Kotter vs Feinberg

Response to classmate

Hello, excellent insights on the Feinberg approach to bringing change at UCLA. I must admit that his way of turning around the healthcare facility from a complacent one to a leading academic and healthcare institution was, indeed, ingenious. Feinberg put a humanistic aspect to change; he made every major and minor detail evolve around being human. It was as if he viewed everything from the lens of ‘ what would I want someone to do for me?‘  That, to me, is the heart of service, and yes, I agree with you; a perfect example of servant leadership. It brings me back to the time that Jesus washed His disciples’ feet; though He too would have appreciated it if one of His disciples reciprocated and washed His feet, none offered to do so. Yet Jesus was not deterred by their non-voluntarism. Instead, He told them that they would do as He did if they were truly His servants. Jesus offered His disciples a comfort/luxury experience that none had experienced. Feinberg put himself in the shoes of the patients at UCLA and walked the mile. That said, I don’t believe that Kotter would have accomplished as much as Feinberg did with the eight steps that he proposed. This is because Kotter focuses on employees with regard to cementing change. Additionally, the main focus of the eight steps is making sure that an organization becomes more profitable rather than ensuring the customer becomes loyal. I do believe that Kotter should include some of the aspects of change exhibited by Feinberg. These aspects include effecting immediate change for urgent needs, maximize on resources to improve customer satisfaction, learning from other successful players in the industry, and evolving the entire change and business around creating enhanced customer satisfaction and, hopefully, lifetime customer loyalty.

Reference

Feinberg (2011). TEDxUCLA – David Feinberg – One Patient at a Time.mov https://www.youtube.com/watch?v=cZ5u7p-ZNuE

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Kotter vs Feinberg

Peer Responses

Hi, I would like to respond to a fellow student’s discussion post regarding Kotter vs Feinberg. Thank you.

Kotter vs Feinberg

As you review Kotter’s eight steps for transforming an organization, compare this with the teaching of Dr. Feinberg at UCLA and discuss the differences and similarities. Is there anything you would add to Kotter’s steps to improve the process after assessing these two models? Write 300 words and then respond to two other postings (100 words each).

Classmate’s Post

Kotter’s eight steps for transforming an organization are to act with urgency, develop the guiding coalition, develop a change mission, communicate the vision, empower action, generate short-term wins, don’t let up, and make change stick (Wheeler, & Holmes, 2017).  Dr. Feinberg’s hospital transformation did utilize all eight of Kotter’s steps for transformation, but he also incorporated servant leadership principles, utilized the Ritz Carlton’s talent plus criteria, and in some instances skipped through the steps to bring immediate changes (Feinberg, 2011).  While most large transformational projects require more conversational depth, Feinberg demonstrated that smaller projects such as seeing a need for more bed pans in the hospital and then buying more bed pans for the hospital can create transformational change, but it does not require plodding through all eight of Kotter’s steps (Feinberg, 2011).  In contrast Kotter (1996) suggests that his eight steps should be followed sequentially and that disregarding a step could potentially be problematic (as cited in Thornton, Usinger, & Sanchez, 2019).  The larger institutional problem that Feinberg addressed utilizing Kotter’s eight principles was the overall quality of care that was being provided, which was evidenced by the poor scores from patients ranking their care on a scale from 1-10 and whether they would recommend the hospital to a friend (Feinberg, 2011).

Although Feinberg did deviate from Kotter’s eight steps in some regards he also adhered to them by acting with urgency to immediately begin a transformational change in the quality of care at UCLA by identifying problems, establishing focus on the patient as the number one priority, implementing kindness as part of the mission statement, and then developing solutions in a collaborative fashion (Feinberg, 2011).  Feinberg already had a board of directors as a guiding coalition, but he also sought to create an atmosphere where every employee at the hospital and even guests touring the hospital were integrated as part of the coalition to provide the highest quality care possible (Feinberg, 2011).  Also Feinberg developed a clear vision of change to focus on the patient, while communicating that vision not only verbally, but through his actions, which exemplified servant leadership principles of leading by example and spending time with the patients asking how the care was (Feinberg, 2011).  “Show yourself in all respects to be a model of good works, and in your teaching show integrity, dignity” (Titus 2:7, ESV).  Further action was taken by converting a meeting room into a fast track room that could be utilized for the 4 out of 5 patients that came to the facility, but did not need a bed and this transformational change allowed for a far more efficient process (Feinberg, 2011).  Dr. Feinberg listened to the needs of his employees and empowered them with the resources they needed to do their jobs including wheelchairs, bedpans, and established a lift team to prevent nurses from getting injured (Feinberg, 2011).  A short-term win accomplished by Feinberg was having the air conditioning fixed in the neuro-intensive care unit so that the patients and employees would be more comfortable (Feinberg, 2011).  Dr. Feinberg also did not let up, but continued to change and evolve every aspect of the hospital from employee hiring practices, to having meetings focused on patient stories instead of just on the numbers, and required all non-clinical staff members to follow his lead by being involved in coordinated rounds visiting with patients and leaving their cards with the patients (Feinberg, 2011).  The changes that were implemented have also stuck as UCLA became the number one ranked academic hospital and has continued to strive for perfection instead of becoming complacent (Feinberg, 2011).

Essentially Kotter provides a broad outline for transforming an organization, but it misses the mark in addressing the importance of prioritizing the patients experience and does not coincide with servant leadership principles.  Kotter’s eight steps would benefit from implementing servant leadership principles established by Greenleaf (1970), “The 10 principles of servant leadership are listening, empathy, healing, awareness, persuasion, conceptualization, foresight, stewardship, commitment to the growth of people, and building community” (as cited in Mitchell, 2014, p.19).  I would also implement the extra steps that Dr. Feinberg utilized to Kotter’s eight steps, which would be to prioritize patients first, integrating kindness to the mission statement, leading by example, taking the time to listen to your patients and staff, focusing on every detail, utilizing ingenuity from other successful companies to improve, and continually striving for perfection.  If Kotter had taken over and utilized his eight steps at UCLA during its struggle instead of Dr. Feinberg do you think he would have been as successful as Dr. Feinberg was?

References

Feinberg (2011). TEDxUCLA – David Feinberg – One Patient at a Time.mov https://www.youtube.com/watch?v=cZ5u7p-ZNuE

Mitchell, J. W. (2014). Confessions of an (American) hospital administrator. Kai Tiaki Nursing New Zealand, 20(1), 18–19. Retrieved from http://www.nzno.org.nz

Thornton, B., Usinger, J., & Sanchez, J. (2019). Leading Effective Building Level Change. Education, 139(3), 131. Retrieved from http://www.projectinnovation.com/education.html

Wheeler, T. R., & Holmes, K. L. (2017). Rapid transformation of two libraries using Kotter’s Eight Steps of Change. Journal of the Medical Library Association, 105(3), 276–281. https://doi-org.ezproxy.ccu.edu/10.5195/jmla.2017.97