Psychology of Change in Process Improvement
There Is More Than One Way To Skin A Cat
Total Quality Management is one method of bringing about change in the
organization. There are many more. This section reviews some of the more common
ones and presents data concerning whether these approaches work.
Too many alternatives
There are many approaches to change. Some come with new names. You may have
heard about Learning Organizations, Socio-technical Systems, Leadership
Challenges, Thriving on Chaos, Value-based pay systems, Re-engineering, and so
on. Some of the proposed alternatives are nothing but renamed approaches. Some
are new and do not have sufficient data about their effectiveness. We briefly
review some of these alternatives. We choose to review the alternatives
discussed and evaluated in academic literature, because we wish to know what
works. Ideas that seem great in a book, may be difficult to implement, once
implemented may fail to achieve the promised behavior changes.
The reviews are brief. You can write a book about any one of these methods of
change. The purpose of this section is to make you sensitive that alternatives
to Continuous Quality Improvement exist. This lecture does not prepare you to
apply these alternatives.
There are many theories of change. Some of these are based on the experience
of successful executives. Science believes that you cannot learn from experience
of one company, that you have to look at the application of a theory across many
organizations. Science believes that you can learn from mistakes, i.e. you can
prove a hypothesis wrong, but there is little to learn from success.
Unfortunately, executives that fail are not writing books. I like to read books
titled "What did I do wrong." Our fascination with success may mislead us. When
people succeed you do not know why. What people attribute to their own skills
may be due to other factors. People often fail to see how environment helps
them. They mistake good writing with truth. They believe and get involved with
the examples of the application of the theory. They believe in the analogies
that are embedded in good writing. Slogans that make the point of a theory may
make the reader believe in the method of change without looking at the data. In
short, many executives put out books and advice that derives its logic from an
appeal to our common sense.
Some people go as far as thinking that management is common sense. You do not
really need to go to school to learn it. You can do it.
I do not agree with these contentions. I believe that we should look at data.
We should see what works. Without such corrections of our intuitions, the
science of management will not progress. We will remain permanently victim to
the next fad.
Value Expectancy and Expected Utility
Two theories of how individuals change is based on the notion of
self-interest. These theories are Value Expectancy and Multi-attribute Expected
Utility. Both theories have their historical roots in psychology, economics, and
business research. In the Value Expectancy it is assumed that when decision
makers face several outcomes, they decide on the course of action based on the
value of these outcomes and their subjective probability or 'expectation' that a
particular action will achieve the outcome. In short, decision makers choose the
course of action that maximizes their expected value. In the health care area,
the health belief model is an example of a Value Expectancy model. The Health
Belief model has been applied extensively to predict patients' behavior. The
Health Belief model uses notions such as perceived susceptibility to disease,
perceived severity of illness, perceived benefits, perceived barriers to change,
and self efficacy to predict patients' behaviors.
The Multi-attribute Expected Utility model is also based on the same notion
of self interest. It assumes that the decision makers evaluate the outcomes they
face based on a number of attributes. Given the relative weight of each
attribute, the decision maker arrives at an overall judgment of the value of
each outcome and selects the outcome of highest value to them. People choose
what to do based on their perception of their own self interest.
Does it work?
It does. Both Expectancy theory and Expected Utility Models predict
individual behavior accurately. Glanz, Lewis and Rimer edited the book "Health
Behavior and Health Education" in which the authors review the ability of both
models in predicting patients' behavior. The studies they reviewed strongly
supports the notion that either model can predict patients' behavior. Here are
some example results. In one study, the Expected Utility model accurately
predicted 82% of the decision to get flu vaccination for a randomly selected
high risk patients of a clinic. In another study, the Expected Utility model
accurately predicted 68% of patient's compliance with follow-up recommendations
for abnormal pap smears.
Problem with self-interest
- Not all individual behavior can be predicted by self interest. There are
many examples of behaviors when individuals do not do what they wish to do.
A good example is all the resolutions we make at the beginning of a new
year. Why do people fail to do what they wish? Neither Expectancy theory nor
Expected Utility model give us a clear answer . Additional models of change
help explain this paradox better than either of these two models.
