Managing Change in the Urology Department of a National Health Service Hospital in England - Essay Example

Managing Change in the Urology Department of National Health Service in England Abstract The mission of the National Health Service in England is to sustain continual improvement in delivery of health care services. The management seeks to ensure a healthy working environment for employees who are the drivers of change. This change will enable the hospital to be competitive in health care provision. The main challenge emanates from the Department of Urology which is struggling to respond to external pressures for change. This has threatened to undermine its orientation to offer effective health care. The events that caused the need for change in the hospital were the combined financial crisis and the newly introduced regulations on the number of working hours for hospital personnel. Improving the situation will require the application of effective strategies and techniques that would change the current situation. The strategies and techniques require efficient processes and procedures. The hospital should be prepared to apply efficient change initiatives that are inclusive and address the needs of all the stakeholders. Otherwise, resistance will arise among the stakeholders. The three crucial areas that require change include stakeholder/employee relationships, management of technological change, and worker motivation. This report begins with the summary of the organization that paves way for discussion on the issues that require close attention. Table of Contents Managing Change in the Urology Department of National Health Service in England 1 Abstract 1 Table of Contents 1 Managing Change in the Urology Department of National Health Service Hospital in England 3 Change Management 4 Goals of the Change Process 4 Approach to the Change 5 Planning For Change 5 Change Management Models 7 Organizational Fabric Model 7 Pesteli Model 8 Mckinsey’s 7-S Model 9 SWOT Analysis 9 Stakeholders 9 Analysis of Hospital Stakeholders 10 Stakeholder Engagement 10 Systems Perspective 11 Motivation 11 Application of Myers-Briggs Type Indicator (MBTI) 12 Recommendations 13 Conclusion 13 Managing Change in the Urology Department of National Health Service Hospital in England The mission of the National Health Service Hospital in England is to sustain continual improvement in delivery of health care services. The management seeks to ensure a healthy working environment for the employees as well as other stakeholders. The Department of Urology is struggling to respond to external pressures for change that have threatened its ability to offer efficient medical care. The hospital works with five consultant surgeons, a few middle-grade and junior doctors, a range of nurses and other clinical personnel. The hospital infrastructure is not efficient enough to offer competitive and efficient health care services. The events that triggered need for change in the hospital were the combined financial crisis and the newly introduced regulations on the number of working hours for the hospital personnel. The introduced regulations on treatment duration made the hospital sub-contract some of treatments to a private hospital, leading to financial losses. The factor that contributed to the shortage of medical staff is the conflict in the regulations involving the working hours. The management of the crisis is loaded with many challenges such as tension between managers and clinicians and failure to agree on the staff capacity, allocation of extra beds, and operating theater. Others include information overload, ineffective problem solving, disagreement on the number and qualifications of new entrants, and inefficient data collection. The current challenges facing Urology Department of the National Health Service Hospital in England are related to the incompetence of the stakeholders in managing the changes facing the health care industry. Change Management Change management is a structured process designed to deal intentionally and directly with human resource involved in planning and implementation of the strategies of an organization (Davidson, 2006). Change is normally driven by necessity in response to a problem. The need for change may be hastened due to the external changes occurring in an organization. According to Pugh (2009), the process involves changing the behaviour to refocus on the initial aim that triggered the establishment of the process. The required behavioural change is achieved by assisting the employees understand and internalize their roles. The strategy should also focus on helping them be fully prepared to future performance. Effective change management in health care delivers strategies that help the employees possess the requirements for effective performance, meeting the needs of the patients and ensuring the health of the organization. The three crucial areas that require change the Urology Department of England’s National Health Service Hospital include stakeholder/employee relationships, managing technological change and worker motivation. Goals of the Change Process In initiating the change process, the hospital will purpose to improve the education standards of the employees and patients, recruitment of an efficient team necessary for handling all the functions of the hospital, and enhancing team work (Coran and Burnes, 2001: 94-110). Other benefits will include the reduction in hospitalization rates, easing the burden on the doctors and surgeons, and preventing the disease complications among others. Approach to the Change Implementing changes in service delivery institutions and organizations is often difficult, with the top-down change models being perceived as destabilizing and demeaning to the junior staff. This model backfired in England hospital due to the resentment that the junior employees portrayed towards their seniors who were spearheading the function. Change management in should focus on the role, position and the status of individuals. Implementation of the change will require changes in clinical responsibilities, training and development and exposure to new ways of doing things. The hospital staff should be ready to shun the previous inefficient practices of operation and adopt the new efficient ones (Church, Siegal, Javitch, Waclawski, Burke, 1999:2). The management should be ready to dedicate significant investment in employee development, equipment and facilities. This implies that the process will require enormous financial investment. Overcoming these challenges will provide a framework for laying the groundwork for the hospital to experience future success and achieve its mission. However, the achievement of the stipulated goals requires enhanced planning. Planning For Change Effective change management should focus on three aspects namely employees, process and technology (Mento, Jones, Dirndorfer, 