Jick TD. The challenge of Organizational Change
New York: The Free Press; 1992.
6. Kotter JP. Leading change: why transformation efforts fail.
Harvard Business Review. 1995;Mar-Apr:1–7 .
7. Kotter JP. Leading change. Boston: Harvard Business School
8. Kotter JP. Choosing strategies for change. Harvard Business
9. Kotter JP. Accelerate! Harvard Business Review. 2012;90(11):54–
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