Tom Hilton is a retired NIH science officer and NIDA program official now in private practice. Tom has over 40 years of experience studying and conducting large-scale organizational change initiatives in publically-traded corporations, DOD and other large federal agencies, as well as general-medical and addiction health service organizations. In this blog post, Dr. Hilton comments on a recent study published in the Journal of Behavioral Health Services Research that discussed the factors influencing use of NIATx. That study found that larger organizations with more administrative resources that treat more patients and participate in national associations and in NIDA’s Clinical Trials Network are more likely to use the NIATx model.
Organizations change in response to one of two things: being oriented towards continuous improvement, or crisis. Both are usually rooted in leadership.
Organizations in crisis suffer from emotional blindness caused by fear, panic, and role overload. As far as leaders of declining organizations can see, exploring changes in policies and practices is an impediment to immediate mission accomplishment. That lack of foresight too often leads to the organizational equivalent of a massive coronary that usually puts the organization out of business.
How does one overcome such thinking? The real challenge in change involves overcoming inertia. Usually that inertia emanates from the widely accepted values, beliefs, and practices that determine what and how work gets done (i.e., organizational culture). Some cultures facilitate productivity and quality outcomes. Other cultures unwittingly undermine it. So how can one determine if their culture is in need of peaks and tweaks or complete overhaul?