Change Management in Hospitals - Essay Example

?Running head: CHANGE MANAGEMENT Change Management in Hospitals Module: Change Management in Hospitals Hospitals just like any other institution have to be managed well for them to successfully and sustainably offer required medical services. The last 20 years or so have notably seen many hospitals change their institutional environments to reflect both changing times and needs. Some trends like shifting to prospective payments from cost related reimbursement, technological advancement and management of care plans among others have hugely influenced how hospitals are being managed today. As such, hospitals have shifted their conventional approach where they were run on voluntarism basis to a more contemporary and competitive approach. This approach has seen many hospitals corporatize their services thereby adopting normal organizational management approaches and strategies like change management. It is important to note that in their pursuit of organizational strategizing many of them have closed down while others have survived the competition. Majority of those which have closed down have done so as a result of inefficient management, others have created barriers for all patients to access medical care. In the workplace there is need for change management to take place in respect to number of staff. The hospital is operating quite inefficiently as a result of having an unnecessary high number of staff. Redundancy creeps in where many workers are doing the same thing without creativity or level of innovation. Considering the number of both outpatients and inpatients the available manpower is way above the optimum which results in wastage of time. This also results in wastage of finances which could otherwise be used to improve on quality of medical care provided. In order to ensure that all employees work optimally and to reduce on cost of operations, a downsizing plan is necessary (Schulz & Johnson, 2003). When considering the Lewin’s Force Field Analysis driving forces and restraining forces have three major elements each. Downsizing strategy/ Lewin’s Force Field Analysis This is a measure that is quite sensitive in many organizations as labor unions and other restraining forces play crucial roles. It is also referred to as restructuring or reorganizing. It is complex to implement as it also requires restructuring of job designations, change in departments and their consolidations among others (Cohn & Hough, 2008). Although highly unpopular this strategy has worked for many corporate organizations like GM and IBM. Since hospitals have adopted corporate measures in management then change strategies cannot be blind to downsizing. One of the driving forces is cost saving which is the most obvious of all benefits. Due to the increased pressure for hospitals to be self reliant and increased control of care plans the hospital needs to cut down on its cost of operations (Mason, Leavitt & Chaffee, 2007). This subsequently creates an internal pool of resources which are in turn used to improve on services offered. The economic condition is not at its best with many sectors still recovering from the recent 2007-09 global economic meltdown. The other force is improved efficiency especially by targeting employees whose jobs do not contribute directly to revenues and which do not heavily affect the hospital’s core operations. The strategy will also help in weeding out poor performers and retain highly skilled employees. Efficiency is also derived when the few remaining employees focus their energy towards core duties of the hospital. There is also shorter communication channels and improved responsiveness. This way bureaucracy is eliminated resulting to a more flat command structure. The third major force is labor mobility which benefits the hospital in an indirect way. In case many employees will be found to be non performers it will be relatively easy to hire new ones coming from inefficient or closed hospitals. On the other hand there are competing forces that are against downsizing the first being opposition from the workers’ union and possible strikes or slowdowns (Jasper & Jumaa, 2005). As mentioned earlier layoffs are quite unpopular and efforts to implement such a strategy in the hospital will attract heavy criticism from labor unionists demanding either other measures to be taken altogether or huge compensation to be offered with the former taking precedence. The other force is the disruption and disorganization that comes after a layoff. Employees take up new roles and increased responsibilities which they take time to adjust to. For sometime this interruption may lead to inefficiency hence the need to carefully execute the plan. The third force is that workers who are left will most likely feel insecure and may disorient their working schedules. Implementation plan As clearly highlighted implementation will not be easy. Layoff will start with the clinical support staff whose effect to the hospital is minimal. The hospital director is the one to approve the layoffs citing organizational changes as the primary reason. The director is free to consider other options like reducing work schedules or initiating leaves without pay among others. When the layoff strategy is in place then the targeted personnel need to be notified. Notification should not be immediate and adequate time will be provided of not less than 30 days. Notification will contain reasons for the layoff and rationale behind choosing the particular employee (Grossman & Valiga, 2009). Also a clear message will be sent stating that the vacant positions will not be subject to refill and indicate how work will be redistributed. In the case that the hospital and the employees or the union, in this case, are in agreement notifications will be forwarded in regards to; criteria to serve a transition period, dates for the layoff plans to be selected by employees and which appeal rights are available in these circumstances. In case of personal delivery of the notice, the date and time of delivery should count as the first for the notice. In case that the notice is to be sent by mail, the date of sending counts at the first for the notice. After consideration of the above plan and various forces that affected the strategy implementation went ahead. Hitches developed whereby the union demanded other measures to be taken in place of layoffs. It was difficult to explain that change was necessary in the hospital and that the best way to do it was by a layoff in the clinical support section. Their argument was that the hospital was to start from there and end up sending home all employees and finding replacements. As the layoff clauses clearly stated no single position was to be refilled and that jobs held by laid-off people were to be redistributed. A slower layoff scheme was introduced where the duration within which all targeted employees were to have left was extended from 2 months to 6 months. This was agreed upon between the union leaders and the hospital management. It acted as a sign of good faith from the side of the management that it was not intending to replace any staff but to improve efficiency and cut on cost thereby safeguarding the employment of all the rest. The management argued that if the hospital was to continue running as before at high costs especially in maintaining unnecessary workforce, it would not survive for more than 3 years. Change strategies are heavily criticized in many organizations with hospitals not being an exception. Human beings are known to be receptive to change and will show quite an effort in stopping implementation of change. In the above plan the resentment that was witnessed would have been minimized if consultations had been made with the union leaders prior to notification. When implementing any change strategy it is important to ensure that all stakeholders especially the affected parties are duly consulted. References Cohn, K. H. & Hough D. E. (2008). The business of healthcare: Improving systems of care. Greenwood Publishing Group. Grossman, S. & Valiga, T. M. (2009). The new leadership challenge: Creating the future of nursing. 3rd edn. F.A. Davis. Jasper, M. & Jumaa, M. (2005). Effective healthcare leadership. Wiley-Blackwell. Mason, D. J., Leavitt, J. K. & Chaffee, M. W. (2007). Policy & politics in nursing and health care. 5th edn. Elsevier Health Sciences. Schulz, R. & Johnson, A. C. (2003). Management of hospitals and health services: Strategic issues and performance. 3rd edn. Beard Books. Read More