- Individuals do not always decide what to do. Sometimes, they decide out of
habits. Habits that endure despite the changing attitudes of the individual.
Other times, our peers heavily influence our decision. Many change by
imitating the behavior of individuals they admire. While self-interest is an
important component of how we change, group influences on the individual are
ignored by this approach to change.
- Both theories assume that the individual is aware of the outcomes of
his/her decision and is willing to gather the necessary information. Often
the information about the impact of the decision on the person's self
interest is not available. These theories assume an ideal person willing to
gather information and decide in a rational manner, and that is just how
what most people do.
- When we look at people's behavior from the perspective of self-interest,
we are likely to blame people who do not act in their own self interest. At
the personal level, this leads to blaming the victim and at the
organizational level this contradicts the TQM principle of blaming the
system and not the people. It creates an environment of fear.
Consumer Information Processing
A thorough explanation of consumer information processing was provided by
Bettman in his book titled "An Information Processing Theory of Consumer Choice"
(Addison Wesley, 1979). In this book he suggests the basic elements of the model
- Information processing capacity is limited and search for information
requires both internal (memory) and external costs.
- Motivation determines how extensively we search for information.
Motivation changes because of clues available from the environment. When
motivation changes, the information we pay attention to changes and the
decision processes we use changes.
- Attention to various sources of information changes. Important stimuli
may be ignored, if the individual consciously or unconsciously chooses not
to pay attention to it.
- Perception of information may differ from the actual information.
- Information acquisition and evaluation go hand in hand. People do not
gather information before evaluating it. They evaluate the information as
they gather it. They stop when the information gathered so far gives them a
level of confidence with their judgment. Sometimes, they may stopped
prematurely. Other times, the early pieces of information may inadvertently
influence where they search for information and they may miss important
information. Still other times, the framing of the information affects its
- Decision processes and rules do not follow an optimization procedure.
People do not maximize their self interest. They satisfy the constraints
(e.g. the amount of resources they have) they face. The nature of how
information is gathered also affects what decision rules are followed. When
many options are available, it is more likely to follow heuristics that
simplify the task quickly.
- People choose but fail to effectively learn from experience. Because
many decisions are self fulfilling prophecies, because often the information
on effectiveness of a choice is not available and because, even when
available, negative information is often ignored by decision makers, many
fail to learn from their experiences.
The implications of Consumer Information Processing theory for a manager
planning to change an organization is clear. He/she must organize the
information and communicate it effectively. He/she should think through the
frequency of communications, the amount of the information, the channels for
distribution of information, cognitive styles of the target population, the
appropriate framing of the information, and point of choice summary labels for
A good example of how decision making is affected by information search is
the patients' decisions about choosing a provider. Glanz and Rudd in their 1989
article in "Advances in Health Education and Health Information Policy Review, "
and subsequently in their chapter in the book titled "Health behavior and health
education," arrived at the following conclusions concerning how patients use
information about quality of care:
First, it appears that most individuals do not actively seek out health
care information. The cost of seeking information may deter
information-seeking behavior. Both information seeking and information
processing for use will not only require knowledge but also motivation,
skills, and peer or social support.
Second, studies of consumers reasons for choosing and changing health
providers indicate that consumers often rely on the recommendations of
friends and relatives because of lack of information about quality of care,
the difficulty of evaluating such information, and/or the belief that lay
opinion is an adequate substitute for expertly developed indicators.
Does it work?
Information processing limitations have been well established and researched.
The extent to which these limitations affect business decisions are not known.
The use of organized information and clear communication to bring about changes
has also been documented. Data show that successful implementation of change is
associated with clear communications.
Problem with information processing model
- The extent to which limitations in information processing affects our
behavior is not known. Obviously, despite the limitations in information
processing human beings have had a great deal of accomplishments.
Furthermore, studies of information processing ignore the role of decision
aids, such as paper and pencils, in overcoming processing limits.
