The Context in Which Health and Social Care Managers Operate - Case Study Example

 The Context in Which Health and Social Care Managers Operate Introduction Change management is a requirement in most of the businesses as well as the health facilities. The social care manager is faced with a number of challenges when entering into a health facility that has not been functioning well in a couple of years. The paper will explore such a scenario in Basinger House; a number of things such as the quality issue, the changes needs to be addressed, key factors to consider when bringing change, factors likely to lead to a successful change, barriers to the change, and the success criteria to ascertain the achievement of change will be discussed. A timeline and an action plan will also be drawn and written respectively. Change in an individual is a basic and fundamental thing that is required to be achieved by any organization. Once the individual change has been achieved (the individual has the motivation to perform something different), the change in the whole world can begin. However, the individuals are to some level under the governance of the group norms and the groups are bound by the whole system of groups that interact with each in a habitual way (Cameron and Green 2004, p7). Change management is a general skill that the managers and leaders are required to be competent in. There are a number of working environments that do not require change; these working environments are very few. The change in the management requires five key principles to be taken into consideration; (a) reaction to change is different among the individuals, (b) every individual in the organization has important needs that have to be met, (c) the change in most cases is accompanied by a loss and the individuals have to go through the loss curve, (d) the expectations put by the organization and the people have to be managed in a realistic way, and (e) any fear has to be dealt with (TeamTechnology n.d. p1). There are a number of factors (specific) that may necessitate the organization movement from the status quo. The most common factor that may drive the organization to seek change is the external environment. A good example is global warming which drives social, commercial, and regulatory forces to converge under the perception that they are main producers of greenhouse gas (McCalman, Paton and Paton 2008, p9). Change Management Theory According to John Fisher’s change model, eight stages are involved in the process of change with respect to people’s reactions (Luecke, 2003). The stages include denial and anxiety, happiness, fear, threat, disillusion and guilt, hostility and depression, gradual acceptance and forward progress. In response to these reactions ton change, Kotter proposes a number of actions which include the establishment of a sense of urgency, the formation of a influential guiding coalition, and establishment and communication of clear vision (Luecke, 2003). Further to these, some individuals must be empowered to attend to the vision in the form of creating plans and establishing minor wins. The consolidation and improvement of change and the institution of new approaches come as the final steps toward change management according to Kotter. Change management is a complex issue considering that different individuals react differently to different changes. Whereas some people will embrace change positively, others will abhor or react to it with great opposition. One of the reasons people react differently to change is because every individual that is affected by a change that is instituted has certain basic needs to be met according to Team Technology (nd). In other words, some individuals that are affected by the change may end up experiencing losses thereby getting caught up in the loss curve. Yet again, people’s fears and anticipations regarding impending changes always need to be comprehensively dealt with in order for the change to be embraced with greater optimism while at the same time being realistically managed (Team Technology, nd). Generally, the management of change demands that stakeholders be given honest, open and factual information regarding the change. This however should be done taking caution not to present overoptimistic speculation to those affected. In order to achieve this mission, an effective communication strategy should be put in place. This will ensure that the right information is disseminated effectively giving little room for pessimism and negative reactions. Personal strategies for the management of change should also be adopted by individuals so that they may cope better with the change. In the midst of change, individuals need to be given the chance to make choices regarding issues that affect them (Team Technology, nd). This means that those affected ought to Have some level of control and be included in the management and institution of the change. This in effect helps in mitigating the negative influences that are commonly associated with the institution of change. This also means is that those affected must be given time to express their views, concerns and reassurances, argue their cases and receive mutual support as they go through the loss curve. Support should be given such as to mitigate the chances of loss or to replace the losses incurred by individuals with an aim of dealing with the associated fears. On the other hand, change managers must be vigilant in their endeavours ensuring that informal feedback and discussions are made with those affected (Team Technology, nd). Managers need offer positive and negative reinforcements so as to ensure the right responses from stakeholders gradually removing such reinforcements are results are achieved with time. Positive rewards may come in the form of performance based rewards while negative reinforcements may be in the form of removing a negative task that should otherwise be done. Management of Change in Practice at Basinger House The Quality