2002; 45-59; Fogg, 2002). The hospital will require the assistance of Organizational Development practitioners that assists in decision making. These specialists will also warn of the impending future dangers that a certain action may pose on the well-being of an organization. The process of change requires the linear progression from one state to the next i.e. from the current state to the transition state and finally to the desired future state. This could be an intricate starting point for implementation of change. However, its simplicity in achievement of change neglects other factors that are necessary in the success of these steps. Such aspects demands objective thinking, subtle communication and collective agreement on the reasons why the change is being implemented. Overcoming the impact of the associated aspects requires the formulation of a clear plan that predicts the potential pitfalls and problems. According to Anderson and Anderson, (2001), these considerations can be grouped into five groups namely why, what if, what, how and who. The why factor of change involves assessment of the problems facing the hospital and the reason why change management is crucial and urgent. The What factor of change involves the art of having a compelling vision of an organization with the anticipated benefits. The who factor enhances the understanding on who will be spearheading the change process and the people who might develop resistance. The purpose of this factor is to guarantee inclusion and participation among the stakeholders of change. The how factor entails realizing which action should be taken and the shortest time that can be used in achieving the change strategy. The what if factor gives priority to the potential problems that may derail the action. A rational case for change can be built by a combination of analytical tools and techniques (Kotter, 2011). These include benchmarking through overtime comparisons, surveying and ranking the health care service users and purchasers, understanding the trends influencing change and understanding the organizational internal culture through appraisal. Change Management Models One of the models that should be applied by the Urology Department to manage change is Organizational Fabric Model (Green, 2007). Organizational Fabric Model The model focuses on the six primary variables that are interwoven in the culture of an organization. According to Sarros, Cooper, Santora, (2008), these variables include vision, sponsorship, stakeholder management, communications, training and reinforcement. Under this model, the hospital fabric can only become effective if all the six threads are structured to work in unison. The department should ensure that these threads are structured to collectively influence the desired change. If poorly woven, the application of the model will hit a snag. This results into a gap that detracts the strength of intervention strategies. The purpose of the model is to offer guidelines on understanding of the future state and the role of each variable in change management. The poor quality of the data being collected by departmental employees and the increase in the rates of information overload is a product of unprofessional technological adoption. Efficient technological adoption creates an environment for success. After understanding the organizational culture, other models can be applied in understanding why the organization requires change. Pesteli Model The model involves the changes that influence performance in organizations (McNulty and Ferlie, 2004: 1389-1412). This model will focus on the changes in technology involving the industry that includes: Political Factors- these factors involves the focus on national government policies, local policies and other smaller political groups. Understanding of the political factors will help the hospital management deal with any political challenges that may affect the change management. Economic Factors-these factors influences the availability of funding and the nature of the competition in the health care delivery. The factor is crucial because the hospital yearns to create a competitive advantage in health care delivery and this will require the input of paramount financial resources. Sociological Trends- the factor requires focus on behaviour, health issues and lifestyle. Sociological trends enable the change practitioners to invigorate efficient strategies that changes with the changing trends in lifestyles. The changes should be acceptable by all the employees. Technological Innovations-most of employees will be well receptive to strategies that take recognizes the change in medical technology and information. In fact, most of the challenges to management facing National Health Service Hospital in England are related to this factor. Ecological Factors- this involves focus on the environment and development in the public health systems. The system changes are normally undertaken after the analysis of this factor. Legislative Requirements-most of the employees will be comfortable if the changes being implemented correspond to the regulations regarding health, safety and employment. Industry Analysis-analysis of the health care industry will be necessary in ensuring that all the strategies applied in managing change correspond to the demand and supply issues affecting service delivery. Mckinsey’s 7-S Model The model focuses on the shared values among six factors namely strategy, structure, systems, style, staff and skills. The analysis of the model will address both the management of the employees’ interactions and motivation in the enactment of efficient change strategy. SWOT Analysis The model involves the focus on strengths, weaknesses, opportunities and strengths (Anwar and Siddique, 2000:128-133). The model involves the integration of information on both internal and external environment i.e. opportunities and threats. SWOT analysis results into the formulation of the conclusions on the fitness or incapability of the hospital in service delivery i.e. strengths and weaknesses. Stakeholders A successful change management process depends on the effective involvement of all the stakeholders through the consideration of who needs to be involved and how. Some of the stakeholders involved in the efficient running of the hospital include suppliers, media, financial institutions, employees, the public and competitors. After identifying the hospital stakeholders’, the practitioners assess the stakeholders’ power and interest to ensure that the correct technique are adhered to when implementing changes For instance, the overarching role of change management is to accelerate the rate at which employees move successfully through the test of the change process. This ensures that the anticipated goals are attained hastily. The job should be organized in a way which ensures integration and inclusion of