Change Management In The Healthcare Environment Policies Business Essay Example

and gain enthusiastic support for the outcomes (Wallace, 2007).

In Mercer Medical Centre's case, pressures driving the need for change can be attributed to market competition and the constant requirement to update systems and equipment in order to stay ahead. The increasing influence of managed care and Mercer's acquisition of smaller private clinics along with its own managed care insurance program further emphasize the importance of competitiveness.

To tackle these challenges, Mercer Medical Centre pursued contracts from high-tech companies like Syntel, renowned for manufacturing computer chips and their Physician Order Entry (POE) system. Mercer decided to implement its physician order entry (POE) system earlier than planned due to rival companies' plans to do so as well. This decision was also influenced by a recent detrimental incident that had a negative impact on the corporation's reputation and managed care contracts. According to Anderson, possessing a state-of-the-art POE system would prove advantageous in contract negotiations.Resistance to change is a common occurrence and can arise due to factors such as lack of communication, limited involvement from top management, and the use of forced change processes. It is crucial for the Project Manager to anticipate and address this resistance. The most challenging time to face opposition is during the transition period to the new solution, which is both hectic and critical. To ensure successful implementation, strong support from leadership plays a vital role. By delivering the message from top management and reinforcing it through immediate management, employees will be encouraged to believe in and support the proposed changes.

In evaluating bureaucratic wellness organizations, it is essential to assess their strengths and weaknesses. Bureaucracy refers to a structured form found in large-scale administrations

that relies on task specialization, authority hierarchy, decision-making processes, rules and regulations, as well as an impersonal approach by officials (Mullins, 2007). It represents administration based on division of labor with written document preparation and dispatch at its core. Contrary to popular belief, bureaucracies do not autonomously govern but serve as a means through which various forms of authority such as monarchies or democracies exercise rule (VectorStudy, 2008).Bureaucracies offer a safe haven for managers to evade accountability and responsibility for their mistakes or unresolved issues they have caused. They can utilize bureaucratic rules to suppress self-management and enforce compliance among employees (Mullins, 2007). As per Weber's perspective, bureaucracy is a specific kind of administrative structure established through rational-legal authority. Bureaucratic constructions have evolved from traditional structures with certain modifications. The ideal bureaucracy is characterized by impersonality, efficiency, and reason. Crucially, officials' authority is subject to published regulations and codes of practice, and all decisions and actions are documented in writing. The organizational structure follows a continuous hierarchy where each level is controlled by the level above it. Each position within the hierarchy stands on its own merit without any entitlements to a specific position. Responsibilities within each level are clearly defined, and each level has its own domain of expertise. Assignment to an office and the extent of authority bestowed upon individuals are solely based on evidence of technical competency (VectorStudy, 2008). Clients often use the term "red tape" to describe organizations with rigid policies and procedures that appear inflexible and unresponsive to individual situationsSenior managers often lack information and are shielded from what happens on the front lines or in the field. Decisions are

made based on the perceived desires of superiors, rather than considering mission accomplishment. Bureaucratic direction prioritizes control and consistency, with a focus on satisfying governmental bureaus' board of managers rather than individuals within the administration. "Bureaucracy," as seen by clients and employees, includes negative forces, attitudes, or actions that harm client and employee satisfaction. It also reduces organizational effectiveness, decreases employee morale and commitment, creates divisions within the organization, and directs energy towards internal conflict or competition instead of fulfilling the mission (Airy Publications, 2010). On the other hand, organizational development (OD) is crucial in leveraging an administration's corporate talent, facilitating change, and improving performance. It involves taking planned measures to establish an environment where staff understands and achieves the administration's objectives (People Development Team [PDT], 2010).These measures involve the development of necessary skills, behaviors, attitudes, culture, and leadership styles that promote optimal organizational performance (PDT, 2010). It is important to have clear direction, strong leadership, and a focus on people-oriented issues such as public presentation and promoting learning, development, creativity, and innovation. Team building refers to a systematic process where a group of individuals enhances their individual and collective performances (TBO, 2010). This process requires shared goals aligned with the company they work for and effective leadership. The team building process consists of four stages: forming - establishing order and a sense of belonging; ramping - conflicts and problems arise leading to internal disagreements; norming - openly discussing conflicts to establish new guidelines; executing - organization members working together to meet high performance standards.Valuing each team member, creating a desirable company culture, motivating them to achieve goals, having a strong leader, and ensuring effective