- Our peers heavily influence our decision. Information processing
theories do not explain how group judgments affect the formation of decision
processes and individual's habits.
Attributions are the causes people generate to explain events. Two people
faced with the same information may act differently because they attribute to
different causes. In our minds, a complex process helps human beings decide what
is the cause of an effect. In part, causes should precede effects, should be
co-occur with effects and should not be co-occur with other spurious events. The
types of attributions people generate can be classified along four dimensions:
- Locus of causation. Is the person the cause or events outside the person?
- Controllability. Could the person have controlled the cause?
- Stability. Is the cause stable or changing over time?
- Globallity. Does the cause affect a wide variety of outcomes or specific
When change occurs people have a mix of failures and successes. To the extent
that an optimistic view helps individuals remain open to change, it is important
that we manipulate how we attribute early success or failures. Data show that
attribution of a failure to stable or internal causes leads to expectations of
more failures and loss of self esteem. In contrast, attribution of a success to
a stable or external causes leads to expectations of more successes. When
failure is attributed to controllable events, additional effort can be expected
in the future. In contrast, when failure is attributed to uncontrollable events
or to global causes, future effort will diminish. Agents of change need to
develop a therapeutic relationship with people undergoing change. They need to
understand how do people perceive the reasons for change. To the extent that
these reasons highlight external, controllable, stable and specific causes,
optimism will prevail, more effort may be exerted and change is more likely.
Furthermore, the agents of change can enhances the chances of proper
understanding of the need for change by clearly communicating their own
understanding of the reason for change.
If the objective is to make sure that difficult tasks are initiated and
continued despite early obstacles, it is important to attribute success to the
person's effort and failure to events outside the control of the person.
Does it work?
The effect of attribution on employee behavior have been demonstrated. But
the question of how one can change employee's attribution has not been
addressed. It is assumed that optimism is a precursor for change, but such
assumptions have not been tested in an organizational setting.
Problem with changing attributions
- As mentioned above, data on key assumptions of this method of change is
missing. It is not clear how attributions could be changed, once changed
does it always lead to more optimism, and does more optimism lead to more
effort in face of adversity . Attribution theory helps us understand
behavior but does not tell us how to change behavior.
- Attribution like all models of individual change focus attention on the
individual and ignore how relationships affects attributions.
Reasoned Action and Social Learning Theory
The theory of Reasoned Action suggests that human behavior is influenced by
two factors: attitudes towards the behavior and the influence of social
environment and general subjective norms on the behavior. Social norm is
determined by examples that significant others set for us and by the attitudes
they convey to us. Social Learning theory suggests that:
- Behavior dynamically influences the environment and personal constructs.
Likewise, the environment and personal characteristics affect each other and
the person's behavior.
- For a person to perform a particular behavior he needs to know what the
behavior is and know that he/she has the skills to do the behavior.
- Individuals learn what to expect through their own experience and
through their social groups.
- Individuals act in their self interest to get likely outcomes they
- Individuals learn through imitating the behavior of others around them.
- Individuals learn through reinforcements and rewards they receive from
A key element of both Reasoned Action and Social Learning theories is the
importance of social norms in changing the individual's behavior.
Does it work?
The effect of social norms in influencing behavior has been demonstrated in
many studies. An example, is the study reported in the dissertation of Baker at
University of Wisconsin in 1988. He studied condom use among patients in a
sexually transmitted disease clinic. He found that 36% of variations in
intentions to use condoms was explained by the Reasoned Action model. The belief
that one's health care provider believed in the use of condoms was one of the
most important predictors, demonstrating that norms could have a significant
influence on our behaviors.
Problem with social norms
- While the influence of social norms on behaviors are known, our ability
to manipulate these norms is unclear.
- It is difficult to understand what comes first, the social norm or the
employee behavior. Since behavior and social norms are dynamically
influencing each other, it is difficult to discern the relative importance
of each on the other.
