Order 1121761: The Impact of Change of Management in Healthcare

6

Running head: IMPACT OF CHANGE MANAGEMNT IN HEALTHCARE

Introduction

Change management is one of the pressing issues every organization is confronted with especially in an environment where change is associated with success or failure. The healthcare organizations are not left out in this change frenzy as they also seek to succeed through successful change implementation. Rapid change is being recorded in the health care organizations, mostly as they try to adopt new technologies and improve the quality of patient care, as well as manage the performance of the healthcare personnel. The best way to deal with the change, as literature reveals, is helping the employees adopt new ways of doing things (Campbell, 2008).

By definition, change management entails the process leading to the realization of the ideal state of the organization. In other words, change management in an organization entails overseeing the transition from the current state to the desired state. The process of change begins with the creation of a vision for the change. This is then followed by empowering the people responsible with the change to act as agents of the change and help attain the change. The change management process often involves many participants with roles that are clearly defined. These may include the owners of the change, the managers of the change, and the owners of the processes among others.

Change management often impacts on various people differently. The stakeholders within change management are varied which includes the participants to the change, and other groups that are either affected directly or indirectly by the change. In healthcare organizations, these impacts will be felt depending on the type of change and the result of change. For example, the change might be concerned with the introduction of new technologies, and this will mean new skills for the personnel and possibly a new structure for the entire organization. Change management in healthcare organizations, therefore, requires that the managers fully understand change and its impacts before making efforts to implement the change.

Literature review

There are several major types of changes explained in the literature that are experienced in the healthcare industry. In this case, literature has revealed that technological changes, strategic changes and innovations in pursuit of better patient care are among the most influential ones. Change management, it has been hypothesized, will entail managing the change process itself and the people who most likely to resist the change.

It is acknowledged that the healthcare managers today tend to occupy an extremely challenging position requiring them to maintain a competitive edge in a healthcare market while leading the organization through a constant change (Campbell, 2008). Organizations today, regardless of the industry or sector, are experiencing rapid technological change. The healthcare organizations are also subject to this phenomenon whereby technology is the key driver of change. The healthcare organizations are adopting new technologies as they try to implement quality improvement initiatives and performance management initiatives such as pay-for-performance (Campbell, 2008). Technology can be disruptive in that it can completely change the face and operations of the organizations, and the change management in healthcare will need to take into account that new models and structures might result. In such a case, the biggest challenge is often preparing the nurses to cope with such changes which could have huge impacts in the nature of their careers. For example, they could not be required to have IT skills for them to handle the new IT systems being implemented.

Besides the technology changes, the change management in healthcare is also concerned with the shifts in the environment which tend to compel the healthcare organizations to change their strategies (Caldwell, Chatman, O'Reilly III, Ormiston, & Lapiz, 2008). Research in change management in healthcare has revealed that strategic change often fails owing to the inability of the individuals to adopt the necessary behaviors for the successful implementation of the new strategy. The healthcare management and leadership, therefore, are seen to be deficient in terms of proper change implementation. A change in strategy is something that would require a change in behavior, meaning that the behavioral change should be the first thing to implement. The behavioral change should lay the foundation for the strategy change whereby everyone is brought on board.

Literature has established that this form of change requires a unique approach. The hypotheses set out by Caldwell, Chatman, O'Reilly III, Ormiston, & Lapiz (2008) include that the management and leadership should gain support for the strategic change and introduce norms for change readiness. According to Klein, Conn, and Sorra (2001), a successful change implementation will require an ‘implementation climate’, a term defined as support for the specific change. Their study was concerned with the application of advanced computerized manufacturing technology, but the principle applies to all organizational contexts. An implementation climate in a healthcare organization would probably be that climate where the organizational members are not only ready for the change, but also support the change entirely.

Teamwork in change management in healthcare has also been found to facilitate a successful change implementation. Researchers like Markoczy (2011) have established that when the members of the management team are in agreement or have a consensus on the change direction, there is a greater likelihood of success. This leads to another hypothesis that there will be greater performance improvements where the members agree on the nature of the new strategy. The healthcare management is, therefore, presented with a challenge of achieving this unity that will drive the speed and effectiveness of the change process. Team leadership becomes a necessity because, as research has established, the senior leaders may have a critical role in the identification and implementation of the new strategy, the middle managers leading the various groups have the ability to enhance or undermine this implementation (House & Aditya, 1997). This means that the middle managers and the nurses collectively and individually have an influence on the success of change implementation. Each individual must be brought on board, a challenge for the managers who need to overcome the resistance to change. According to Kodama & Fukahori (2017), the nurse managers are the first-line managers who are responsible for inducing change in the clinical environment.

According to Al- Abri (2007, p. 9), the change management in healthcare has to contend with the fact that the healthcare professionals, including nurses, are obligated to acquire and maintain the expertise requisite for their tasks as they will only be given tasks falling within their individual competencies. With the change occurring frequently, all these professionals may be required to update continuously their expertise in order to remain relevant to this sector. This is why researchers like Al- Abri (2007, p. 9) argue that change management entails managing the complexity of the processes – that is, planning, evaluating, and implementing operations, strategies and tactics that ensure that the change is relevant and worthwhile. Managing resistance is especially important at the lower levels where professionals like the nurses could face and resist a change in the nature of their careers.