Issue As the new manager of Basinger House, the quality issue is the transition from the old management to the new management. The transition is faced with a number of issues such as the poor management by the former manager. The report from the quality inspection indicates that the residents were rarely consulted on how the home was to be run, the activities and services to be made available to them. The resultant effect was that majority of the residents never left their rooms. Following the problems facing the residential care home, the manager left and a new manager was appointed to take over. Change is always anticipated with the arrival of a new manager or leader; the leader is tempted to remodel or alter the existing business processes. In this case the change anticipated is the change in the residential care home. In majority of the cases, the change means the significant turnover among the senior executives. The new leader or the manager is not comfortable at the first instance and comfort is achieved when he or she is at ease with every person within the organization. The change comes from the new leaders and the managers (Luecke 2003, p2). Not all the people within the organization enjoy the change process and the change experience. On the other hand, change at times is very frustrating and disheartening and it generally leads to a number of causalities at its inception (Luecke 2003, p2). There is a general tendency among the managers that the change takes a significant amount of time and money. However, there are others who believe that the change is not costly and it does not take a lot of time. The change is regarded as disruptive and in most cases traumatic. Thus, many people try to avoid it as much as possible. However, the change is necessary for the progress and the life of the organization. The individuals who are capable of anticipating, catalysing, and managing the change will find the process fulfilling and successful both to the individuals and the organization (Luecke 2003, p2). Change is not an event, it is a process and the development of a strategic change entails the shift in a number of things and they include; paradigms and values, practices and norms, feelings and expectations, beliefs and thoughts, sudden events, competent ices and behaviours, and paradigms. “Change must be perceived as a useful process, which it is most often if identified in the context of adding measurable value at all levels” (Kaufman 2003, p226). A change from the current situation to the wanted state within the company or the organization essentially entails the transition from dissatisfaction (the dissatisfaction is coupled with pain from the old management) to fulfilment in the new management (Kaufman 2003, p226). Changes that need to be Addressed There a number of needs that requires to be addressed by the new management under the new manager. The first change is the overhaul of the staff; majority of the staff members have been in the organization for a couple of years. The second and the last change to be made is how the organization is run, and the services and activities available to the residents and the staff. The change in staff requires the principles stated in organizational development. Organizational development entails the implementation, design and the reinforcement of the change. Organizational development is aimed at improving the organization effectiveness. The effectiveness is measured in regard to the following three dimensions: (a) The organizational development states that the effective organization can be adapted and the organization is capable of solving its own issues and problems and put all the focus on the resources in order to accomplish the main goals. The organization development helps the organization members to attain knowledge and skills that are necessary to perform the activities by allowing them to be part of the change process. (b) An effective organization has high technical and financial performance like high productivity, and quality products and services. The organization development assists the organization to accomplish these ends by levelling the social science practices to improve the quality of the services and increase productivity (Cummings and Worley 2008, p3). In this case (the residential care home), the organization development will assist the home care in improving the technical performance in order to increase the quality of the services being provided. (c) An effective organization has the following characteristics; the customers and other stakeholders are satisfied and loyal, and a satisfied, learning and engaged workforce. The performance of the organization responds to the needs of the external groups such as the customers, stakeholders, government agencies, and the suppliers. It also offers the organization with the legitimacy and resources. Other than the legitimacy and resources, it will motivate and attract the effective employees who will perform at the higher levels (Cummings and Worley 2008, p3). In this case, all the stakeholders will benefit from the changes made in the organization. The employee activities will be effective and the customers (the residents) will benefit from the quality services. Key Factors to Consider when Bringing Change to the Home Care There are many key factors that an organization leader has to consider before bringing any type of change into an organization. These factors are considered to be successful when implementing and managing the various changes in an organization. An organization leader has to identify the key factors that will bring a successful change. The leader has to have the capacity of not only implementing the changes but also be able to manage the change and enhance resilience. He/she (the organization leader) has to also maintain a correct balance between the various work demands and resources allocation. Some of the main factors are: Having a leading change – this means having a leader who would