Soins intégrés: comment accompagner un changement de culture [Integrated care: how to support a culture change?].

The primary care center at Lausanne University Hospital trains residents to new models of integrated care. The future GPs discover new forms of collaboration with nurses, pharmacists or social workers. The collaboration model includes seeing patients together or delegating care to other providers, with the aim of improving the efficiency of a patient-centered care approach. The article includes examples of integrated care in consultation for travelers, victims of violence, pharmacist medication adherence counseling, medicosocial team work for alcohol use disorders and nurse practitioners' primary care for asylum seekers.

Culture change in academia: Making sharing the new norm

Presentation at Open Repositories 2014, Helsinki, Finland, June 9-13, 2014

Managing the change of organizational culture in cross-border mergers and acquisitions: The role of post-acquisition integration in organizational culture change

Over the years, cross-border mergers and acquisitions have become a popular strategic option for variety of firms. Companies often seek rapid growth through acquiring potentially valuable enterprises or attempting to enhance their organization’s profitability by merging with other firms. However, managing the change of organizational culture is a major managerial challenge as companies often confront difficulties when merging two previously autonomous organizational cultures into one, joint organizational culture. Therefore, the purpose of this study is to increase understanding related to the challenges and possibilities concerning the management of organizational culture change in cross-border mergers and acquisitions. The research question “How to manage the change of organizational culture in cross-border mergers and acquisitions?” is analysed in relation to the theories presented in this thesis regarding organizational culture, organizational change and acculturation as well as in relation with the collected empirical data. The research question is divided into three sub-questions according to the following: (1) “What is the role of organizational culture in organizations?”, (2) “How to manage organizational change in mergers and acquisitions?” and (3) “How to manage organizational culture change through acculturation?”. The thesis is conducted as a qualitative case study research including three personal interviews and one group interview. The interviews were conducted as a combination of semi-structured and unstructured interviews. Theories related to organizational culture, the management of change as well as acculturation are studied and further analysed in relation to empirical material collected by the researcher. Research findings indicate that that several factors can influence the success of managing the organizational culture change in cross-border mergers and acquisitions. Factors such as defining the preferred acculturation model prior the merger; managing the resistance of change; open communication; acknowledgement of local culture and cultural differences; involvement of personnel in change processes; as well as the formulation and implementation of comprehensive change plans proved to be important factors with relation to successful management of organizational culture change

Mid-Holocene Climate and Culture Change in the South Central Ande

This chapter reviews the history of study and the current status of Mid-Holocene climatic and cultural change in the South Central Andes, which host a wide range of different habitats from Pacific coastal areas up to extremely harsh cold and dry environments of the high mountain plateau, the altiplano or the puna. Paleoenvironmental information reveals high amplitude and rapid changes in effective moisture during the Holocene period and, consequently, dramatically changing environmental conditions. Therefore, this area is suitable to study the response of hunting and gathering societies to environmental changes, because the smallest variations in the climatic conditions have large impacts on resources and the living space of humans. This chapter analyzes environmental and paleoclimatic information from lake sediments, ice cores, pollen profiles, and geomorphic processes and relates these with the cultural and geographic settlement patterns of human occupation in the different habitats in the area of southern Peru, southwest Bolivia, northwest Argentina, and north Chile and puts in perspective of the early and late Holocene to present a representative range of environmental and cultural changes. It has been found that the largest changes took place around 9000 cal yr BP when the humid early Holocene conditions were replaced by extremely arid but highly variable climatic conditions. These resulted in a marked decrease of human occupation, “ecological refuges,” increased mobility, and an orientation toward habitats with relatively stable resources (such as the coast, the puna seca, and “ecological refuges”).

