Effective Ways of Managing Shift Pattern in Health System - Essay Example

?MANAGEMENT IN HEALTH CARE - SHIFT PATTERNS Introduction One of the main challenges in modern health sector is to adopt the most effective ways of dealing with emerging changes in the sector. Due to the increasing demand for its activities, the diagnostic changing department have in the recent past adopted an effective mechanism of ensuring 24 hours operations. The department has focused on shift-pattern in their operation. However, one of the main concerns, among healthcare practitioners is to develop an effective means of managing work shift changes. The change in the department to incorporate shift pattern is expected to coincide with the healthcare organisational culture and leadership styles. The changes should take place in a systematic place without tampering with the existing system. This paper presents an in-depth analysis of the most effective ways of managing shift pattern in health system. Extended working hours and shift work has in the recent past become a universal state of affairs in most organisations and industries in the world. Recent statistics have confirmed that, more than 25% of employees in the world are engaged in work outside regular working hours (Martin, Charlesworth and Henderson 2010, p. 123). Shift working has equally become an integral facet in many sectors in the world including health care systems. The contemporary healthcare intricacy has turned global healthcare system in to a 24 hours operating system. This has a result brought about the need for the introduction of a shift pattern to facilitate effective 24 hours operations. The reality in 24-hours service delivery in health sector is that, health professionals are expected to develop a consistent shift pattern that will meet the needs and demands of the clients, administration, and employees. The adoption of shift pattern or change in shift pattern is a complicated process which brings about ethical, personal, and legal complications in health sector (Higgs, Jones, Loftus and Christensen 2008, P. 95). If inadequate managed, shift pattern can result to fatigue and ill health among healthcare professionals. Fatigue and work overload can as a result generate harmful implications on patients’ healthcare. As defined, shift pattern is a process where one employee is expected to replace another one in the same job within 24-hours period. Shift pattern is used to explain healthcare activities that are scheduled outside the normal working hours and is characterised by handing over of duties from one person to another (Royal College of Nursing 2009, p. 97). Based on the available statistics on the long term and short term health and professional complications associated with shift pattern, a lot need to be done by healthcare employees and management to protect the safety and health of healthcare professionals (Royal College of Nursing 2009, p. 97). Management/Leadership Style To effectively attain the maximum benefit of shift-pattern, healthcare managers ought to adopt coaching leadership. This form of leadership will educate the employees on the most effective means of adapting to the proposed changes. The style also helps leaders to build personal strengths among employees in an organisation. Coaching leadership style will also help employees to learn the most effective way of working as a team. On the other hand, participative and democratic leadership is as well very essential in the achievement of health system change process. in this cases leaders are expected to involve members in decision making process and in the entire change process. Total involvement of all employees in decision making process is also very essential in improving employees’ job satisfaction. Moreover, despite improving organisation profitability, participative leadership also helps in the development of employees skills. By using participative form of leadership employees and other stakeholders develop a feeling of control of the organisation destiny. Organisational Culture As defined, organisational culture entails the shared perceptions values and beliefs in an organisation. In most cases employees in healthcare sector have unique perceptions on the organisation operations which are instituted by the organisation itself. Therefore, all changes in an organisation should coincide with the existing norms and values in an organisation. Employees should as well be given an opportunity to give meaning to the changes in the organisation. Moreover, instituting changes that line with the organisation values reduces internal conflict and confusion. The Importance of adopting changes to incorporate Health and Safety of Shift Workers in Health System Employees in the organisation play a very essential role in the productivity of health systems. Healthcare professionals are to a great extent the ones who decide on the future destiny of an organization. Therefore, it is the responsibility of healthcare management to consider the impact of any change in employees’ health. Human beings are controlled by 24 hours body clock commonly known as circadian rhythm. The circadian rhythm is controlled by the brain and helps in the regulation of sleep, eating habits, blood pressure, body temperature, pulse, and other essential aspect in human body functions. In most cases, human beings are active during the day