Lakhasly

We also reviewed the experience using other mod- els."Integration to bridge traditional intra-organ- izational boundaries" among individual components was exemplified by the multidisciplinary approach and by the integration of the spectrum of the multi-layer healthcare system from primary to tertiary."Alignment to achieve consistency of organization goals with resource allocation and actions at all levels of the organization" was demonstrated by the coordinated work to mobilize the resources for imple- mentation."Improvement initiatives that actively engage staff in problem-solving" were evident by the engagement of departmental teams and staff in the change process."Impetus to transform" in our case was reflected by the urgency to implement the EMR.

We also reviewed the experience using other mod- els. Lukas’s change management model, proposed for organizational transformation in healthcare systems, has five elements . “Impetus to transform” in our case was reflected by the urgency to implement the
EMR.
“Leadership commitment” to quality was reflected by a clear vision to transform the organization to use a full-suite EMR system.
"Improvement initiatives that actively engage staff in problem-solving” were evident by the engagement of departmental teams and staff in the change process.
“Alignment to achieve consistency of organization goals with resource allocation and actions at all levels of the organization” was demonstrated by the coordinated work to mobilize the resources for imple- mentation.
“Integration to bridge traditional intra-organ- izational boundaries” among individual components was exemplified by the multidisciplinary approach and by the integration of the spectrum of the multi-layer healthcare system from primary to tertiary.

These elements drove change by affecting the components of the complex healthcare organization and by dealing with the mission, vision, and strategies; culture; operational processes and infrastructure such as IT and human resources .
We also reviewed the experience using Lewin’s change management model, which consists of three steps: unfreeze, change, and refreeze.

One may consider the first three steps in Kotter’s change management model: “creating a sense of urgency, building the guid- ing team and developing a change vision and strategy” to correspond with the “unfreeze” step in Lewin’s change management model, and the “understanding and buy-in and removing obstacles” to correspond with the “change” step and finally, “creating short-term wins, building on the change and anchoring the changes in corporate cul- ture” to correspond with the “refreeze” step.