Organizational Change in Health Care

Introduction

Organizational change is the adoption of a new idea or behavior by the organization. The environment, whether it is internal or external, keeps on changing and it is the task of the organization to be structured in such a way so as to respond to the changes by changing itself in the right manner, or else it will be left somewhere behind in the race of this cut throat competition. Organizational change is a phenomenon that needs to be carefully studied as this factor distinguishes profitable and admired organizations from failing and unimpressive ones (Patron, 2000).

Facing the ordinariness of the business life is a task that every organization can do but it is not easy to implement a change which is applicable to the whole organization and do it successfully. It is a task which has to be accomplished with the help of many resources within the organization, be it be the leadership available or through the kind of corporate culture that has been developed and exists over the years.

As far as health care organizations are concerned, they are also organizations, which are acting as social entities and are benefitting society as well as themselves through their business. The process of planned change can also be well applied to a health care organization as will be seen now. The hospital by the name of Horizon Care will be analyzed within areas in which problem exists and where can change be implemented.

The Problem

The problem that was identified at Horizon Care was in the record keeping area. Patient records were kept on a manual basis but they were maintained in a very haphazard manner. Often when nurses were asked to refer to old records of a patient so that their history could be known and further medication and treatment on the patient can be told, the records were missing or they were so badly maintained that the doctor could not make any sense out of them. Often the handwriting was poor and the doctor would feel that it was no more than a child’s scribble. Moreover, maintenance of records were done on a plain sheet, thus there were no directions or a proper form to direct the person who was completing the form to know what information was necessary and required and which was irrelevant.

The creation of backup handwritten data too difficult thus the management had decided not to have any backups. Effective utilization of the data could also not be made since the data was handwritten. By effective utilization, it is meant the use of computer intelligence wasn’t used. In simpler words it means the artificial intelligence should be used to derive the patterns of various patients, their diagnosis and treatment given by the expert doctors which can be accomplished by creating a knowledge database and knowledge system, which can accumulate data over time and give the hospital a competitive edge over other hospitals. Lastly space for patient data storage had been exhausted thus new data storage was becoming a problem.

Driving and Restraining Forces of Change

One of the first factors in implementing change is that a company or the health care organization should recognize that there will be resistance to change and that there will be certain forces that will drive the change and certain forces that will restrain the change (Darwin, 2002). Studying these two types of forces is an elementary factor in implementing any kind of proposed change. Such a study is called doing a force field analysis. This concept has been derived from the findings of Kurt Lewin who contented the driving and the restraining forces of change will always compete with each other and whichever excels over the other will determine whether the change will be implemented by the driving forces or the idea of change will be scrapped by the restraining forces. (Darwin, 2002)

The driving forces in this proposed change are:

  • Readily available information that is time will be saved of the doctors and the nurses in finding a specific record of a patient.
  • A paperless health care hospital
  • The ability to store and save archives and archives of data without worrying about storage problems
  • A standard format of form will be made through which information of every patient will be uniform in terms of their nature.

The restraining forces in this proposed change are:

  • Resistance from the labor force of the health care hospital as they are not that computer literate.
  • The costs involved with getting a specific computerized system according to the needs of the health care.
  • The costs involved with training the labor to use the system.

Development of the Plan for Change

The proposed change

The proposed change is the implementation of a computerized system to keep the records of all the patients that ever visit the hospital. The proposed change is to make the move from manual paper and handwritten documentation to a computerized formal and systematic procedure of keeping records. This change is monumental since it will alter the way the whole system at the hospital works. Health care hospitals are process-focused and thus the implementation of computerized system will change the whole process.

Goals and objectives

The goals and objectives of this change process is to make a paperless hospital, a place where record maintenance is highly efficient and when retrieval of records is necessary then it is achieved with a single click. Moreover, standardization of the records that are kept of the patients will be done. If the “history” and “doctors referred to” of one patient are recorded, then the same will be recorded of the other patient. This will help the doctor in serving the patient better.

Target dates for implementation

Implementation of the propsed change program will take approximately one month after all the developments are finalized in the plan for change. These developments should be given at least a month’s time since it is essential that the human resource of the health care hospital accepts or at least becomes indifferent to the change before it is formally implemented. Moreover, the kind of change that is being proposed here is very technical and requires proper formation of a computerized system which is made especially for the health care hospital and it also requires the training of personnel to handle the system. (Fleming, 2006)

Who would be involved in the planning?

The people who would be involved in the planning phase will be the top management of the health care hospital, 41doctors who usually use the patient records, the 73 nurses who usually fill out these patient record forms and a special consultant who will facilitate the whole process of change by managing the whole process from start till end. This change agent can also be the idea champion, which is the person who proposes the change in the first place. (Rob, 2000)

Strategies to improve the likelihood of successful change

Some of the strategies to improve the likelihood of successful change are to use the models that were given to us by old theorists and conceptualists. These models give great insight as to how change can be implemented and how organizations and leaders should go about it.

Lewin’s Change Model

The step by step process of initiating and implementing a change within an organization needs to be understood if change has to be successfully brought in the organization. Lewin says that bringing an organization change is a three step process, 1. unfreezing, 2. changing and 3. refreezing. (Richard, 2000)

In the first step of unfreezing, participants have to be made to unlearn what they have learned up till now and things that they need to give up in order for the change process to be effective (Richard, 2000). Awareness has to be spread among the participants and they should be made to be willing to change. This can be done by giving financial information and showing the bad condition of the organization and persuading everyone that if change does not take place, things will go even worse. Benchmarking can also be used at this stage by marking a single hospital who our hospital needs to beat or alteast come close in terms of quality of service and patient feedback. This step can also be called diagnosis of the change process.

The second step is changing, where new behavior is taught to the participants. This can be done through various ways such as training, seminars, team building, mentorship programs etc. The individuals have to learn the new skills, if any are required. This step can also be called the intervention stage. (Richard, 2000)

The third step is refreezing where the change process is reinforced by rewarding the individuals for embracing the change process. By this stage, the individuals have adopted the new skills. This stage is also called reinforcement stage. (Richard, 2000)

A System’s Model of Change

A systems model of change involves the general depiction of how change can take place generally in any organization and the various factors that get affected by it. The major components of the model are the inputs, the target elements of change, and the outputs. (Patron 2000)

In inputs, the company is seeing external components through examining its strengths and weaknesses. On the other hand, externally it has to study the opportunities and threats within the environment and act accordingly (Patron 2000). When this is done, it will be seen which element change has to be brought. It can be any of the five elements of methods, goals, people, social factors and organizing arrangement. These are factors on which, using the inputs, the process of change can be applied.

Lastly, the outputs are either on the organizational level, departmental / group level or the individual level. It has to be carefully seen how each change is affecting people on every level, whether it is individually, in a group or as bring a part of the organization. (Fleming 2006)

Understanding the systems model of change gives us a better idea of what are the inputs, process and outputs of the complex change process and thus it can be done in a better manner.

Conclusion

As far as change is concerned, if it is planned well before its implementation, then the odds of success increase substantially. Resistance to change is a natural phenomenon by employees everywhere, but the management should know how to overcome this resistance and bring the situation to its own advantage.

References

Carnall, C. (2003) Managing Change in Organizations. Prentice Hall.

Darwin, J. (2002) Develop Strategies for Change. Prentice Hall.

Fleming, J. (2006) Organizational Change. Prentice Hall.

Rob, P. (2000) Change Management: A Guide to Effective Implementation. Sage.

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