The pursuit of patient safety initiatives is another reason why the healthcare organizations have to be worried about change management. There are often some unintended consequences when these organizations pursue patient safety without undertaking effective change management (Ramanujam, Keyser, & Sirio, 2005, p. 455). Herein, the management and leadership in the healthcare organizations need to understand the inputs shaping the strategy (both internal and external) before developing strategies to achieve specified outcomes. According to these researchers, the senior management and leadership has an active role in the change initiation, and are also responsible for energizing the process of change. This leadership must also make sure that on board are senior administrators, clinicians, nurses, and opinion leaders among others. In other words, all members of the organization have to participate in the change process.

The improvement of patient care has been a top priority in almost all healthcare organizations and this exerts a lot of pressure. Ducharme, Buckley, Alder, and Pelletier (2009, p. 70) establish that among the challenges facing Ontario healthcare organizations include overcrowding and long wait times that degrade the quality of care. Innovative and timely solutions to such challenges are a priority. A literature review presented by Antwi and Kale (2014, p. 1) also indicates that the Canadian healthcare organizations were in need for solutions to problems such as long wait hour and timely access to care. This literature review reveals that the patient care is a critical factor affecting the changes in the healthcare. The pursuit of better patient care means pursuing innovations in both systems, structures, technologies, etc. These researchers express the need for the managers and decision makers to understand how change occurs in order for them to create a conducive environment for the innovations.

References Al-Abri, R. (2007). Managing Change in Healthcare. Oman Medical Journal, 9-10. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3294155/ Antwi, M., & Kale, M. (2014). Change Management in Healthcare: Literature Review. Retrieved from https://smith.queensu.ca/centres/monieson/knowledge_articles/files/Change%20Management%20in%20Healthcare%20-%20Lit%20Review%20-%20AP%20FINAL.pdf Caldwell, D., Chatman, J., O'Reilly III, C., Ormiston, M., & Lapiz, M. (2008). Implementing Strategic Change in Health Care System: The Importance of Leadership and Change Readiness. Health Care Management Review, 124-133. Retrieved from http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.462.6697&rep=rep1&type=pdf Campbell, J. (2008). Change Management in Health Care. The Health Care Manager, 23-35. Retrieved from https://pdfs.semanticscholar.org/fd5c/f11e42ff1adf514014f75e65764b38207b66.pdf Ducharme, J., Buckley, J., Alder, R., & Pelletier, C. (2009). The Application of Change Management Principles to facilitate the Introduction of Nurse Practitioners and Physician Assistants into Six Ontario Emergency Departments. Healthcare Quarterly, 70-77. Retrieved from https://pdfs.semanticscholar.org/0ad7/985633b9e47ee8dc5609aa2e307f7343990d.pdf Gerhard, M. (2011). Institutional Ethnography. In C. Chapelle, & L. Harklau, The blackwell encyclopedia of applied linguistics (pp. 1-5). Malden, MA: Wiley Blackwell. Retrieved from https://people.umass.edu/~mgebhard/Gebhard%20Publication%20PDFs/2012%20-%20Institutional%20Ethnography%20-%20Ency.pdf House, R., & Aditya, R. (1997). The Social Scientific Study of Leadership: Quo Vadis? Journal of Management, 409-473. Retrieved from http://psgleadership.scripts.mit.edu/2012IAP/pdf/1_required_reading/Scientific%20views%20on%20Leadership.pdf Klein, K., Conn, A., & Sorra, J. (2001). Implementing Computerized Technology: An Organizational Analysis. Journal of Applied Psychology, 811-824. Kodama, Y., & Fukahori, H. (2017). Nurse Managers’ Attributes to Promote Change in their Wards: A Qualitative Study. Nursing Open. Retrieved from https://onlinelibrary.wiley.com/doi/full/10.1002/nop2.87 Kothari, C. (2004). Research Methodology: Methods and Techniques. New Delhi: New Age International (P) Ltd. Retrieved from http://www.modares.ac.ir/uploads/Agr.Oth.Lib.17.pdf Lippitt, R., Watson, J. and Westley, B. (1958). The Dynamics of Planned Change. New York: Harcourt, Brace and World. Mason, J. (2002). Qualitative Researching. London: Sage. Retrieved from http://www.sxf.uevora.pt/wp-content/uploads/2013/03/Mason_2002.pdf Naidoo, L. (2012). Ethnography: An Introduction to Definition and Method. In L. Naidoo, An Ethnography of Global Landscapes and Corridors (pp. 1-8). InTech. Retrieved from http://cdn.intechopen.com/pdfs/31534/InTech-Ethnography_an_introduction_to_definition_and_method.pdf Ospina, S. (2004). Qualitative Research. In G. Goethals, G. Sorenson, & J. MacGregor, Encyclopedia of Leadership. London: Sage. Retrieved from https://ualr.edu/interdisciplinary/files/2010/03/Qualitative_Research.pdf Ramanujam, R., Keyser, D., & Sirio, C. (2005). Making a Case for Organizational Change in Patient Safety Initiatives. Advances in Patient Safety, 455-465. Retrieved from https://www.ahrq.gov/downloads/pub/advances/vol2/Ramanujam.pdf Shagrir, L. (2017). Journey to Ethnographic Research. Willian, N. (2011). Research Methods: The Basics. New York: Routledge. Retrieved from https://edisciplinas.usp.br/pluginfile.php/2317618/mod_resource/content/1/BLOCO%202_Research%20Methods%20The%20Basics.pdf