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      A Change-Management Approach to Closing Care Gaps in a Federally Qualified Health Center: A Rural Kentucky Case Study

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          Abstract

          Effective organizational change requires intentional planning. We applied Kotter’s 8-Step Process for Leading Change model in understanding and evaluating how a federally qualified health center in rural Kentucky implemented a significant organizational change — a proactive office encounter (POE) model — to improve preventive care service delivery, close care gaps, and reduce health disparities among its patients. We completed qualitative interviews with 21 clinic personnel (eg, administrators, physicians, support staff, care coordinators) who were directly involved with POE implementation. We found evidence of steps 1 through 7 of Kotter’s 8 steps of change in the POE implementation process. Step 8, anchoring new approaches in the organizational culture, was an area for improvement. Change-management models, such as Kotter’s 8-Step Process for Leading Change, provide a systematic guide for health clinics to implement sustainable organizational change aimed at improving patient health outcomes.

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          Is Open Access

          Multiple Chronic Conditions Among US Adults: A 2012 Update

          The objective of this research was to update earlier estimates of prevalence rates of single chronic conditions and multiple (>2) chronic conditions (MCC) among the noninstitutionalized, civilian US adult population. Data from the 2012 National Health Interview Survey (NHIS) were used to generate estimates of MCC for US adults and by select demographic characteristics. Approximately half (117 million) of US adults have at least one of the 10 chronic conditions examined (ie, hypertension, coronary heart disease, stroke, diabetes, cancer, arthritis, hepatitis, weak or failing kidneys, current asthma, or chronic obstructive pulmonary disease [COPD]). Furthermore, 1 in 4 adults has MCC.
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            Using Kotter's Change Model for Implementing Bedside Handoff: A Quality Improvement Project.

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              Change management in health care.

              This article introduces health care managers to the theories and philosophies of John Kotter and William Bridges, 2 leaders in the evolving field of change management. For Kotter, change has both an emotional and situational component, and methods for managing each are expressed in his 8-step model (developing urgency, building a guiding team, creating a vision, communicating for buy-in, enabling action, creating short-term wins, don't let up, and making it stick). Bridges deals with change at a more granular, individual level, suggesting that change within a health care organization means that individuals must transition from one identity to a new identity when they are involved in a process of change. According to Bridges, transitions occur in 3 steps: endings, the neutral zone, and beginnings. The major steps and important concepts within the models of each are addressed, and examples are provided to demonstrate how health care managers can actualize the models within their health care organizations.
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                Author and article information

                Journal
                Prev Chronic Dis
                Prev Chronic Dis
                PCD
                Preventing Chronic Disease
                Centers for Disease Control and Prevention
                1545-1151
                2019
                08 August 2019
                : 16
                : E105
                Affiliations
                [1 ]University of Kentucky College of Public Health, Department of Health, Behavior & Society, Lexington, Kentucky
                Author notes
                Corresponding Author: Angela L. Carman, DrPH, University of Kentucky College of Public Health, Department of Health, Behavior & Society, 151 Washington Ave, Bowman Hall, Room 352, Lexington, KY 40536. Email: angela.carman@ 123456uky.edu .
                Article
                18_0589
                10.5888/pcd16.180589
                6716404
                31400097
                c551b07f-3e4d-4072-829e-e761bafa82e1
                History
                Categories
                Program Evaluation Brief
                Peer Reviewed

                Health & Social care
                Health & Social care

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