This paper examines change management strategy and leadership theory in the context of Longford Medical Services (LMS), a small rural general practice in Tasmania, Australia. Beginning with an overview of the practice's background — including its patient population, staffing, and the introduction of the Mental Health Nurse Incentive Program (MHNIP) — the paper surveys key leadership frameworks, from trait and behavioural approaches to situational and contingency theories. It then applies a structured change management model to LMS, detailing the three core strategy elements: situational awareness, supporting structures, and strategy analysis. The paper argues that a well-formulated change management strategy is essential for successful organizational change, providing direction, informing decision-making, and guiding subsequent planning activities.
Longford is a small community of approximately 3,000 people situated 20 kilometres south of Launceston. It lies within the Northern Midlands local government area and has a predominantly Anglo-Saxon community. Longford Medical Services (LMS) has an active patient population of 9,905 people residing in or around Longford and employs eleven General Practitioners (GPs).
In the past, some GPs experienced difficulties managing clients with mental health issues. These clients frequently required longer consultations, creating delays for other LMS patients that became difficult to accommodate. There were also long delays for appointments with private psychiatrists, Tasmanian Psychiatric Services, and other programs that must be accessed in Launceston. As in other small communities, transport options are limited.
The Mental Health Nurse Incentive Program (MHNIP) commenced in Longford in early 2009. This coincided with the closure of a residential psychiatric service (Howard Hill) in Longford. Medical services are delivered from two LMS premises: the main site in Longford itself, and a smaller surgery located in Perth, 8 kilometres away. In addition to medical services, a monthly hearing service is offered, and until recently a dietician was also available.
The MHNIP nurse is employed directly by Longford Medical Services Pty Ltd. on a permanent part-time basis. Due to space restrictions, the MHNIP nurse works from the Perth clinic, which is not ideal since the majority of clients live in or around Longford, and this location isolates the nurse from the main practice. The offer of home visits is used to increase access to the service. LMS is currently seeking funds to increase the number of consulting rooms at their Longford premises in order to co-locate the nurse in the future.
Leadership theories can be characterized generally as being concerned with who leads, how they lead, under what circumstances they lead, and who follows the leader. One of the earliest approaches to studying leadership is the trait approach. This approach emphasizes leaders' attributes such as personality, motives, values, and skills. Underlying the trait approach is the assumption that some people are natural leaders, endowed with certain traits not possessed by others (Yukl, 2006).
Deficiencies in trait theories led researchers in the early 1950s to begin studying the specific behaviours exhibited by leaders (French, 2007). The behavioural approach focuses on what leaders do rather than what traits they possess. This represented a shift from the assumption that leaders are born to the notion that leaders can be developed (Yukl, 2006). The attractiveness of the concept of leadership style lies in the possibility of labeling and objectifying an otherwise confusing diversity of behaviours.
As a response to findings that leadership styles differ across contexts, theories taking into account situational factors have gained popularity. This body of theory was developed to reconcile differences among findings within behavioural approaches to leadership. Situational approaches emphasize the importance of contextual factors and their influence on leadership processes. Theories that explain leadership effectiveness in terms of situational moderator variables are also called contingency theories of leadership (Yukl, 2006; Warnstam, 2008).
At a holistic level, the interpretation of environmental scanning ought to lead to the creation of a vision aligned with a best estimate of the future environment. The organization's vision represents an idealized picture of what the organization should strive to become. The subsequently developed strategy should explicitly align ends (objectives), ways (concepts and methods), and means (resources) to ensure the organization's resources are committed in a manner that allows it to succeed in its current and future environments — in short, to enact the vision (Carter, Ulrich & Goldsmith, 2012).
Strategic leaders must therefore ensure that they align the vision with their interpretation of the changing environment, and that the organization's strategy is aligned with this vision. Similarly, structure, culture, personnel policies, and technology also need to be aligned with the vision and strategy in order to achieve the vision and maintain competitive advantage (Gerras et al., 2010; Fuller & Green, 2005). Leadership in this study refers to the ability of an individual to influence, motivate, and enable others to contribute towards the effectiveness and success of the organization (LMS) of which they are members (House et al., 2002).
A "one-size-fits-all" approach is not effective for change management. Implementing an enterprise resource planning solution at LMS requires change management to be successful. Change management strategy elements include situational awareness, supporting structures, and strategy analysis.
"Change characteristics, organizational attributes, impacted groups"
"Team structure, sponsor coalition, risk and resistance"
Formulating the change management strategy is the first critical step in implementing a change management methodology. The strategy provides direction and results in informed decision-making throughout the change process. A well-formulated strategy brings the project or change to life, describing who will be affected and how the change will impact the organization.
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