people. Well-designed and integrated work motivates the employees and ensures that they achieve their goals. Focus on the employees attracts their willingness to apply their abilities and efforts. Analysis of Hospital Stakeholders The stakeholders with high power and high interest include the ministry of health, senior doctors and the executive senior managers. Those with high power but low interest include the senior doctors, senior managers and non-governmental organizations. Stakeholders with high interest but low power include patients, some doctors and junior health workers. Those with low power and low interest include nurses, patients and junior medical staff. After assessing the stakeholder power and interest, the practitioners should be involved in the planning of stakeholder management. The planning strategy should entail the stakeholders, interests and issues, the project role and actions and communications. Stakeholder Engagement To ensure collaboration with the stakeholders, a consolidated plan is required. This will involve designing the survey, theoretical testing of the credibility of the survey, briefing the stakeholders on the plan, and undertaking the survey. The results are then gathered to pave the way for the designing and running of the workshop. The feedback after conducting the workshop guides the formulation of the processes’ recommendations (Green, 2007). Once gathered, the views and opinions of the stakeholders should be prioritized in the formulation of the change process. One of the perspectives that the hospital can employ in managing change in the organization is the system’s perspective. Systems Perspective This strategy is related on the ability of practitioners to view the big picture when addressing the problems facing an organization. This involves the scrutiny of the interrelationships among the variables within the fabrics of an organization and the influence of the synergized impacts of the variables on the effectiveness of an organization. The information overload and the inefficient communication that the hospital is facing are related to the poor focus on the interrelationship of these variables. Effective technological adoption will serve to improve this interrelationship and align these variables to drive sustainable outcomes. Motivation Effective change strategies require an accurate assessment of what motivates the key stakeholders through consideration of their needs, personalities and temperaments. The key stakeholders that the hospital should focus on are the employees at all levels of management. This helps the change management to perceive how they will view the process; predict the role they may wish to play in the process, and the motivation that will be included in the proposal in mobilizing support. Some of the theories that may be included during the appraisal of the change process include Herzberg, Maslow and McClelland (Jones, 2007). These theories are need based. Herzberg theory will help the practitioners in identifying individual responsibilities, advancement and growth, job security, working conditions and achievement (Sachau, 2007:379). The Maslow theory is based on the self-motivation of the individual stakeholders. The factors considered include self-actualization, esteem needs, belongingness, safety needs and physiological needs (O'Connor and Yballe, 2007: 738-756). The consideration of this theory will help solve the tension being experienced between managers and clinicians. Their negative perception towards each other is a product of the overwhelming self-actualization and esteem that makes both sides think their opinions are right. The McClelland theory is based on the need for power, achievement and affiliation. The process should utilize the traits among the stakeholders to ensure that its contents do not kill their morale. Understanding of the efficient modes of communicating with people requires application of personality theories. Some employees may work better with theories while others are more comfortable with technological aids. Such a theory includes Myers-Briggs Type Indicator (MBTI) Application of Myers-Briggs Type Indicator (MBTI) The model lays emphasis on factors such as extraversion, sensing, thinking, judging, introversion, intuition, feeling and perception (Saggino, Cooper and Kline, 2001:3-9). These factors will enable the practitioners identify the personality traits of the stakeholders related to their energy, prowess in information gathering, decision making and their view on the external world. Recommendations Change management process should focus on the role, position and the status of individuals. Effective change management should focus on three aspects namely employees, process and technology .Plan for change management will involve identification of the management team, development of training curriculum, mobilization of financial resources and identification of the change practitioners. This should then be followed by choosing the appropriate venue for presentation of the propositions contained in the plan and implementing these strategies after ensuring that all the stakeholders are contented with the proposal. Conclusion The events that triggered the requirement for change in the Urology Department of the National Health Service Hospital in England were the combined financial crisis and the newly introduced regulations on the number of working hours for the hospital personnel. An effective change management process should be characterized by participation whereby all the stakeholders are contented with the recommendations. This cultivates willingness amongst all the hospital stakeholders, exhibits a sense of leadership, and enhances communication. The process should also be characterized by reinforcement. This is whereby the old but effective strategies are combined with the new ones to improve performance while shunning the ineffective ones. Effective change management will improve the hospital performance and outcomes, enhances the service delivery and improves the employees’ satisfaction, engagement and morale. It also assists in the achievement of the anticipated benefits and development of an engaged workforce due to higher levels of openness and trust. This will improve the hospital’s ability to easily transform to the changing developments and improve its service delivery and competitiveness. References Anderson, D. & Anderson, L.A. (2001) Beyond change management: advanced strategies for today’s transformational leaders. San Francisco: Jossey-Bass/Pfeiffer. Anwar, S. & Siddique, S. (2000) SWOT with a quantitative outlook: re-visiting the analysis. Management of Innovation and Technology, 2000. ICMIT 2000. Proceedings of the 2000 IEEE International Conference on, 1, vol. 1, pp. 128-133. Church, A.H., Siegal, W., Javitch, M., Waclawski, J. & Burke, W.W. 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