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

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

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
R2

R3

Restraining forces

R4
R5
Desired equilibrium
Existing equilibrium

D3
D1

D2

D4

D5
Driving forces

Lanjutan
.

Step and Processes of Planned Change

INPUT

PLANING
Preliminary
Dignosis
Date
gathering
Feedback of
Results
Action
planning

Unfreez
ing

TRANSFORMATION

OUTPUT

ACTION

RESULTS

Learning
processes
Action
Planning
Action steps

Changes in
behavior
Data
Gathering
Measurement

Changi
ng

Refreez
ing

Feedback Loop A

Feedback Loop B

Feedback Loop C

B. The ADKAH
Model

C. The Change Curve

Models

Lanjutan
.
The Change Curve Models

Lanjutan
.
STRATEGIES FOR CHANGE

PROCESS OF PLANNIG CHANGE

Identify Need for
Change
Identify Areas for
Change

Feedback

Assessing the
Situation
Planning of change
Assess change Forces
Action for change/
implementing

Monitoring and
evaluating
change

HUMAN RESPONSE TO CHANGE

A. Responses of
Change
1. Management
Viewpoint
2. Staff Viewpoint

B. Resistance to
Change
1. Anxiety
2. Happiness
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
Referent
Moral
Responsibilit
y
Relational

Power of
Others

Continge
ncies of
Power

TYPES OF POWER

TYPES
OF
POWER

CONSEQUENCES OF
POWERS
SOURCES OF
POWER

Expert Power
Referent Power

BASES OF POWER

INDIVIDUAL
CHARACTERI
STICS/
FACTOR

Legitimate
Power
Reward Power
Coorcive Power

ORGANISATI
ONAL
FACTOR

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 ones interests in
certain organisational issues.

Characteristics of
Organizational Politics
1
2
3

Techniques Used
in Organizational Politics
8. Building
Coalitions

Techniq
ues

Factors/Conditions influencing
Political Behavior

Personal
Characteri
stic

Organisati
onal
Change

Ambigu
ous
Goals

FACTO
RS
Comple
x&
Ambigu
ous
Decisio
n

Scarce
Resource
s
Technolog
y&
Enviromen
t

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