1Research Center for Health Services Management, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
2Research Center for Modelling in Health, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
Background Change theories provide an opportunity for organizational managers to plan, monitor and evaluate changes using a framework which enable them, among others, to show a fast response to environmental fluctuations and to predict the changing patterns of individuals and technology. The current study aimed to explore whether the change in the public accounting system of the Iranian health sector has followed Kurt Lewin’s change theory or not.
Methods This study which adopted a mixed methodology approach, qualitative and quantitative methods, was conducted in 2012. In the first phase of the study, 41 participants using purposive sampling and in the second phase, 32 affiliated units of Kerman University of Medical Sciences (KUMS) were selected as the study sample. Also, in phase one, we used face-to-face in-depth interviews (6 participants) and the quote method (35 participants) for data collection. We used a thematic framework analysis for analyzing data. In phase two, a questionnaire with a ten-point Likert scale was designed and then, data were analyzed using descriptive indicators, principal component and factorial analyses.
Results The results of phase one yielded a model consisting of four categories of superstructure, apparent infrastructure, hidden infrastructure and common factors. By linking all factors, totally, 12 components based on the quantitative results showed that the state of all components were not satisfactory at KUMS (5.06±2.16). Leadership and management; and technology components played the lowest and the greatest roles in implementing the accrual accounting system respectively.
Conclusion The results showed that the unfreezing stage did not occur well and the components were immature, mainly because the emphasis was placed on superstructure components rather than the components of hidden infrastructure. The study suggests that a road map should be developed in the financial system based on Kurt Lewin’s change theory and the model presented in this paper underpins the change management in any organizations.
Devos RM. Lewin’s Change Management Model: Understanding the three Stages of Change [internet]. Available from: http://www.mindtools.com/pages/article/newPPM_94.htm
Alvesson M, Sveningsson S. Changing Organizational Culture: Cultural Change Work in Progress. London, New York: Routledge; 2008. doi: 10.1177/13505076110420020603
Todnem R. Organizational change management: a critical review. Journal of Change Management 2005; 5: 369–80. doi: 10.1080/14697010500359250
Vogel I. Report of Review of the Use of Theory of Change in International Development. The UK Department for International Development (DFID); 2012. p. 1-83.
Van Oosten EB. Intentional change theory at the organizational level: a case study. Journal of Management Development 2006; 25: 707–17. doi: 10.1108/02621710610678508
Peters T, Waterman RH. In Search of Excellence: Lessons from America’s Best-Run Companies. London: Harper and Row; 1982. doi: 10.7202/050045ar
Kanter RM. When Giants Learn to Dance: Mastering the Challenges of Strategy, Management and Careers in the 1990s. London: Unwin; 1989. doi: 10.5465/ame.1991.4274731
Pettigrew AM. The Politics of Organizational Decision Making. London: Tavistock; 1973.
Burnes B. Kurt Lewin and the planned approach to change: a re-appraisal. Journal of Management Studies 2004; 41: 977–1002. doi: 10.1111/j.1467-6486.2004.00463.x
Kaminski J. Theory applied to informatics-Lewin’s change theory. Canadian Journal of Nursing Informatics [serial on the internet] 2011 Mar [cited 2013 Aug 12]; 6: [about 3 p.]. Available from: http://cjni.net/journal/?p=1210
Sligo F. Managing Change. New Zealand General Management Handbook, n.d [internet]. Available from: http://www.massey.ac.nz/massey/fms/Colleges/College of Business/Communication and Journalism/Staff/Staff research files/FSligo/Managing Change.pdf
Kritsonis A. Comparison of change theories. International Journal of Management, Business and Administration 2005; 8: 1–7.
Eriotis N, Stamatiadis F, Vasiliou D. Assessing accrual accounting reform in Greek public hospitals: an empirical investigation. International Journal of Economic Sciences and Applied Research 2011; 4: 153–84. doi: 10.2139/ssrn.1978671
Wynne A. Is the move to accrual base accounting a real priority for public sector accounting? [internet]. Available from: http://www2.accaglobal.com/doc/publicsector/ps_doc_009.pdf
Vasicek D, Roje G. Accounting system in Croatian public healthcare organizations: an empirical analysis. Theoretical and Applied Economics 2010; 6: 37–58.
Abolhalaj M, Ramezanian M, Bastani P. Accrual Accounting Accomplishments in Iranian Universities of Medical Sciences: A Mixed Method Study. Middle-East Journal of Scientific Research 2012; 12: 294–300.
CESIFO DICE. The Accrual Accounting in the Public Sector [internet]. 2007. Available from: http://www.cesifo-group.de/ifoHome/facts/DICE/Public-Sector/Public-Finance/Public-Expenditures/dicereport307-db1/fileBinary/dicereport307-db1.pdf
Bastani P, Abolhalaj M, Molania Jelodar H, Ramezanian M. Role of Accrual Accounting in Report Transparency and Accountability Promotion in Iranian Public Health Sector. Middle-East Journal of Scientific Research 2012; 12: 1097–101.
Christensen T, Christensen M. The implementation of a guideline of care for patients with a Sengstaken-Blakemore tube in situ in a general intensive care unit using transitional change theory. Intensive Crit Care Nurs 2007; 23: 234–42. doi: 10.1016/j.iccn.2006.05.004
Geraci EP. Computers in home care application of change theory. Compu Nurs 1997; 15: 199–203.
Bozak MG. Using Lewin’s force field analysis in implementing a nursing information system. Comput Inform Nurs 2003; 21: 80–5. Doi: 10.1097/00024665-200303000-00008
Mehrolhasani MH, Abolhalaj M, Nekoei Moghadam M, Dehnavieh R, Emami M. [Systematic review of examining the implementation of accrual accounting in public sector and health system: challenges and solutions]. Health Information Management 2013; 10: 33.
Ritiche J, Spencer L. Qualitative data analysis for applied policy research. In: Bryman A, Burgess RG, editors. Analyzing qualitative data. London: Routledge; 1994. p. 1–17. Doi: 10.4324/9780203413081_chapter_11
The President’s Office Deputy of Strategic Planning and Control Statistical Center of Iran. National Population and Housing Census [internet]. 2011. Available from: http://iran.unfpa.org/Documents/Census2011/2011 Census Selected Results - Eng.pdf
Khayatzadeh-Mahani A, Fotaki M, Harvey G. Priority setting and implementation in a centralized health system: a case study of Kerman province in Iran. Health Policy Plan 2013; 28: 480–94. doi: 10.1093/heapol/czs082
Breese R, Eyre G, Cogill P. Change Management-Practising what we Teach: Issues in Engaging International Students in Learning, Teaching and Assessment. Student Engagement and Experience Journal 2012; 1: 1–14. doi: 10.7190/seej.v1i1.35
McGarry D, Cashin A, Fowler C. Child and adolescent psychiatric nursing and the “plastic man”: Reflections on the implementation of change drawing insights from Lewin’s theory of planned change. Contem Nurse 2012; 41: 263–70. doi: 10.5172/conu.2012.978