Professional Leadership and Organizational Change - Case Study Example

Author’s Name Instructors’ Name Course Date Professional Leadership and Organizational Change Introduction According to the studies by Cicely Saunders Institute and Hospice UK, there has been increased demand for the hospice services due to inadequate primary care given to patients suffering from chronic illnesses that threaten their lives (Dept of Health 2016). The psychosocial and physical support that patients need before diagnosis, during treatment and follow up stage has been lacking. Therefore, it is for this reason that the establishment of palliative care program in the facility, to provide primary care to the patients is proposed. The objective of the program is to reduce the number of people seeking hospice services and ensure that more lives are saved in the society. Proposed Change Overview The change that this project wishes to introduce is to establish a palliative care program for the hospital. The objective of the palliative care will be to assist those people who are suffering from serious illnesses before and after they are provided (Bass& Riggio, 2006). Most importantly, the common reason for this reality is that over eighty per cent of the sick people under hospice services noted that they were not introduced or provided with palliative care in any of the healthcare facilities across the country, making it hard for them to recover or believe in themselves. Critical to note is that patients need not only physical support but also psychosocial support for them to get better and hopefully recover quickly from their illnesses. The problems that most of the patients suffer from in the hospice facilities have been due to lack of primary care before or during the treatment process. The palliative care program will be provided at all stages including when an illness is diagnoses, before and during treatment as well as during follow-ups process (Bass& Riggio, 2006). Further, the program will provide services to people suffering from different diseases such as cancer, heart disease, lung diseases, kidney failure, and dementia, HIV/AIDS, and ALS (amyotrophic lateral sclerosis) among other diseases. Impact to the External Environment The PESTLE analysis tool, which stands for political, economic, social, technological, legal , and environmental factors, is commonly used to identify the impact of external environmental factors on any planned changes to health systems and providing opportunities for more robust strategic plans to be embedded for safer patient outcomes (Cooper 2000; Iles and Cranfield 2004; Briggs et al. 2015). The PEST analysis below shows some of the political, economic, social, technological aspects of the palliative care program (Raymond Caldwell, 2012). Besides providing palliative care, the program is intended to create awareness to the public, which is expected to trigger political will in providing facilities that will help in early diagnosis of chronic illnesses such as cancer (Benjamin, 2008). Consequently, the facility expects to reduce the cost it incurs while providing hospice services, which include the high number of permanent staff members who are always needed at the facility. Instead, some employees will be working on contract basis, thus reducing the cost of staffing. The competitive edge that the facility will get will also help in raising the sales, which will translate into profit. Socially, the patients seeking hospice services will reduce since some, if not all, will receive or will be able to live a normal life (Benjamin, 2008). Technologically, with experts, an application will be started for providing personalised calendar for all patients on the days they are required to receive services. In this way, technology will play a pivotal part in enhancing delivery of palliative care services. Impact to the Internal Environment Although the main aim of the palliative program will be to strengthen the quality of care in the facility, the program will also have other benefits. For example, the program is expected to facilitate financial savings, increased patients, and staff satisfaction, as well as to provide a competitive edge for the facility. Notably, palliative care programs have been known to help hospitals and healthcare facilities avoid costs in different ways. For example, the program helps in the elimination of unproductive, redundant, unwanted care and related services and supplies. As noted above, there has been congestion in the facility for those people seeking or need hospice services. Consequently, some of the patients and other stakeholders, including the entire community have been complaining of delayed services or reduction of the quality of services being provided (Berwick, James & Coye, 2003). In this way, the reputation of this facility is jeopardised due to the increased demand for the services. At the same time, the management is pressured to provide more staff and caregivers, which is sometimes challenging. Therefore, the introduction of palliative care program will go a long way in reducing the demand for hospice service in the facility. In fact, the number of employees providing hospice services may be cut in the end and transferred to the palliative care services. In this way, the congestion that is being experienced at the facility will be highly reduced, and the hospital will have regained its positive reputation from public, which will raise the level of trust and confidence (Burnes, 2012). Further, it should be noted that palliative care programs involve teaching as well as modelling supportive techniques such as meditation, mindfulness, Schwartz Center Rounds, team debriefing, and reflective writing and reading, which is helpful for the clinicians and staff in the facility. In such sessions, the team members will be able to diminish compassion fatigue including easing moral and emotional burnout among the staff (Lucas et al. 2013). Consequently, the program will help in reducing the rate of turnover since most personnel complain of being overworked. Measurement of the Outcome of the Palliative Care Services Evidently, it is only by measuring the outcome of any organisational change that the management and the change agents can understand its impact (GAO and Peng 2011). In this respect, there are different strategies or models that can be applied in measuring the impact of organisational changes. However, it is critically important