and are as a result expected to sleep at night. Therefore, shift work and particularly night shift interferes with circadian rhythm. The interference with circadian rhythm brings about fatigue stress and other physical health complications (Josten, Ng-A-Tham and Thierry, 2011, p.643). The safety and health problems that are associated with shift works have severe impacts on health practitioners’ productivity and in the general management of the organisation. Working for long hours, lack of rest or break times, and fatigues increases chances of errors that can negatively affect client’s health. Long-term exposure to shift work is commonly known for bringing about health complications that include cancer, depression, and increased vulnerability to minor sickness such as gastroenteritis and cold, cardiovascular problems, sleep deficits, and gastrointestinal problems (Boddy, 2012, p. 127). Moreover, some professionals are more vulnerable to health complications that result from work shift than others. Older employees, pregnant workers, and people with chronic diseases are as a result more susceptible to complications that are related to work shift. To effectively manage changes of adopting shift patterns diagnostic imaging department the department leadership should consider the side effects of the plan to the employees. Role of Employer in managing Work Shift Related Complications Under the Safety and Health Regulations, the health system management have the responsibility of protecting the health condition of the employees. To meet this obligation, healthcare managers should come up with effective measures of preventing safety and health risks that is associated with shift work (Bonnefond, Tassi and Roge, 2009., p. 67). Healthcare managers also have the mandate of complying fully with the laid down working time regulations that defines limits of daily and weekly working hours. According to the available regulations, health care managers should ensure that they provide adequate break rest between shift changes and in shift hours. The available literature provides a number of evidence-based good practices recommendations for reducing and managing shift work risks. By referring to the Global Health, Safety, And Welfare Policy, healthcare management should provide suitable facilities by providing an environment where employees would take meal during shift hours and prepare hot drinks (Ahasan, Lewko and Campbell, 2009, p. 217). Pregnant mothers should be excluded from working in night shift due to the nature of their health conditions. Legal Obligations in the management of changes in diagnostic imaging department With reference to the Occupational Health and Safety Regulations, the health care managers have the responsibility of providing a health and safe workplace and a safe working system. Healthcare managers should recognise all the risks that are associated with shift work and take the necessary action to counteract their impacts on the health status of the employees. Under the Occupational Health and Safety Regulation, healthcare managers are expected to consult with health care professionals or their employees on the most effective ways of dealing with emerging health care issues. Healthcare managers are expected to provide appropriate and adequate information, instruction, and training on the most successful ways of preventing health conditions that might emerge as a result of work shifts. Under the available regulations, healthcare managers also have the mandate of conducting consistent evaluation on the employees working conditions to effectively eliminate the likely health risks in the healthcare systems (Reid and Dawson, 2009, p. 61). Management of Change Theories John Kotter's Change Model Adapting to changes in an organisation is a very complicated process which requires adoption of effective mechanism. John Kotter's Change Model talks about eight steps which are effective in facilitating effective changes. According to Kotter, healthcare manager ought to establish a sense of urgent to the identified change. Secondly creating a powerful guiding coalition is very useful for success implementation of changes. Creating a clear vision and a clear model of communicating the identified vision is also essential and paramount. The success of an organisation is based on empowering employees by creating effective empowerment plans. Therefore, the application of all these steps will also be very in the implementation shift pattern. Kaizen Theory Kaizen Model revolves around five specific elements, improvement traits, quality, high level of morality personal discipline and teamwork. Therefore, the understanding of this theory among health care managers will be very essential in advancing the impact of the proposed changes in the organisation. On the other hand, for shift pattern to be effective in healthcare sector, healthcare management ought to inform the employees on the significant of team work and personal discipline. Although it is sometimes very difficult to measure the impacts of some aspects of this model, healthcare managers should be committed towards ensuring that all employees understand these concepts and their significant in healthcare operations. Change Management Process Change management process can be defined as a process which involves a sequence of activities and steps that alters the management in an