An analysis of culture change in the Ackmen-Lowry area / John B. Rinaldo, Assistant, Archaeology.

v.36:no.5(1950)

What's in it for us? A case study research about micro sense making processes through the eyes of front line employees, during culture change implementation

Abstract How employees make sense of change is a very complex process. Recently, academics have neglected to research sense making activities in a micro culture implementation context, through the eyes of front line employees. In contrast to a macro view, a micro perspective limits researchers to only look at an individual, departmental or group level. By doing so, we can zoom in on the details of sense making processes that employees use in their daily work life. A macro (organisational) view is based on the notion that there is a general integrated culture that can be found in all organisational units and departments. It is assumed that culture can be researched by using the entire organisation as one single research entity. This thesis challenges this assumption. In case of planned change it is usually the management community who are in charge of the change intervention. Because of their formal hierarchical position, they have the power to abort or initiate change programs. It is perhaps therefore that researchers tend to be focused on the management community rather than on lower level organisational members, such as front line employees. Apart from the micro view, scholars also neglected to research culture change implementation through the eyes of front line employees. This thesis is an attempt to fill these two gaps that currently exists in academic change management publications. The main research question is therefore: From a micro point of view how do front-line employees make sense of the impact of culture change, during the implementation phase? This thesis starts with a literature review which exposes the two main gaps. The most important outcome of this review is that only 2% of the research articles dealt with culture implementation, through the eyes of front line employees. A conceptual research model is built on the integrated sense making theory of Weber and Manning (2001) and the micro variables of Raelin and Cataldo (2011). These theories emphasize elements of sense making in a daily working context. It is likely that front line employees can identify themselves with research elements such as tasks, skills practices, involvement and behaviour. Front line employees were selected, because as lower level organisational members they are usually the change recipients. They are further away from the change initiating scene (usually the management of an organisation) and form a potential sense making ‘hotspot’ that could provide new academic insights. In order to carry out the primary research, two case organisations were selected in the leisure industry. A participative case study research method was chosen. This meant that the researcher worked in the concerning departments of the case organisations. The goal was to observe and interview front line employees, while they were performing their jobs. The most important advantage of this approach is that the researcher temporarily becomes one with the organisation and is therefore able to acquire both formal and informal narratives that front line employees use during sense making activities. It was found that front line employees make sense of organisational change by using a practical approach. They make sense of the change program by carrying out new tasks, developing new skills and sharing best practices. The most noticeable conclusion was that sense making activities predominantly take place at an individual level in relation to change acceptance. Organisational members tend to create a mental equation in order to weigh the advantages against the disadvantages. They evaluate whether the concerning change program is beneficial to them or not. For future research a sense making scheme model is suggested that is based on two methods: an introspection and an action method.

Culture change in a museum: An action research analysis

The move of a museum in the western United States to larger quarters resulted in an increase in visitors and requests for tours. To respond to the greater number of tours, new volunteers (docents) were recruited and trained. But conflicts arose between the old and new docents. As Docent Chair, one of the authors worked with the Curator of Education to understand the culture change faced by the old docent group and integrate the old and new docent groups. This paper analyzes the culture change using Lewin’s Action Research model. The success of the culture integration was demonstrated when the old and new docents moved away from «this is how it should be done…» to «this is what I see…» in speaking about an event or problem. The language and perception changes were steps toward building a common meaning.

The impact of organizational change on the perceptions of UK managers change

Redundancy, delayering, downsizing, and various other forms of organizational change have become increasingly prevalent. This article focuses on the impact of different forms of organizational change on managers' perceptions of the organizations they work within and the comparison between changes that involve redundancy and/or delayering and those that do not involve such changes. The literature has many accounts of the negative effects associated with redundancy and delayering, but are these effects unique to these types of change or are they a consequence of negative experiences of a range of organizational changes? Hypotheses were tested to assess, first, whether there are differences between different levels of management, notably between directors and nondirectors in the way they perceive organizational change, second, to assess how change has affected managers' perceptions of their organizations and their working lives, and third, to explore if different forms of change are associated with differences in managers' perceptions of their organizations “as a place to work”. Hypotheses were tested with data from a cross-sectional survey with 830 managers from the UK. Organizational changes include cost reduction and culture change programmes, delayering, mergers/demergers, outsourcing, redundancy programmes, and contract/ temporary workers. The analyses reported here indicate clearly that specific forms of change are associated with managers' reports of their experiences at work; some forms of change (notably redundancy and delayering) seem to have particularly damaging implications for managers' experiences in the workplace. The analyses also show that there is a difference in the way directors and nondirectors perceive the changes. Finally, the article considers strategies for ameliorating the effects of change including the role of HR.