Case Series

Organizational Change and Emotional Impact within a Hospital Pharmacy

Bel Houari M1,*, Bouhlala N1, Ennefah W1, El Ouadghiri B1, Wartiti A1 and Lmsaouri J2

1Pharmacy department of the Mohammed V Military Training Hospital in Rabat, Morocco
2Department of Therapeutic Chemistry and Clinical Pharmacy, Faculty of Medicine and Pharmacy of Rabat, Mohammed V University of Rabat, Morocco

Received Date: 23/11/2022; Published Date: 19/12/2022

*Corresponding author: Meriem Bel Houari, Pharmacy department of the Mohammed V Military Training Hospital in Rabat, Morocco

DOI: 10.46998/IJCMCR.2022.23.000559

Summary

It is known that any change within an organization involves a certain degree of concern depending on various actors.

After a first stage of diagnosis, which revealed an unsatisfactory situation, the pharmacy department of the military hospital decided to enroll in a process of organizational and structural change. This survey was conducted during the transition phase of the change.

A questionnaire was submitted to the various members of the team. It is composed of 4 items in the form of closed questions and open questions with the aim of evaluating the impact of this change on the emotional level as well as the extent of their involvement and adherence to the project.

The responses were subjected to an overall analysis and an analysis by sub-population.

The results showed that only 15% of employees were asked to give their opinion on the project, and that nearly 31% did not understand the purpose of the project, but paradoxically all of the respondents were convinced of the merits of this change. However, this change was also a source of stress for the vast majority of staff (89%), which impacted the quality of work for more than half of them. Everyone's needs and expectations are different, but some proposals were recurrent and may prove useful for the rest of the project.

In conclusion, we can say that the change is generally well accepted by the staff of the pharmacy pole but that efforts in terms of communication and participative management on the part of the management would help to better guide and anticipate the negative emotions that accompany any change and which may interfere with its smooth progress.

Keywords: Change; Emotions; Stress

Introduction

Any organization is led to experience organizational changes and adopt them in order to remain competitive and efficient, but also in order to follow and adapt to specific changes in its environment [1].

By organizational change, we mean any transformation affecting one of the dimensions of the organization, namely, the structure, the corporate culture, the people, the technical, information, management systems, etc.

So, is the change considered as the transition from a stable state A to a known and pre-formalized state B? [2].

According to some authors: «change encompasses many different meanings. To change is to become, to adjust, to adapt and to transform at the same time” [3].

However, other management works still convey the idea of ​​change "as being the work of decision-makers installed at the top of the company who, armed with a global vision, have the task of implementing the organizational consequences" [4].

But organizations can only change if their workers also change, i.e., adapt to change and take ownership of it.

Several studies mentioning the bad conception and/or the bad management of the change can generate reluctance to this change on the part of the employees, work stoppages, absenteeism, sleep disorders, a depressive state, ... which can hinder the expected benefits of the change.

The change can be caused or undergone, the change caused or chosen is the one which "is decided while the performance of the company remains good and therefore does not require, a priori, recovery actions, The change is decided either to improve a situation, or to anticipate a possible deterioration of it” this type of change does not come up against very restrictive blockages

The change undergone or imposed “is the one which is initiated late. It then becomes the necessary condition for the survival of the company” [5].

There are different styles or strategies of change management:

a) Model based on authority: or "direction/coercion" style [6], based on a vertical and top-down mode of operation, these models do not value agents, they are changes designed unilaterally by these teams.

b) Intervention-based model

Also called "innovative" style [7], consists of the intervention of a team that supports the development of the change project and the development of an approach that it applies, while being concerned about its acceptance. .

c) Model based on information/communication

The change project, designed and finalized by the management team, is presented to the agents with the aim of getting them to adhere; the designers deploy and take care of communication and negotiation techniques in order to convince the base and bring it to support.

d) Model based on participation

In this model, grassroots agents have the opportunity to participate in the very development of the change project. It is an endogenous model where the agents carry the change project through all its stages.

In this study, we are interested in the emotional impact that an ongoing organizational change can have on the staff of a pharmacy department of a university hospital. And this in order to better support this transformation and carry out this project.

Material and Method

Context of the study:

This is a qualitative prospective study within the pharmacy department of the Mohammed V military hospital in Rabat.