organisation. In this case, healthcare managers have the mandate of following the set steps in achieving the projected changes. Therefore in implementing the shift pattern changes healthcare managers should prepare the employees for the proposed change. Secondly, it is the responsibility of healthcare management to ensure that effective management and control of the proposed changes. Finally, to acquire the best outcome health care managers should as well reinforce the proposed changes. Benefits of Effective Management of Shift Work Patterns Creating an effective shift work system is a time consuming and a costly process. In most cases, health workers are resistant to change in their shift work schedules. In any shift pattern, there are some workers who benefits from the shift and there are others who are underprivileged by the plan. Due to this reasons, it is vital for healthcare employers and healthcare managers to have sufficient consultation with the employees in order to come up with an agreement that can benefit the healthcare system, patients, and healthcare professionals. It is essential for healthcare professionals to understand the fact that, a systematic and well planned approach of assessing and managing shift work risks can extensively advance the safety and health status of healthcare employees. In general therefore, minimising safety and health risks associated with shift work may economically benefit the healthcare sector and the society in general by reducing absenteeism and preventable sickness, minimising staff turnover, improving work efficiency, increasing the quality of health care services, decreasing time lost in healthcare operations as well as reducing the probability of compensation claims. Why Are Shift Works and Extended Working Hours Hazardous for effective performance of diagnostic imaging department? Despite its understandable benefits, working in shift in most cases severely affects the health conditions of healthcare employees. Irregular roster, working for long hours, and shift work especially at night increases health hazards and difficulties. Shift work is blamed for interfering with domestic and social lives of health practitioners and their families. Working during the night and weekends may create social problems since those times are presumed by many societies to be social hours. The subsequent are some of the main health and social complications that are brought about poor management of shift work Family and Social Effects In most cases, shift workers are isolated from social activities by their families and friends. This is due to the fact that, shift workers are especially committed during the family’s social times. Secondly, due to work overload and lack of adequate resting time, shift workers encounter reduced interest in sexual affairs. This as result leads to family conflicts, separation and increased cases of marriage breakdown. Thirdly, shift workers are faced with a challenge of being isolated from cultural, social, and community events. Excessive anger and irritability are also some of the main facets that characterises the lives of shift employees. Sleep Difficulties Sleeping is a complicated process that involves several stages of light and deep slumber. Sleep process covers a full sleep cycle which is expected to take roughly eight hours for an adult. The deep slumber stage in sleeping cycle is as a result extremely essential in physical recovery and for psychological adjustments. Therefore, any interrupted sleep is likely to result into unproductive rest. Lack of adequate sleep can in extreme cases force human brain to spontaneously shift into sleep during daytime. Sleeping during the day after night shift is in most cases a problematic procedure. Most night shift workers sleep one or two hours less in day time thus reducing the quality of their rest. This result due mismatched between circadian rhythms and other external cues such as noise temperature, food, and light. Sleep complications which are brought about by shift work leads to chronic sleep problems. Consistently poor quality sleep is commonly known for bringing about physical and psychological problems. Some of psychological and physical difficulties associated with sleep include: mood change, disturbances of eating habits, fatigue, dizziness, inability to concentrate and perceptual changes (Tucker, Smith, MacDonald I et al, 2008, p. 275). Fatigue Fatigue is an excessive tiredness that is brought about by mental or physical exertion. The level of fatigue is mostly determined by the level of workload, the time spent in working, and the amount of time spent in resting. Jobs that require long time standing, repetitive movement, and manual handling lead to increased level of fatigue as opposed to job that does not require a lot of physical and mental energy. A job that demands high level of attention and alertness may increase fatigue. To counter the health impact of lack of sleep among health professionals, shift work ought to be tolerable enough to reduce sleep debt. Rest days should be distributed throughout the duty roster to give room for recuperation and recovery (Royal College of Physicians 2006, p. 73). How to Counter Health Complication in Work Shift in the Management and Operations of Health Sector Shift Duration With reference to the Working Time Regulations, healthcare professionals are legally