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CHAPTER 15: LEADING CHANGE 477
Leadership at Work

Organizational Change Role Play
You are the new director of the Harpeth Gardens not-for-profit nursing home.
Harpeth Gardens is one of 20 elder care centers managed by Franklin Resident
Care Centers. Harpeth Gardens has 56 patients and is completely responsible for
their proper hygiene, nutrition, and daily recreation. Many of the patients can move
about by themselves, but several require physical assistance for eating, dressing, and
moving about the nursing home. During daytime hours, the head of nursing is in
charge of the four certified nursing assistants (CNAs) who work on the floors. During
the night shift, a registered nurse is on duty, along with three CNAs. The same number
of CNAs are on duty over the weekend, and either the head of nursing or the registered
nurse is on call.
Several other staff also report to you, including the heads of maintenance, bookkeeping/
MIS, and the cafeteria. The on-call physician stops by Harpeth Gardens once a week to
check on the residents. You have 26 full- and part-time employees who cover the different
tasks and shifts.
During your interviews for the director’s job, you became aware that the previous
director ran a very tight ship, insisting that the best way to care for nursing home patients
was though strict rules and procedures. He personally approved almost every decision,
including decisions for patient care, despite not having a medical degree. Turnover has
been rather high and several beds are empty because of the time required to hire and train
new staff. Other elder care facilities in the area have a waiting list of people wanting to
be admitted.
At Harpeth Gardens, the non-nursing offices have little interaction with nurses or
each other. Back office staff people seem to do their work and go home. Overall, Harpeth
Gardens seems to you like a dreary place to work. People seem to have forgotten the
compassion that is essential for patients and each other working in a health care environ-
ment. You believe that a new strategy and culture are needed to give more responsibility
to employees, improve morale, reduce turnover, and fill the empty beds. You have read
about the concept of a learning organization (Chapter 15), and would like to implement
some of those ideas at Harpeth Gardens. You decide to start with the ideas of increasing
empowered roles and personal networks and see how it goes. If those two ideas work, then
you will implement other changes.
During your first week as the director, you have met all the employees, and you have
confirmed your understanding of the previous director’s rigid approach. You call a meet-
ing of all employees for next Friday afternoon.
Your assignment for this exercise is to decide how you will implement the desired
changes and what you will tell employees at the employee meeting. Start by deciding how
you will accomplish each of the first three steps in the model in Exhibit 15.2. Write your
answers to these three questions:
1. How will you get employees to feel a sense of urgency?

2. How will you form a guiding coalition, and who will be in it?