MANAJEMEN PERUBAHAN :

KOMITE KEPERAWATAN DALAM

IMPLEMENTASI UU KEPERAWATAN DI RS

OLEH : PRAYETNI, S.KP., M.KES

DIREKTORAT BINA PELAYANAN KEPERAWATAN DAN KETEKNISIAN MEDIK
KEMENKES RI
BERUBAH……….
Organizational Change Management

Organizational Change Management is a structured

approach to transitioning individuals, teams and
organizations from a current state to d desired future
state.

Organizational Change Management is characterized

by a shift in behaviors and attitudes in people to
adopt and embrace the future state.
 DIMENSIONS OF PLANNED CHANGE

Strukture

Technology Task

People
SEVEN DIMENSION OF CHANGE

Level one
1. Client requirement
2. Technology

Level Two
3. Client environment
4. Team

Level three.
5. Organization change
6. External environment
7. Competency expectation
PURPOSES OF PLANNED CHANGE
Essential Elements of Organizational/
Planned Change

1 2 3 4 5

6 7 8 9 10
 PRINCIPLES OF CHANGE MANAGEMENT

1. Involve people and agree suppan from them within system.

The system is environment, processes, culture, relationships,
behaviours. ete., whetlner personal dr arganieatienal
2. Understand where the organization is at the moment
3. Understand where you want to go, when, Why and what the
measures will be for having get there.

4. Plan development in appropriate achievable &

measurable stages.
5. Communicate, involve people & enable and facilitate
them as early and openly and as fully as is possible
THEORIES AND MODELS OF CHANGE MANAGEMEN

A. Planned Change Theory

R1 Restraining forces
R2
R3
R4
R5

Desired equilibrium

Existing equilibrium

D5
D4
D3
D2 Driving forces
D1
 Lanjutan…
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Step and Processes of Planned Change

INPUT TRANSFORMATION OUTPUT

PLANING ACTION RESULTS

•Preliminary •Learning •Changes in

Dignosis processes behavior
•Date gathering •Action Planning •Data Gathering
•Feedback of •Action steps •Measurement
Results
• Action planning

Unfreezing Changing Refreezing

Feedback Loop A Feedback Loop B

Feedback Loop C
B. The ADKAH Model
C. The Change Curve Models
 Lanjutan…
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The Change Curve Models
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STRATEGIES FOR CHANGE
PROCESS OF PLANNIG CHANGE

Identify Need for Change

Identify Areas for Change

Feedback

Assessing the Situation

Planning of change
Monitoring and
evaluating change
Assess change Forces

Action for change/

implementing
HUMAN RESPONSE TO CHANGE

A. Responses of Change B. Resistance to Change

1. Management 1. Anxiety
Viewpoint 2. Happiness
2. Staff Viewpoint 3. Fear
4. Threat
5. Guilt
6. Disillusionment
7. Hostility
8. Denial
9. Factors for Resistance to
Change
POWER
 POWER
• Power is the probality that one actor within a social
relationship will be in a position to carry out his own
will despite resistance. Max Weber
• Power is ‘the production or intended effects. Russell
• Power is ‘the potential for influence. Roger
• Power is the ability and willingness to influence the
behaviour of others to produce certain intended
effects. This ability is based on certain strengths,
requires expenditure of energy and is manifested by
characteristic actions. Emerson
SCHEMATIC MODEL OF POWER
IN ORGANIZATION

Sources of
Power
Legitimate
Reward
Coercive
Expert Power of
Referent Others
Moral
Responsibility
Relational
Contingencie
s of Power
TYPES OF POWER

TYPES OF
POWER
CONSEQUENCES OF POWERS

SOURCES OF
BASES OF POWER
POWER

Expert Power INDIVIDUAL

CHARACTERISTICS
Referent Power / FACTOR

Legitimate Power

ORGANISATIONA
Reward Power
L FACTOR

Coorcive Power
POLITIK
POLITIC
• Pettigrew (1973) described it as the use of power to influence
decision making. lt is power and influence based on coalition
building.
• Organizational power is linked to dysfunction in organizations.
Allen et al., (1979)
• Politics refers as ‘individual or group behavior that is informal,
divisive, and above all, in the technical sense,
iliegitimate,sanctioned neither by formal authority, accepted
ideology, nor certifed; system of inflence, linked to conflict; results
both in ‘games' and positive change. Mintzberg (1983)
• The meaning of politics in an organization is conceptualized as the
exercise of power to negotiate different interests among members
while maintaining one’s interests in certain organisational issues.
Characteristics of Organizational Politics

3
Techniques Used
in Organizational Politics

8. Building
Coalitions

Technique
s
Factors/Conditions influencing
Political Behavior

Ambiguous
Goals

Personal Scarce
Characteristic Resources

FACTORS
Technology &
Organisational Enviroment
Change
Complex &
Ambiguous
Decision
CONTROLING ORGANISATIONAL POLITICS
 PENUTUP
1. Dengan melakukan perubahan pada organisasi RS melalui
implementasi Komite Keperawatan akan meningkatkan
profesionalisme perawat dalam melakukan pelayanan/ asuhan
keperawatan
2. Implementasi komite keperawatan akan mempercepat penerapan
UU Keperawatan sebagai regulasi keperawatan di RS:
a. Pengaturan SDM perawat (Jenjang Karir, Kredensial)
b. Implementasi praktik keperawatan oleh perawat yang memiliki tugas
dan kewenangan jelas dan penerapan standar-etik keperawatan.
c. Sebagai dasar untuk pemberian jasa kepwerawatan
d. Menjamin pasien memperoleh pelayanan keperawatan berkualitas
melalui pemenuhan hak-haknya.
e. Mewujudkan keperawatan sebagai profesi
TERIMA KASIH