Runninghead:MRSAPREVENTION

MethicillinResistantStaphylococcusAureusPrevention.
AssessingOrganizationalChange.VolunteersofAmerica
AmyLEllsworth,AshleyDGillam,
JodiANewcomer
WesternWashingtonUniversity

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Abstract:
Thispaperispertainingtoorganizationalchangeandthedynamicprocessesinvolvedwhen
analyzingtheorganizationalsystemstochange.Ouroverallquestionwas:Howtoprevent
MethicillinResistantStaphylococcusAureus(MRSA)infectionforthedisabledpopulation?In
evaluatingtheVolunteersofAmerica,thecommunityagencythathousesandservesthisatrisk
populationwehadtheprivilegeofdiscussingtheorganizationwithtwoSeniorDirectorsof
differentprograms.Thesediscussionsaidedusingatheringinsightinformationaboutthe
organizationandtheorganizationalknowledgebaseinregardtoMRSA.Wealsoresearched
articlesusingOneSourcewiththeterms:VolunteersofAmerica,HistoryofVolunteersof
America,OrganizationalChangeAssessment,LewinsTheoryofChange,MRSAprevention,
andcurrentCenterforDiseaseControl(CDC)protocolsaboutMRSA.Inthisresearchwefound
thatassessingtheorganizationalstructure,andcreationofthecultureisnecessaryfor
analyzingmotivatingfactorsforindividualstoimplementchange,andinthisanalysistoincrease
knowledgebaseaboutMRSA.

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Introduction:
CreationoftheOrganizationalCulture
TheVolunteersofAmerica(VOA)beganin1896inNewYorkasareligiousandphilanthropic
organization.Theaimandobjectiveoftheorganizationwastoreachtheoutofchurchand
neglectedpeople,withthefounderbeingknownastheguardianoftheunfortunate(Johnson,
1953).TheVolunteersofAmericacamefromaneedandcontinuestobeaplacetoturnwhen
peopleareinneed.Wehelpovertwomillionpeopleperyear(VOA,2016).
Organizationalcultureiscreatedthroughthemissionoftheorganization.CharlesLusthaus
P.h.Danexpertinorganizationalperformanceandassessmentrecommendsthatitisbestto
firstunderstandthemissionoftheorganization,thehistory,howitwasdevelopedandhowit
currentlyfitsintothecommunity(2002),fortheVolunteersofAmerica(VOA)thevision
statement:
Aworldwhereallpeopleliveinsafety,withsocial,emotionalandphysical
wellbeing,spiritualfulfillment,justiceandhope.
(VOA,2016).Sincefounding,theVOAhas
gonethroughmanyleadersandstill,thevisionoftheVOAcontinues.Sincedeathoftheoriginal
founders,TheVolunteersofAmericahasshownthatitisnotonlystrongenoughtosurvivebut
tocontinuetogrow(Wisbey,1994).TheVOAhasaplacewithinthecommunityitservesanda
positiveimpactonsociety,andthisistheestablishedculture.TheVOAhasan
ethicallybased
mission,withaninspiringvision,destinedtohaveapositiveimpactonsocietyandsocietal
change.AsamoralbasedorganizationJamesOToolatheoristinorganizationalchange
recognizesthatchangeisaninherenttrait(1999)andthattheorganizationcanrelyonthe
missionitserves.
LogicModel:
UsingLogicModelsforChange
Logicmodelsareusefulfordeterminingactionsneededfortoreachorganizationalgoalsandin
decidingwhereresourceswillbeneeded.Logicmodelsareausefultoolinmappingouta
strategicplan.Yet,logicmodelsarealinearwayofthinkingandeventhoughtheyarehelpful

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thinkinginthismannereliminatesthedynamiccapacityoforganizationandabilitytochange
(Lusthaus,2002).Lusthausgoesbeyondthelinearmodelindeterminingorganizationalchange
andinsteadstatesthatChangeinorganizationalperformanceisdepictedasasetofinteractive
orclusteredchangesthatareperceivedbyorganizationalmembersindifferentwaysandin
differenttimedimensions.(2002).Insayingthis,LogicalModelshavetheirplaceinthe
organizationalassessment,whereresourcesshouldbedistributed,whatactionsneedtobe
takenandinimplementingwheretheoutcomewasnotachievedandwherechangeneedsto
occur.IndetermininghowtoimplementthesechangesLewinsTheoryofchangecanbeused.
LewinsTheoryofChange:
OrganizationalChangeThroughaTheory
Totiethistoatheoryofchange,andlookatorganizationalchange,a
behavioralstructuralanalytictheoryisusedtoassesschange.ToassesschangewithLewins
Theory,thecurrentorganizationalstructureneedstobeevaluated.Basedonthisstructure,the
behavioroftheindividualwithreflectwherethereisaneedforchange.AsLewinexplains,the
structureencompasses:
structuralaspectsoftheenvironmentas:clarityandstabilityofthe
culturalvaluesandnorms,stabilityofsocialstructures,strengthandsanctionsarisingfromsuch
socialstructuressuchaspeergroups,strengthoftheindividual'semotions,egodefensive
needsandwellarticulatedcognitiveabilities(Apteretal.,1972,p.2021).
LewinsTheoryofChangestatesthatafterassessingthecurrentstructurethereneeds
tobeacatalystforunfreezingthecurrentstructureandanefforttoimplementthechange.Karl
EWeickandRobertEQuinn,twoprofessorsfromMichiganBusinessSchool,statethatthese
organizationalchangesandcatalystscanbelarge,revolutionary,termedepisodicchangeor
continuous,evolving,cumulative(1999).Motivationalfactorsforchangecanbeinternallyor
externallydriven(Weick).WiththeVolunteersofAmericaanexternalcatalystforchangewould
bethegovernmentmandatedqualityassurance.Ourrecommendationfollowingourcommunity