expected to have resting hours in shift work period. Based on the available researches in different sectors, working for long hours with an inadequate rest breaks has a harmfully impact on the safety of patients and health professionals in health care environment. In most cases, a good number of healthcare staffs prefer a 12-hours shift as they need fewer shift and more days off. Having more days off is relatively beneficial in advancing recuperation rate as opposed to many shifts with few resting days. Moreover, the twelve hours shift is beneficial as its makes working hours shorter and creates more social and health benefits to healthcare professionals (Wortley and Grierson-Hill 2010, p. 42). Rest Breaks Adequate rest break within shifts is vital in preventing excessive fatigue and tiredness. Adequate rest break gives a health professional adequate time to refuel and rehydrate especially in demanding responsibility. Enough resting time is also indispensable in facilitating productive recuperation. Employees and health care managers are as a result supposed to consider the length of the shift when scheduling the frequent and duration of breaks. Sleeping during night shift breaks has proved to be effective in preventing tiredness and fatigue. Copying With Shift Work for Employees Despite the managers’ role of reducing work shift risks, health care practitioners have a specific responsibility of minimising the side effects of shift work. In most cases, night shift is a disturbing experience especially to newly employed healthcare assistants and nurses. This is due to lack of instant people to ask immediate and technical questions during the night shift. As a result, new employees feel more tired during night session as opposed to day shifts. The subsequent strategies can serve a very essential role in reducing fatigue and tiredness that is associated with work shifts (Akerstedt, 2008, p. 127). 1. Getting a good sleep Good sleeping habit is essential for the safety of healthcare practitioners. Excellent sleeping habit involves adopting a regular sleeping custom which includes setting specific time to go to bed and having a specific waking up time. Although this habit could be complicated for shift workers, good sleeping habit has proved to be one of the most effective means of reducing fatigue and tiredness. It is important for healthcare professionals to develop an effective bedtime ritual such as listening to music before sleeping (Naidoo & Wills 2010, P. 21). Sleeping place should be cool and quit to facilitate quality sleep. Regular exercise during day time is vital for a health sleep. Moreover, to be a successful night worker, health care professionals are also advised to effectively manage their day time sleep by minimising disturbance through turning off mobile phones and closing the bedroom doors. Health practitioners should ensure that the bedroom is dark and calm (Tucker P, Smith L, MacDonald I et al 2009, p. 679). 2. Staying awake and alert during the night shift Eating healthy diet helps individual to stay awake in the entire night shift period. It is important for health practitioners to ensure that they take adequate meal before commencing into night shift duties. Health professionals are advised to make consistent movement during their shift in order to keep their body active. Hydrating through taking water is essential in reducing sleep during night shift. However, workers are advised against taking too much caffeine as caffeine may hinder sleep for a long period of time thus interfering with the sleeping time (Health and Safety Executive 2012, p. 167). 3. Maintaining The Health Professionals’ Health Since shift workers are more vulnerable to many diseases, regular health check up is exceptionally essential and significant. It is also important for shift workers to actively participate in social activities with their friends and society members. Total involvement in social activities is essential in minimising chances of mental complications. Eating health food is vital in reducing health complications among shift workers. Minimising smoking and regular exercise has also proved to be very effective in reducing the risks of gastro-intestinal complications, cardiovascular problems, and diabetes. Health care managers have the responsibilities of financing regular health checkups to healthcare practitioners (Department of Health, 2007, p. 67). To minimise the risk of breast cancer that may result from work shift, female workers need to be subjected to frequent breast cancer checkups. Additionally, shift workers are in addition warned against relying on sedatives and stimulants such as high energy drinks, cigarettes, and coffee in night shifts. This is due to the fact that, sedatives and stimulants are short-term solutions and can increase the risks of physical health complications, addiction, and dependency. Legal and Ethical Issues Despite the significant of shift work in health sector, the introduction of the shift pattern has brought about some ethical and legal complications. According to the existing regulations health professionals are supposed to work for less than twelve hours in a day. However, due to the increased complexity in contemporary ailment, health care professionals are forced to work in extra hours per day thus bringing about legal complications (Herring 2010, P. 97). The exclusion of