also to realise that the model for change measurement depends on the type of problem and solution implemented including the variables of change to be measured. Based on the nature of the program and the expected outcome, Donabedian model will be used in measuring the impacts. An Overview of Donabedian Model Donabedian model refers to a conceptual model that offers a framework for assessing health services as well as evaluating the level of quality care (Newton, 2007). The design provides that information about the quality care services can be based on three categories, which include “structure,” “process,” and “outcomes.” As the name suggest, “structure” explains the context in which services are delivered which include staff, buildings, equipment, and financing. On the other hand, “process” refers to the transaction and circumstances under which care providers and patients meet to deliver healthcare. Finally, “outcome” is the effects or impacts that health services are having on patients or consumers of those services. Application of Donabedian model Notably, under the structure, different factors should be included. However, since the issue of concern is the palliative care services, the availability of the facilities and equipment including human resources will be a key consideration. The required facilities such as machines, gyms, and others will have to be purchased and installed. However, the equipment must be functional to be the best level to have the positive outcome. At the same time, healthcare providers including nurses and special teams must be enough to attend to all patients (Newton, 2007). Critical to note is that by establishing palliative care for the hospital, the aspect of “structure” will have been considered since the program is also a “structure” through which the flow of services will depend on. In this model, factors under “structure” help in controlling how care providers in a system behave and are used to measure the average quality of care in a health facility. Therefore, the objective of creating a palliative care program will be to provide a structure that will act as the basis for provision and measurement of quality care. More so, the “process” will include the actions taken to ensure that the physicians, clinicians, nurses and other employees that will be recruited through the program deliver care in an efficient manner (Stiglitz, 2010). A closer look at the responses from the patients, their friends and families will also be analysed. Finally, the outcome will include the general effects of the program to not only the patients and the surrounding community, but also staff members. To collect the data, the random observation, interviews, focus group discussions, and questionnaires will be used. Leading the Change Organisational change is one of the certain aspects of any institution (Van, 2015). Change does not only occur in working places but everyone’s life as well. This means that change is unavoidable. However, in working areas, there are usually two forces of change: restraining and driving forces. Restraining forces are those that oppose a given change in an organisation while driving forces are the change agents or those supporting the change. In reference to the palliative care program, as nurse manager, the change agents including the nurse manager will convince few colleagues including departmental managers and members of the board of directors. The change agents, in this case, would be few forward-looking employees in the facility (Van, 2015). However, the team will have to start by selling the idea to more players for it to be accepted. The objective of sharing the idea before proposing officially to the board of director and other bodies is to ensure that the resistance to the program is minimized as possible. According to Kurt Lewin’s Theory of Change Management, there are three stages of change management, which the team will intend to apply. Application of Lewin’s Theory of Change Management Evidently, Lewin’s theory of change management is one of the standard claims in organizations (Lewis 1951). Lewin describes the change in three steps. The first step is unfreezing the status quo or current situation, which comprises of making sure the workers and other stakeholders see the need for change. The objective is to indicate dissatisfaction of how things are at a given moment, thus sparking a sense of action in the minds of individuals (Newton, 2007).The second step is changing behaviour of persons through making a move, whereby actions should be taken towards the future change. The last step is refreezing, which ensures that the cultural values and practices are integrated into the change that has already been implemented. The major aim is to ensure that people do not go back to their previous behaviours, thus institutionalising the change through the introduction of policies and procedures. In reference to Lewin’s Theory of Change Management, the team of five to ten members will have to unfreeze the status quo by explaining the need to start the palliative care program in the facility. For example, the team will highlight the current challenges of congestions and the problems faced by staff as the basis for the change with the intention of marshalling support from all stakeholders (Van, 2015). Secondly, after the project has been accepted and approved, the team, together with more partners will start the program. The last step of refreezing will be vital to ensure that the program is sustainable. Notably, this will require rules, policies, and culture change. All these will have to be integrated into the daily operations to form an organizational culture. However, this will take time, close to five years. Recommendations and Conclusion In order to ensure that the program is successful, the management and the senior personnel will have to change their attitude from offering only hospice services to diversifying healthcare to the community. Further, this paper recommends that both patients and staff needs and demands be reviewed to minimise the rate of employee turnover, which harms the facility’s reputation (Stiglitz, 2010). All stakeholders in the hospital must work together to facilitate the program. In this respect, communication will be instrumental in ensuring that information is provided with accuracy and at the right way. Finally, leadership will be needed in this program. 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