communication between members and management are all important aspects of team building. Coaching plays a significant role in both one-on-one and team situations as leaders serve as managers for the entire organization. Coaching involves enabling others to succeed through various means such as conversations, encouragement, confrontation, and challenging individuals to do their best. Building trust is crucial for successful organizational coaching which can be achieved by actively listening to people's thoughts and demonstrating genuine concern for their success. By spreading the leader's message throughout the organization and giving employees a voice in the process, organizational coaching fosters ownership among employees and promotes pride in their work. This leads to a more determined effort towards achieving success (Baldoni, 2005). Strategic planning serves as an overall approach that guides effective decision-making processes. It goes beyond day-to-day activities by providing a broader perspective on what needs to be done and where the organization is headed. Strategic planning offers clarity regarding desired outcomes and strategies for achieving them rather than focusing solely on daily operations (Shapiro, n.d.).Mercer Medical Centers, a health care administration organization, recognizes stakeholders as individuals, groups, or businesses with an interest in the organization's success. Stakeholders are focused on achieving desired outcomes and meeting financial objectives. They can directly or indirectly contribute to the organization's activities, such as community development projects or local health services. The decisions and policies implemented impact stakeholders' level of gain or loss.

Involving stakeholders throughout a project serves two important purposes. Firstly, it increases the likelihood of success by incorporating a feedback loop that allows for self-correction. Secondly, it builds confidence in a product and facilitates its acceptance among the target audience.

It

is vital to treat different types of stakeholders differently when addressing any business change. Providing clear communication that explains the reasons for change and its impact is crucial. This demonstrates consideration for people's needs and willingness to collaborate with them to gain their support and commitment to the change.Consistency in leading the change initiative is crucial. It is important to constantly pay attention to the direction of undertakings, activities, and enterprises that contribute capabilities into administrations delivering desired benefits. Make sure your people have all the necessary resources and capabilities to support them through the change. This is vital because people are often stressed, tired, and frustrated with change initiatives. They require careful explanations of what change management entails, why the proposed change is necessary, and how it directly affects them while also benefiting them. Practical help and support are also needed.

A company has two types of stakeholders: internal (employees, directors, owners) and external (suppliers, society, government, creditors, shareholders, customers). Understanding stakeholder roles in change can be helpful in assessing their support or resistance towards planned changes. To build a stakeholder map as a team exercise:
1. Analyze stakeholders
2. Write their names on Post-It Notes
3. Stick the notes on a chart on the wall

Resistance and support from stakeholders represent different forms of stakeholder power.The level of power held by stakeholders varies, whether it is in the form of formal authority or societal influence, which may either support or oppose change. It is crucial to conduct a power analysis to prioritize stakeholders as those with high power can be valuable allies or dangerous opponents. Some stakeholders actively dedicate their time and effort to support change, while others

actively work against it. These active stakeholders receive significant attention; however, there is also a silent majority that is more difficult to identify. These gatekeepers subtly either support or oppose change through their actions or lack thereof.

Conducting a Stakeholder Analysis and Map is vital for identifying and planning communication strategies for a program. This process involves categorizing stakeholders based on their specific interests in the program and addressing any known or anticipated issues associated with individuals or groups involved. Each individual and group participating in the program will have expertise and interests in areas such as finance, proficiency, regulation, etc. Recognizing these specific areas of interest is important when considering their roles in order to effectively manage their expectations.