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assessmentforafactsheetaboutMRSAhasimplicationsforchange.Thischangewouldstart
byunfreezingthecurrentbehaviorandbeliefsattheindividuallevelknowledgebaseabout
MRSA.Inchangingattheindividuallevel,thiscouldthenimpactthecommunitysculturalview
aboutMRSAaswellasasystemsstructuralchangeaboutMRSAtreatment.
LewinsChangeTheory:
ChangeasaNewTrait
AfterthoroughanalysisofthecurrentbehaviorwefoundthatthelackofMRSA
knowledgewaspartofthecurrentstructureandthedrivingforceofthecurrentbehavioroffear.
CurrentlytheVOAdoesnothavetrainingaboutMRSAandthecurrentbehavioristosenda
clientwithanyindicationofpotentialMRSAinfectiontotheemergencyroom.Thisactivitynot
onlyputstheclientatahigherriskofcontractingMRSA,itisalsowastefulofcommunity
resources.Ourintendedinterventionaddressesthis.
Thesubsequentstagesinimplementingchangeisbyimplementingchangeatthe
individuallevelthroughincreasingknowledgebase.WerecommendimplementingaMRSAfact
sheetatthenextstaffmeeting.Presentingthisinformationinthismannerwillallowforquick
diffusionofknowledgeandisinstrumentalinindividualbehaviorchange.
Thethirdandfinalstageisfortheorganizationtorefreezewiththeneworganizational
traitsandbehaviors.Toevaluateifthisisoccurringwerecommendthattheorganization
continuallymonitorMRSAinfectionandtripstotheemergencyroom.Alongwithevaluatingtrips
totheemergencyroom,testingthecaregiversontheirknowledgebaseisrecommended.
Refreezingwiththissuggestedcurrentbehavioralsoalignswiththeexternalstructureofthe
government.Theseexternalmandateswouldreinforcetheorganizationalstructurebehavioral
change.
ChangeattheCommunityLevel:
AddressingResistance

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Anaspectofaddressingresistancetochangecouldbeafacetofthecommunityit
serves.Thisorganizationisconstantlypromotingorganizationalchangebyaddressingthe
currentcommunity.AnexampleofthisisTheWesternWashingtonregionalcluster.Thiscluster
oftheVolunteersofAmericaestablishedthatthereisaneedwithintheTraumaticBrainInjury
populationandhasstartedaprogramtofulfillthisneed.Theseactivitiesshowthatan
organizationwhichiscommittedtoitscommunitycanhavealargeimpactthesocietalstructure.
TheVolunteersofAmericaasanorganizationischangingandgrowingconstantly..The
catalystthatpresenteditselfforthisnewestchangewasaneedwithinthecommunityandthe
VolunteersofAmericaestablishedaprogramtofulfillthisneed.
Resistance:
PreventingResistancetoChange
AttheVolunteersofAmerica,individualsarenotconstantmembersofthecommunity.
Theorganizationmustrelyonthemissionstatement,thecommunityitservesandthegenuine
motivationoftheindividualdeliveringcare(OToole,1999).Whilespeakingwiththeregional
directorsfromtheVOAitbecameapparentthattheindividualsthatprovidecarearenot
permanentstructureswithintheorganization.Assessingeachindividualsabilitytochangeand
barrierstochangeisnotrecommendedduetolimitedresources,andtheimpermanenceofthe
temporaryhelp,parttimeemployeesandvolunteers.Fororganizationaleffectivenessinregard
tothesuggestedchangeitisessentialtomotivatethelongstandingindividualswithinthe
organizationandintegratetheseindividualsintotheplanofchange.Forthetransientindividual
itisessentialtointegratetheindividualquicklythroughcreationofbondstothecommunitywith
regardtothemissionstatementandbymakingmembershipoftheorganizationaprivilege
(Lusthausm).Havingthesebondswillalsoempowertheindividualwithintheirpositionto
implementwhateverchangethatwascreated.