Indeed, the pole has been part of a process of continuous improvement of its services for several years. It is thus, quite logically, that a profound organizational and structural change was imposed.

Among the objectives of this change is the reorganization of workspaces, namely the transition from an “open space” to more individualized and more separated spaces.

The change process took place in three major phases:

A so-called thaw phase: this is a stage, initiated by the hierarchy, of questioning and becoming aware of the disadvantages of the situation but also of communication around the project.

A transition phase: this is the phase where individuals have invested most of their energy in adopting the new organization.

A refreezing phase or recrystallization: During this stage the new attitudes, values ​​and behaviors begin to stabilize and recrystallize

So, the model of led change is induced change based on information and communication.

And our investigation was conducted during the transition phase.

The sample:

All the staff of the central pharmacy were asked to answer the questionnaire; thus, the staff of the satellite pharmacies and functional units were excluded from the study since they will not be directly impacted by this change.

Quiz:

This is a questionnaire read, approved and administered individually to each member of the staff of the pharmacy pole through an interview of about twenty minutes.

This questionnaire, made up of open and closed questions, is divided into several items:

1st item: Segmentation criteria (age, seniority, function)

2nd Change management: Adherence to the project, understanding and the rate of information)

3rd item: stress and manifestations

4th items: what improvements and what needs?

All responses were entered into an EXCEL file and subjected to statistical analysis.

Results

19 questionnaires were duly completed. The average age of the respondents was: 32.1 years, including 11 women and 8 men

The oldest element of the service had 30 years of service and the youngest was assigned the same year of the change.

The selected segmentation criterion will be: "the function" to identify 3 distributed subpopulations (Figure 1).

To the question "has your opinion or point of view been solicited as part of the change project?":

15.5% declare having been solicited verbally before the start of the construction site, 26.5% when the work started, and 58% after the start of the work.

About 31% of staff say they did not understand the reason of the change and have found difficult to accept it, in fact two thirds of respondents fear a loss of habits and acquired work skills as for the remaining one third they see in this change a depreciation of their way of working and a questioning of their competence.

But 90% of respondents believe that these changes will have an overall positive impact, in particular on: their well-being (87%), their motivation (73%).

Moving on to an analysis by sub-population (Figure N°: 2), we note the main benefit expected from this change on the part of pharmacists is a gain in efficiency. Regarding the sub-population formed by pharmacy assistants and secretaries, it is rather an improvement in their well-being at work that they hope for from this change. And finally, the sub-population of handling agents would like this change to boost their motivation.

This change was a source of stress for 89.7% of staff.

The main manifestations of this feeling were physical fatigue in 57.8% of cases, followed by frustration and anxiety in 37% of cases.

From a productivity point of view: about 53% admit that the quality of their work has been reduced since the start of the works and 26.3% add that these same works have been the cause of cases of absenteeism although this remains rare.

According to the people questioned, the main causes of this felt stress and the manifestations that followed were the noise, dust and odors caused by the work, but above all the loss of spatial landmarks.

The main expectations of this change consist of more suitable furniture for better storage and classification of documentation, but also a resolution of the problems linked to the lack of privacy and noise that accompany working in an “open space”.

Passing once again from the global analysis to the detailed analysis by sub-population (Figure N°: 3), we notice that the stress is not felt in the same intensity and does not manifest itself in the same way in all subpopulations. The category of pharmaceutical assistants and secretaries is more frustrated by these changes than the other subpopulations. With handling agents, the stress felt mainly manifests itself in the form of physical fatigue.

To the open question what other improvements/changes would it be wise to undertake, certain proposals come up such as:

-A review of the distribution of tasks and the recruitment and continuous training of staff.

-Redevelopment of common areas, namely changing rooms and rest rooms.

Figure 1: Distribution of the functions of the personnel interviewed from the central pharmacy of the pharmacy pole

Figure N°2: Nature of the expected positive impact of the change by sub-population.

Figure N° 3: Manifestations of stress felt by sub-population.

Discussion

Emotions are not chaotic or irrational as all of the literature on change suggests. In fact, emotions in times of change can have their own logic and observing them provides relevant information and reveals important aspects about people and the organization [8].

Moreover, our results are in line with those of the literature on the subject, which indicates that periods of change are emotional periods. [8-10]. Indeed, individuals need their emotions in order to adapt to organizational changes. According to Morin [11], emotions and stress are the two types of individual responses to a request for adaptation.