Theory of Social Support
There are a variety of overlapping theories about how support affects
- Buffer hypothesis: One of the earliest theories was based on the concept
that poor social ties reduces feedback and as a consequence one becomes
confused; this confusion increases susceptibility to errors. According to
this theory social support protects the individual and acts as a buffer to
- Direct effect: This theory assumes that practical and financial
assistance from friends can alleviate or prevent some stressful life events.
A sense of belonging and positive reinforcement can improve satisfaction
with life. As a consequence, one might have fewer physical and mental
disorders. In contrast to the buffer theory, this theory assumes that social
support has an effect even in the absence of stressful events.
- Personality characteristic: People differ in how they react to help.
Individuals with a sense that they are well accepted by others are more
likely to establish positive relationships and receive help. Similarly,
those who feel that they are not accepted are less likely to feel they have
friends and may fail to get help even when help is available to them. Not
only does the availability of help differ by the sense of acceptance but
also positive sense of acceptance leads to better coping skills. Individuals
reassured about their social support worry less about where help might come
from and spend more time facing their problems. Because a sense of
acceptance is a personality trait learned early in one's childhood, this
theory assumes that social support is a relatively enduring characteristic
of the individual rather than a changing feature of the environment.
- Transactional. The ecological model sees social support as a feature of
neither the individual nor the environment, but as a transaction between the
two. The person must maintain relationships by providing support to others
when needed. In return, others will provide support when the individual is
in need. Over time, the transactions of helping and being helped must
balance, otherwise social ties change. Thus, in stressful situations
sometimes relationships break and other times strengthen, depending on
whether the support has been reciprocated. This interdependence in helping
each other need not involve the same types of support, one may provide
financial support to others and in turn receive emotion support. The theory
also predicts that a person with good personal skills is more capable of
helping others and therefore has more good will to rely on when he himself
endures a series of stressful events. In the transactional model, social
support limits the individual's future behavior by requiring him to
A statement of how support affects propensity to change was given by
Gustafson, Cats-Bariel and Alemi in Systems To Support Health Policy Analysis in
Successful change is more likely to occur when those attempting the
change believe the people they respect are also changing, wanting them to
change, and will help them succeed. Moreover, they need to believe that if
they fail, they fail not only themselves but also their social support
group. Social ties with people committed to the change need to be
established within and between organizations. Ties can extend beyond their
In a rational world there would be no need for social support. People
would implement the things they believe in. But in reality, social support
is essential to continued success.
Does it work?
Extensive evidence points to the fact that individuals who have naturally
occurring social support are more likely to succeed. There is some evidence that
it is possible to organize support for an individual and that such artificially
occurring support will lead to new relationships and benefits similar to
naturally occurring support groups.
Problem with social support
- It is not clear the causal direction. Does support lead to successful
change or does success lead to more support. The relationship between
support and success may be due to the fact that people prefer to befriend
- It is not clear why and how people change their support groups.
refer to implementation of innovations over time as diffusion. Diffusion is
assumed to occur in two steps. During the first steps early adopters think
through the benefits of the proposed innovation and select to try it. In the
later stages, others see early adopters using the new innovation and decide to
try it. Implementation of an innovation may fail for several reasons including:
- Innovation failure. The proposed innovation fails to meet customer
- Communication failure. Customers are not aware of the innovation, how to
use it and what to expect from it.
- Adoption failure. Because of resources or differences in perceptions and
values, customers are deciding not to adopt the new innovation.
- Implementation failure. The organization fails to implement the
innovation despite choosing to adopt it. Usually, because the adoption
decision was made by people who are not affected by the implementation.
- Maintenance failure. The organization fails to keep up with changes
needed to maintain the new innovation.
Does it work?
The concept that adoption of innovations should be examined over time and
that customers differ in their rate of adoption is so basic that needs not be
tested. Nevertheless, this concept was tested in several studies. Despite the
common sense behind this concept and the data supporting it, it is missing from
many other theories of managing change, including Total Quality Management.