Some individuals or groups may be negatively affected by the program and could potentially hinder its progress. Therefore, both positive and negative perspectives should be taken into account as part of stakeholder management.The Pre Programme Review and Planning process has previously identified issues related to individuals or groups and determined potential solutions and strategies for resolving them. Effective information dissemination and two-way communication are crucial for managing expectations. To evaluate the effectiveness of systems in promoting change in Mercer Medical Centers, it is necessary to analyze how well the different components of the system work together to achieve the overall goal. The system takes inputs such as resources (materials, money, technologies, and people) and processes them to generate desired outputs that collectively achieve the organization's goal. These inputs undergo alignment, coordination, and movement to achieve the desired goals of the system. Tangible outcomes such as goods or services for consumers are produced through this process. Another type

of outcome is consumer benefits like employment opportunities and an improved quality of life. Systems can refer to the entire organization or its individual parts, groups, or processes (McNamara, 2010). Decision Conferencing is a proven method for making more effective decisions by involving groups of people in a transparent decision-making process. It is particularly useful for quickly resolving complex issues (Catalyze Ltd, 2008).The decision-making process involves workshops where all parties come together to discuss and identify options and issues. This is facilitated by documenting discussions and using modeling for analysis. Decision Conferencing allows groups to openly discuss their organization, values, issues, and beliefs. The outcomes of these workshops are also valuable for educating individuals who were not present.

Systems technology integrates different subjects and groups into a team effort, organizing a structured development process from conception to production to operation. It considers both the business and technical needs of clients in order to provide a quality product that meets user demands.

Evaluation is an important part of management activities, involving the collection of information to make necessary decisions. Evaluations can occur in various businesses, both for-profit and non-profit, and are closely related to performance management. Performance measures are used to assess the extent of performance by collecting information.

Mercer Medical Centre has attempted several systems implementation projects aimed at improving services for users. One such project was the Physician system implemented two years ago, but it failed due to resistance from medical staff who had concerns that were not taken into consideration.Technical issues played a role in the abandonment of the previous system after just two days. This system was deemed unsuccessful, resulting in significant financial loss and

leading to the dismissal of the CIO. The reputation of the information services department also suffered greatly (Ash, et al., 2000).

Another system called CareReviewer was attempted but faced difficulties due to medical staff perceiving it as unwelcome technology. They believed that this system increased their workload rather than making their jobs easier. Doctors saw this as a reason for reduced salary and a loss of independence, as they were being pressured to see more patients in less time with less compensation while top executives earned more money (Ash, et al., 2000).

Currently, the hospital is aiming to implement a new system known as Physician Order Entry (POE) within a shorter timeframe of nine months. This change in timeline was driven by competition from Mercer Medical Centre and concerns regarding public relations (Ash, et al., 2000).

Reed, recognizing the existing resistance within the organization, is committed to rebuilding trust with the medical staff.She is available 24/7 and provides personal support by visiting people at their homes to establish rapport. Involving influential individuals and ensuring immediate benefit increases the usage of the POE system. Physicians desire a system that is fast, easy to use, accessible anytime, consistent, accurate, dependable, and positively affects patient care (Ash et al., 2000).

Question 3: Develop change management models that consider risks in case studies. Organizational change can be caused by various factors such as economic downturns, strategy changes, government legislation, labor market pressures, technological advancements, and natural evolution. It is crucial for organizations to internally manage this change and understand its impact on employees (Snaith, 2010). Introducing change within an organization can be challenging as directors need to gain support from colleagues and employees

while minimizing disruptions to business operations. Failure to do so can result in the loss of talented employees, credibility, and market share (Snaith, 2010). Administrations often face resistance when implementing changes as employees may have concerns about their job or dislike how it is happening.To address this, employers should maintain consistent communication with their employees, provide necessary training for new or changed roles, and ensure that the reasons for the change are communicated from the beginning (Snaith, 2010). Imposing change on people can make them feel powerless and out of control. Some individuals may adapt to the process quickly, while others may struggle (RapidBi, 2008). Kotter identified several reasons why change fails, including allowing complexity to become overwhelming, failing to form strong alliances, lacking a clear vision, inadequate communication, not planning and achieving short-term wins, declaring victory too early, and not integrating changes into corporate culture (RapidBi, 2008).

There are numerous models for managing change. The most common is the Kubler Ross grief cycle grounded in research within clinical environments. Another model is the ADKAR model for individual change management developed by Prosci. It discusses the five essential building blocks for successful individual level transformation: consciousness, desire knowledge capability support (RapidBi 2008).