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Thenextareaofpotentialresistanceforchangeisattheindividuallevel.Kotterand
Schlesinger,twoprofessorsfromHarvardBusinessSchool,designedamodelaimedto
alleviateresistanceofindividualstochangeandprovidemotivationaltactics.Thismodel
identifiesfourreasonswhyindividualsareresistancetochangewithinanorganization.Thefour
reasonsareparochialselfinterest,misunderstanding,lowtolerancetochange,anddifferent
assessmentsofthesituation(1979).Thechangethatwerecommendstemsfromthe
knowledgebaseoftheindividualandprovidingadequateresourcesforinformationandbeing
abletoanswerquestionsaboutMRSAisthebestwaytoaddressresistance,motivate,and
implementchange.
ChangefortheVOA:
ForceFieldAnalysisattheCommunitylevel
Inimplementinganintendedchangethatpossiblyhasbiggerimplicationstothe
organizationofVolunteersofAmericaitmustlienotonthetransientindividualworkerfor
changebutonthecommunity.Theforcefieldanalysismodelindeterminingdrivingand
restrainingforcesisbestappliedtothecommunityforeffectiveanalysis.Motivationalfactorsfor
thecommunitybasedassessmentreliesonacommunitycommongoalandacommunitybased
solution.Therecommendedassessmentstoimplementchangeisinaddressingtheculturesof
thesubcommunities,theleadersofthesesubcommunities,andwhethertheirmissionsalign
withthecurrentstructure.Thisassessmentwouldgatherinformationonwhetherthat
subcommunityisfulfillingtheorganizationalmissionstatement.Ifthatsubcommunityhasa
differentvision,culture,orvaluesystem,thantheoverallcommunity,thenthatwouldindicatea
needforchangeandwouldrequireareformingandepisodicchange.Thebestwaytocreatean
episodicchangeisbybeingastrongmotivationalleader,andinanethicbasedorganization
(OToole,2009),useofthemoralcodecouldalsobehelpful.
ImplementationofIntendedIntervention:
SuggestionsforVOA

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TheintendedchangeofincreasingcaregiverknowledgeofMRSAthatweare
suggestingfitswithinthecurrentcultureoftheVolunteersofAmericaandalsoalignswiththe
mandatesfromthegoverningbody.Implementationofthischangewillnotbeaparadigmshift
fortheorganizationandadoptionoftrainingforMRSAislikelytodependonresource
availability.ThereisevidencethatincreasingknowledgeinregardtoMRSAcanchangethe
prevalenceofcommunityacquiredMRSA.InKlickitatcountyinWashingtontherewasan
interventionforcommunitywideeducationanddistributionoffactsheetstochangehowMRSA
washandled.InamatteroffourdaysthisinterventionwaseffectiveinchangingMRSA
perception(DOH,2007).Inunderstandingthateducationhasimplicationsforaction,andthat
limitedresourceshaveimplicationsforintervention,webelievethattheMRSAfactsheetwillbe
themosteffectiveinterventionfortheVOA.
Diffusionofthisfactsheetandeducationwithinthecommunitywouldcreatemanysmall
catalyticchangesandresultinaknowledgeshift.ThisknowledgeshiftinregardtoMRSAwould
changetheindividualandcommunityresponsetothesituation.Thischangecouldpossiblylead
toasystemschange,whereprevention,earlyidentification,andassessmentoftheurgencyof
thesituationwillreduceadmissionsattheemergencyroomandthepredictedresultsfromthis
changewouldbethattheoverallcommunityresourcescanbedistributeddifferently.

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Appendix:
ForceFieldAnalysisModel

LogicModel:

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References

Johnson,E.C.(1953).
AStudyofAgencyProgramandCaseworkServicesoftheLosAngeles
PostoftheVolunteersofAmerica.

LosAngeles,CA
:
UniversityofWashington.

Lusthaus,C.(2002).
OrganizationalAssessment:AFrameworkforImprovingPerformance.
Ottawa,ON,CAN:IDRCBooks.Retrievedfrom
http://www.ebrary.com

Toole,J.(1995).
HowtoUseMoralValuestoLeadChange.LeadingChange.
Retrievedfrom
http://nathantnavarro.com/uploads/Leading_Change.pdf

VolunteersofAmerica.(2016).
AboutUs
.Retrievedfrom
http://www.voa.org/ourmission

Weick,K.,Quinn,R.(1999).OrganizationalChangeandDevelopment.AnnualReviewof
Psychology.50:361386.DOI:10.1146/annurev.psych.50.1.361

Wisbey,H.(1994).TheVolunteersofAmerica:18961948.
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VolunteersofAmericaInc.

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