Implementing change in virtually any organizational context is necessary to ensure the continued improvement of products and/or services as new information becomes available. The health care industry is especially susceptible to such changes, as the wellbeing of patients will be compromised if any system within an organization fails to adapt to emerging issues. In general, the change process will result in the reallocation of resources and requires a significant number of steps regardless of the scope of the modifications being at the level of unit, department, or the whole organization. The inherent complexity of any process of change is based on the ultimate need to consider ramifications on the entire system, even when direct alterations are only made to a relatively small subgroup. However, the nature of the organization and the specific issues at hand will have a major impact on both resource allocations and the number of steps required in the change process.
Organizational silence can have a devastating impact on functioning and outputs. When employees are not relaying information about potential flaws in the system there is little to no chance of making improvements where appropriate and errors can multiply over time. There are several potential supporting factors for organizational silence from employees, such as ignorance of the impact, fear of responses from management, and plain disregard. Organizational leaders may also create an atmosphere of acceptance for silence so that they do not have to face their own fears about the potential consequences. It is essential that companies combat this threat through preventative and interventional measures whenever possible. A solid foundation can be built by hiring managers who are known to operate on open terms that will contribute to the creation of a silence-free organizational atmosphere. Other possible actions may include the establishment of formal reporting systems and incentives for employees who contribute.