Executive summary

The goal of our dissertation was to develop a change management plan for the
Hartekamp Group, a mental disability healthcare institution that operates in the
Netherlands, in order to comply with the new performance budgeting system instituted
by the Dutch government.

The new system matches expenditure with results, and has been formulated to
inculcate better financial and administrative discipline in public institutions. The
provisioning of Hartekamp’s budgets from the Dutch Health Ministry is dependent on
achieving the new performance indicators, and in order for us to develop an effective
change management plan to attain this, a qualitative approach was adopted by the use
of secondary and primary data. The secondary data analysis identified that the key
factors that impact change include resistance, readiness, capability and leadership.
The primary data was collected from two senior managers and eleven caregivers at
Hartekamp Group using semi-structured interviews.

In order to achieve performance indicators related to quality control and customer

service, finance and operations, considerable changes are required to be made at the
Hartekamp Group. We found that there is a higher level of resistance to change
amongst the junior employees, compared to the senior management. Sources of
resistance to change include a lack of clarity on what performance indicators to
implement, fear and apprehension over changes in operating requirements, inability to
cope and not being able to link the indicators with positive impact on health of patients.
Regarding change readiness, it was found that neither the senior managers nor the
caregivers are ready to transition to the new system. This is because of issues related
to top-down communication styles, not being convinced of the need to change,
apprehensions about the scale of change required and negative evaluations of how
extra efforts made in achieving the performance indicators will benefit them personally.
An analysis of the Hartekamp Group’s change capability indicates little likelihood that
the organization will successfully transition to the new system. There are no
investments made in infrastructure for event tracking, data collection, storage and
analytic systems, which are required to achieve reporting requirements under the new
system instituted by the Dutch government. There are also no training programs to
help employees to learn the functional and behavioral skills that are required to
transition. The organizational culture which is based on top – down management does
not prepare its employees for a new work culture based on individual accountability
and responsibility.

An analysis of leadership at Hartekamp indicates a distant governing board that is

perceived to be indifferent and not committed to change. These findings were used to
recommend a change management model comprising of a pre-phase, transition phase
and post implementation phase. During the pre-phase, awareness was created about
the need for change, and the sources of the employee’s resistance were identified and
redressed. The transition phase is when change management gets implemented and
involves training and appropriate communication. A process of continuous
improvement is instituted during the post implementation phase.