Innovation diffusion started from research on adoption of agricultural
techniques. It quickly spread to other fields including management. At the core
of this research are factors that promote adoption. On the section on
"organization climate," we return to the innovation research and use proven
predictors of successful change to assess readiness for organization-wide change
Problem with innovation research
- It is assumed that the innovation itself does not change. Research shows
this is not correct. Overtime, as a consequence of implementation, often the
innovation itself changes.
- It is assumed that customers either adopt or not adopt an innovation.
Research shows this is not the case. Adoption and internalization of
innovations is a matter of degree. Some customers believe in some
innovations much more strongly than others. Some make it part of their lives
while others pay only a lip service to it.
Organization Development is not one approach to change. It is a group of
approaches mostly organized to improve work life. French and Bell in their book
titled "Organizational Development" outline the following underpinnings of this
- Organization development is a planned process of changing and is based on
the research done on the change process. Key among these was the research
done by Kurt Lewin that identified three stages for change: Unfreezing,
wherein the organization realizes the need for change, gathers new
information and establishes new relationships, Moving, wherein the
organization acts and brings about the change, and re-freezing, wherein the
organization internalizes the change, maintains existing social ties, and
resists subsequent changes. A key contribution of Lewin to the study of
change was understanding the role of social relationships in bringing about
and maintaining change.
- Organization development interventions are based on a system theory
perspective. General system theory was first articulated by Ludwig and
Bertalanffy in 1950 and was first applied to business management in 1966.
Organization Development believes that organizations are open systems, with
well defined input, thorough-put and output. Input could be labor,
information, capital, and other resources. Throughput are the processes that
transform the input. Output is what the organization provides to its
environment. Open systems have a boundary that separate it from its
environment. Open systems have goals and a tendency to reorganize themselves
through the feedback they receive. Without reorganization all open systems
will degenerate into random chance behavior. Open systems thinking is the
basis of learning organizations.
- Organization Development interventions are based on participation of the
employees in search of solutions to organizational problems. Empowerment is
either a goal for or a method by which Organization Development
interventions are implemented.
- Organizational Development interventions are based on teamwork, sometimes
cross functional team work.
- Organizational Development interventions create a parallel learning
structure for the organization, where ideas can be tried and discarded
without jeopardizing the life of the organization.
- Organizational Development interventions bring about change not through
power and coercive techniques but through setting organizational norms and
- Organizational Development is based on applied behavioral science and
The inventory of Organizational Development interventions is quite extensive
and it includes:
- Diagnostic activities, where facts are gathered about the way things are.
This might be done through asking employees to project their image of
themselves or through questionnaires and interviews.
- Team building activities that relate to organizational tasks or to
- Inter-group activities designed to improve effectiveness of interdependent
- Education and training activities.
- Survey feedback activities, wherein employees review the data and design
- Structural work redesign, wherein the organization's formal structure is
changed or new ways are organized for working across divisions within the
- Process consultation activities wherein employees are helped to understand
how they decide, how they communicate the decision, what roles each plays,
and what problems the organization faces. Process consultation involves an
outside expert who helps the process by asking questions about the
- Peacemaking activities, wherein a third party consultant intervenes to
reduce work conflicts among two employees or two groups of employees.
- Coaching and counseling activities, wherein employees are asked to define
learning goals, describe how others see them, and review non-evaluative
feedback they receive from others in the organization.
- Planning and goal setting activities, wherein organizational employees set
objectives for themselves and the group.
This is not an exhaustive list of interventions. It is set out here to give
you a taste of the breadth and depth of interventions that fall under this
approach to change.
Does it work?
- Organizational Development is not one set of interventions,
- many interventions are not publicly reported,
- there is no valid objective criterion for evaluating some interventions
it is hard to examine whether as a whole these approaches work. Nevertheless,
over the years there have been many meta-analysis or survey research of the
various organizational development interventions. French and Bell summarized the
reviews of these approaches, suggesting that in 51 to 70 percent of cases
Organizational Development techniques led to significant improvements in
reducing cost, improving quality or improving profit margins.