healthcare professionals in social activities has also brought about ethical complications. According to the code of ethics that guides health care practitioners, healthcare management should give their employees adequate time to enjoy their social life. However, by considering their core responsibility in health sector, healthcare professionals have the mandate of ensuring the health care of its patients is protected and improved thus working for extra hours to improve the health status of patients is imperative and essential. Recommendation for Effective Shift Work Practices Health care managers should avoid giving dangerous, demanding, and monotonous responsibilities in night shifts, towards the end of long shift, early morning shifts, and during other low alert periods Health care managers should also avoid placing health care practitioners in permanent night shifts Creating regular free weekends in shift schedules is also very essential for healthcare practitioners health Health care workers should also be allowed a two full night’s sleep when switching from night to day shift or day to night shifts Health care managers should ensure adequate time within successive shifts It is also important for healthcare managers to avoid split shifts Workers should also be discouraged from saving their break time in order to leave earlier in night shift. Shift of variable lengths could offer suitable compromise thus minimising healthcare complications associated with shift. Health care should also consider the needs of vulnerable workers while designing the shift schedule Shifts should be limited to a maximum of 12 hours Healthcare manages have the responsibility of ensuring quick shift rotation Employees should be given a chance to choose whether they would prefer rotating shift schedule or permanent schedule Conclusion With the adoption of the right strategies, adequate supports, involvement of employees as well as the introduction of good risk management, a good number of healthcare professionals are at present able to tolerate with shift work. Shift working has various advantages to the healthcare system, healthcare professionals, and patients. Despite of its financial benefits, shift work is essential in the management of caring responsibilities in health care systems. Carrying out domestic responsibilities at less busy period is as easy transportation during off peak period are also some of the advantages associated with shift work. However, despite of its obvious advantages healthcare professionals require adequate support in order to adapt to shifting pattern. On the other hand, for vulnerable employees such as pregnant women shift work will significantly increase their health risks. It is therefore, the responsibility of health care managers and other key stakeholders in health sector to ensure adequate management of health and safety risks that are associated work shift. It is imperative for healthcare managers to not only protect the wellbeing of health care professionals but provide adequate protection to patients who get healthcare from shift workers. References Ahasan R, Lewko J, Campbell, D et al 2009, “Adaptation to night shifts and synchronisation processes of night workers”, Journal of Physiological Anthropology, 20 (4) 215-226 Akerstedt T., 2008, “Shift work and disturbed sleep/wakefulness” Occupational Medicine, 53 (2) 89-94 Boddy, D., 2012, “Essentials of Management”, London: Pearson Bonnefond A, Tassi P, Roge J 2009, “A critical review of techniques aiming at enhancing and sustaining worker’s alertness during the night shift’ Industrial Health 2, 42 1-14 Department of Health, 2007, “National Service Framework for Children, Young People and Maternity Services”, London: Department of Health. Health and Safety Executive, 2012, “Human factors fatigue”, Bootle: HSE. Herring, J., 2010, “Medical law and ethics”, New York, NY: Oxford University Press. Higgs, J., Jones, M., Loftus, J. and Christensen, N. 2008, “Clinical Reasoning in the Health Professions”, (3rd ed.), London: Butterworth Heinemann. Josten E J C, Ng-A-Tham J E and Thierry H 2011, “The effects of extended workdays on fatigue, health, performance and satisfaction in nursing”, Journal of Advanced Nursing 44 (6) 643-652 Martin, V., Charlesworth, J and Henderson, E 2010, “Managing in Health and Social Care”, (2nd Ed.) London: Routledge Naidoo, J and Wills, J 2010, “Health Promotion: Foundations for Practice”, (2nd ed.), London: Bailliere Tindall. Reid K and Dawson D 2009, “Comparing performance on a simulated 12 hour shift rotation in young and older subjects”, Occupational and Environmental Medicine 2, 58 58-62 Royal College of Nursing 2009, “Past imperfect, future tense: Nurses employment and Morale in 2009”, London: RCN. Royal College of Physicians 2007, “Working the night shift: preparation, survival and Recovery”, London: RCP. Tucker P, Smith L, MacDonald I et al, 2008, “The impact of early and late shift changeovers on sleep, health and well-being in 8- and 12-hour shift systems,” Journal of Occupational Health Psychology 3 (3), 265-275 Tucker P, Smith L, MacDonald I et al, 2009, “Effects of direction of rotation in continuous and discontinuous 8 hour shift systems” Occupational and Environmental Medicine, 20, 57, 678-684 Wortley V and Grierson-Hill L 2010, “Developing a successful self-rostering shift system” Nursing Standard, 17 (42), 40-42 Read More