The individual may have identity problems and when an organizational change occurs, his professional identity may be affected. He can then doubt himself, feel lost and anxious, this is particularly what we observed in our results, or employees who have acquired a certain experience feel this organizational change as a questioning not only of their skills but also balances developed over the years.

Lack of participation in decision-making and insufficient circulation of information can increase the level of tension and insecurity among workers [12].

For Colson (2005) [12], who analyzes change in public services, a good change project must be based on a clear vision, i.e., clearly defined objectives, shared by all stakeholders, give room for social dialogue.

But the participation of all stakeholders is not always the best way to do [13], it will depend on a number of elements including:

  • Type of issue: According to him, grassroots participation is appropriate for issues of intermediate importance. On the other hand, it does not seem to be able to be applied for strategic decisions which are management choices and which fit little with “participatory management”;
  • The economic context: as a general rule, difficult economic situations or the management of emergency situations are hardly favorable to participatory change management;
  • Leaders: their personal convictions, their management style, their representations of the organization, the specific constraints that they themselves undergo are all elements.

On the other hand, good change management must go through the explanation indeed, understanding is the most relevant variable, it is correlated with several positive and negative emotions [14].

In our study, paradoxically, even if around 31% of employees say they do not have a precise understanding of the project, they remain convinced of the positive impact that it will have on their working conditions, this reflects the confidence they have in their managers. It indicates that workers believe that their organization acts for their good and protects their interests.

To support change, it is possible to identify and act on the motivating component of emotion, this is the case, for example, in our study, of the pleasure of performing which seems to enthuse pharmacists or improvement of working conditions for pharmacy assistants and secretaries.

Morin defines stress as “a non-specific response to any request for adaptation” [11].

Reactions to stress vary from person to person. These differences are related, among other things, to personality types. The impacts are felt on three different levels:

1- the affective level: We can notice that the two emotions felt at work, namely frustration and anxiety, are always present during organizational changes [15-17].

Frustration is a feeling strongly correlated with lack of information. In our case, this emotion is especially felt by the assistants and the secretaries of the pharmacy. This may be due to the fact that they consider themselves the least informed and the least involved.

According to Collarette et al., there is an anxiety optimum that allows change to occur. According to the same authors, when anxiety is too low, workers are not encouraged to change, and on the contrary, when it is too high, they do not succeed in their integration. These authors also claim that workers can tolerate a high anxiety load when anticipating major gains in change [15].

2- On a physiological level: stress can be the cause of a certain number of physical problems, ranging from simple fatigue, as is the case for the handling workers questioned, to more severe disorders such as cancers. But this feeling expressed by our agents can be partly explained by the laborious nature of their work and which may have been complicated by the work in progress.

3- On the organizational level: stress often causes costly problems for companies due to absenteeism, loss of productivity, delays, conflicts at work [15].

Emotions are thus associated with stress, fear and resistance, but such simplification can have negative impacts on change management [8].

The expression of emotions can make us realize that the events that are taking place, in this case changes, are important in our life and for our identity. Conversely, if the changes do not cause emotions, whether positive or negative, it may mean that these changes are not important for the workers [18].

So the fact that the various elements of the pharmacy pole express so many emotions is proof that these ongoing changes are important to them and that they care about their success in order to meet their expectations.

We note that several improvements are desired by the employees, which once again confirms their openness to change when the motivations for this change seem clear and reasonable to them.

Some suggestions for improvements are also recurring, such as the case for example of having more adequate office furniture and more storage,

Another improvement, desired by a majority of employees, concerns a reduction in the noise level, in fact they are moderately satisfied with the open space, because they consider it too noisy. In addition, some complain of a lack of confidentiality and privacy. This is also the conclusion reached by a study carried out within SNCF premises on open space working conditions [18].

Conclusion

This study confirmed that organizational changes involve several emotions at work. Just as understanding change is negatively correlated with stress and explaining organizational change is negatively correlated with anxiety.

Indeed, managing organizational change must go through managing emotions. This means involving the various employees at all stages of change and as soon as this seems possible, but above all taking the time to clearly explain the motivations as well as the gains expected from this change with the use of internal marketing, which seeks target groups and distribute specific information to get them to join.

Conflicts of Interest: Authors declares no conflicts of interest.

Grant Information: The author(s) received no specific funding for this work.

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