Problem with Organizational Development
- Organizational Development tends to emphasize the work life experience and
not the customer's experience of the product, as such it may more readily
lead to happier workers than to better quality products and larger market
- Data reporting the effectiveness of Organizational Development
interventions is primarily based on published studies. Since studies of no
impact are usually not published this data may be misleading and biased.
Internal /Social Marketing & Media Advocacy
managers use mass communication to reach their own employees and to manage them
more efficiently. Such mass communications include simple activities such as an
employee newsletter, a Total Quality Management story board, mass mailings,
cybercast e-mails, broadcast to employee voice mails, video exchanges,
television broadcasts and other channels of mass communication. One way to bring
about change is to sell it through mass communication. Marketing is effective in
setting organization wide agenda and expectations. It can create a positive
image for change. The process of marketing to employees is referred to as
Internal marketing. The process of marketing specific products from which a
social good is likely to emerge is called Social Marketing. And the process of
advocating a change through encouraging mass communication companies to cover it
is called Media Advocacy. In marketing, data are used to make effective points
to the target population. The message is organized to make a lasting impression
and to help the target population identify with the needed change.
Does it work?
Of course it does. Or so we believe. There is considerable evidence that
marketing works. Products and ideas are sold through marketing efforts. Data on
use of marketing techniques to help employees change is not as widely available.
Several organizations that advocated life style changes through Social Marketing
of these ideas to their employees report success.
Problem with marketing
- Marketing reduces complex change issues to slogans. Hence many who
change, may relapse to old habits as they have not understood the entire
issues behind the change.
- Many managers are not trained in effective marketing campaigns and
cannot mount such activities on their own.
- Marketing is excellent for setting agenda but not as effective for
empowering people to change.
Business process reengineering
Reengineering uses technology to redesign business processes. The objective
is to create a fundamental and radical improvement. The business process may be
combined with other processes, eliminated, or restructured. Reengineering is a
top down system of improvement with no required involvement from the employees.
Reengineering may lead to layoffs or displacement of employees but does not
always lead to such actions.
Does it work?
We are not aware of data across organizations showing that reengineering
leads to significant improvements of organization's profit or market share.
Nevertheless, there are numerous examples of companies who have tried
reengineering and report savings. Many are reported by Hammer and Champy in
their book "Reengineering the corporation: A manifesto for business revolution."
Problem with reengineering
- Reengineering appears to pay little attention to the interaction between
social systems and technical issues. In particular, the non-participatory
nature of re-engineering may lead to problems in full integration of the
technology in the company operations afterwards.
- Many benefits of technology is not materialized when some parts of
business process or customer interactions occurs without the technology.
Advanced learners like you, often need different ways of understanding a
topic. Reading is just one way of understanding. Another way is through writing.
When you write you not only recall what you have written but also may need to
make inferences about what you have read. Please answer the following
- What strategies are used at your work to encourage change. What does
your manager do to encourage you to change? Make a numbered list. List at
least 5 things your manager does.
- List the recommendations made for bringing about change in the reading
in this lecture and for each item describe to what extent the approach is
used by your manager at your work.
- Given the material you have reviewed, what do you need to help you keep
up with your personal resolutions? Make a list of all recommendations made
in the lecture and discuss how they apply to your personal improvement.
- Select a on going project at your work or alternatively a project at a
friend's work and assess its chances for success.
Please send an email to your instructor with your responses to the above
Make sure that the email subject line includes the course number, topic
name and your name, otherwise it will not get to the right place. For
example, subject line could be: "Joe Smith from HAP 586 responses to
questions in lecture on Psychology of Change" If you wish to receive
a receipt that the instructor has received your email, you may request the
receipt from your email program. Please respond to all of the questions
within the same email. Do not attach a file to your email. Keep a
copy of all your emails to the instructor till the end of the semester.
To assist you in reviewing the material in this lecture, please see narrated
lecture or slides.
Narrated lecture requires use of Flash.
Copyright © 1996
by Farrokh Alemi, Ph.D. Created on Tuesday, September 17, 1996. Sunday,
October 06, 1996 4:20:30 PM Most recent revision
01/15/2017. This page
is part of the course on Quality / Process Improvement.