Business process reengineering aims to improve performance by completely redesigning an organization's structures and processes from the ground up (McNamara 2010). Kaizen is a model for incremental self-improvement applied to business and management.Kaizen is a method used to enhance existing processes and is not suitable for implementing new processes or large-scale changes. Unlike other business process reengineering methodologies that require radical changes in the short term, Kaizen focuses on the human aspects of improvement and

encourages discipline and acceptance of change. This makes it easier to implement compared to other methodologies that often lead to resistance and a need for strong change management skills (JISC Advance, 2009). It is important not to impose change on individuals as everyone has different perceptions of it. Instead, as change managers, we should encourage individuals to make their own choices and decisions.

In planning the implementation of the theoretical model of change developed for Mercer Medical Centers, it is crucial to consider that business process reengineering is a technology-oriented approach that allows radical change but requires significant management skills. According to Davenport (1992), there are five steps involved in business process reengineering: developing the business vision and process objectives, identifying the business process to be redesigned, understanding the existing processes, identifying IT levers, and designing and building a prototype of the new process known as The Executive Fast Track (TEFT) (2010).

Change plays a vital role in continuous quality improvement as any improvement methodology involves introducing change and measuring its impact.According to the Victorian Quality Council (VQC) in 2006, the healthcare industry recognizes the need for system change to support safe and quality care. Simply providing tools and strategies for improvement is not enough; it's important to understand what to expect when implementing change, how to engage staff, and how to sustain that change. Having knowledge of the change process can help ensure project success. Executing successful system alterations is crucial for providing safe and quality care, but it can be challenging to implement improvement projects and maintain resulting changes. It is widely acknowledged that quality improvement projects often fail, making change management an essential component

of successful projects along with proper planning and using quality improvement tools as stated by VQC in 2006. When managing change, people are typically the most critical resource, supporter, barrier, and risk. The uncertainty of change tends to evoke strong emotions as individuals let go of old ways and embrace new ones, often experiencing grief and loss. Understanding these reactions helps leaders appropriately address expressed concerns during the change process according to VQC in 2006.Leaders can drive change by understanding the reasons behind emotions and addressing concerns (VQC, 2006). Winning the hearts and minds of people is essential for improvement as simply instructing them to change will not yield positive responses. Effective communication is necessary in the process, allowing stakeholders to express their perspectives and attitudes. Change involves altering mentalities, utilizing tools and techniques, and collaborating with colleagues to achieve something different. It also entails recognizing the potential of thinking differently and making practical improvements for patients and staff (VQC, 2006). Evaluation plays a crucial role in any change process. When planning a project, there should be careful consideration of the measures used to determine if the planned change leads to improvement (VQC, 2006). Disseminating evaluation requires considerations of the audience, method, and format for communicating feedback. It is recommended to present a final package that includes all planning details, data, results, and learning to staff and stakeholders.If the evaluation of this is shared and focuses on learning in a non-punitive environment, it can become a benchmark or standard for implementing change (VQC, 2006). The key to implementing change and continuous improvement lies in the effective exchange of information between people and processes. It requires

a combination of business and human dimensions towards a shared objective (VQC, 2006).

The result of altering Mercer Medical Centre is evaluated in terms of competition and public relations. These forces for change often lead to resistance from the medical staff. In order for a successful change initiative, three broad areas should be addressed: leadership that directly addresses the emotional impact of the change and provides inspiration, a change model and methodology that considers multiple factors, and action management that guides people on what is required of them.

Dr.Reed is being pressed to implement the POE system quickly, but she knows the organization is not prepared for this change. They need more time to implement such a change, which they currently do not have.

Mercer Medical Centre faces similar environmental pressures as other organizations. It is important for stakeholders to engage in bipartisan communication, engage in constructive problem-solving, develop a common strategy, and take charge of the change process. There is no one-size-fits-all formula for organizational success - able to use them effectively for success.Organizations should acknowledge the existence of multiple theories that can help them achieve success. However, it is important to note that each theory has its limitations and may only be suitable in specific situations. Therefore, managers must approach these theories with skepticism and evaluate their relevance and applicability critically. By understanding and identifying these theories, managers can effectively incorporate them into their organizational planning and transformation process to attain success.