own, initiate and lead the change. Creating a shared need – the leader should ensure that all the individuals are working together towards attaining the organizations goal, why they should work hard for the change and why working hard towards the change is greater than resisting it (letting them know how the change will affect them). Change of the organization systems and structures (changing the organization design, introducing reward schemes, staffing development and appraisal) – this will ensure more change within the organizations infrastructures. It will also motivate different individuals within the organization. Shaping the vision because it will lead to the most preferred outcome from the initiated change. Monitoring the organizations progress after initiating the change – the organization leader will have to define benchmarks, milestones and the experiments that will make it easy for the measurement and demonstration of progress. Making change last (attaining long lasting changes) - the organization’s leader should make sure that the implemented changes last for a considerable time and an on-going commitment is provided (Bierema, Dean and Gilley 2001, p160). Factors Likely to Lead Successful Change The factors that may bring about change in the organization have to coincide with the organization’s objectives and the aspiration of the manager or the leader and other stakeholders. The following factors will likely to a successful bring change in the organization: Having a leading change – this means that the leader will bring the appropriate change through owning, initiating and leading the change. The leader will be at the forefront in bringing about change. The leader must also understand that the local knowledge is very vital in bringing about change that is sustainable (Attwood 2003, p49) Creation of a shared need – the leader will make sure that the individual works towards the attainment of the organization goals. Reasons for working hard and why it is beneficial will be given. Shaping the organization’s vision – this will assist in bringing out the most preferred outcome from the change that has been initiated. It is imperative that the leader gets the others to participate in the formulation of the organization’s vision and also in the strategies in order to achieve the vision (Cameron and Quinn 2011, n.p.). Monitoring the organization’s progress after initiating the change. In this case, the manager monitors the organization as it moves towards attaining its goals and monitoring is also done to ensure that the organization is performing in a way that it will assist it in arriving at its destination at the right time (Griffin 2010, p9). Making the changes to last, that is, to achieve long lasting changes – the manager or the leader makes sure that the implemented changes last for a long period and that commitment is offered by all the stakeholders. There are eight action plan steps that are necessary for creating a lasting change in an organization; case for change, leadership, vision, communicate, empower, celebrate, adapt, and institutionalize (Person 2008, n.p.). In order to make a lasting change that leads to the development of a more successful organization, the understanding of the entire organization are required (Arora 2000, p274). Barriers to Change in the Residential Care Home It is imperative to understand how change happens especially in the change management process (Gingerich and Ondeck 1996, p160). When a change is introduced, some form of resistance is expected; thus, there is a requirement to develop enthusiasm among the colleagues and overcome the individuals who resist the change (NHS Institute for Innovation and Improvement 2008, p1). There driving forces and the barriers to change that motivate change. In the development of a successful strategy for change, there is need to understand a number of barriers that are faced in the healthcare system. With such knowledge, it is possible to consider the levers and barriers that can operate in the organization and the relevant ones to a certain problem. Having made careful considerations, it is easier to create a custom approach to handle the barriers, motivate change in behaviour, and lastly implement the necessary guidance. The following are some of the common barriers found within the home care; (a) the resistance to change and the staff’s attitude, (b) fear of the unknown, (c) status quo comfort (d) limited time in the assimilation and processing of change, (e) the fear to loss power (Gingerich and Ondeck 1996, p160), (f) knowledge and awareness, (g) motivation, (h) acceptance and beliefs, (i) skills, (j) practicalities, and (k) the external environment – the external environment is beyond the control of the organization (National Institute for Health and Clinical Excellence 2007, p9). Some of the barriers are positive and negative to the home care. The negative barriers are important in this context to indicate that the change has been rejected. These barriers are negative staff attitude to the change, fear of the unknown, fear to loss power, inadequate time in the assimilation and processing of the change, lack of knowledge and awareness among the staff members, absence of motivation, lack of skills and the pressure from the external environment. Success Criteria to be used to Determine the Achievement of Change Evaluating measures usually entail the instruments and the assessment skills that are used for the collection of data. The data collected (usually new) from the evaluation measures are thoroughly and critically analysed and they are compared with the expected goals to see whether the required changes have happened or occurred. The primary source of the information is the client or the patient and it may also entail the care givers and family (Heath 1995, p66). It is important to note that the evaluation process is the most neglected part in home care services. According to Humphrey and Milone-Nuzzo (1996, p38), evaluation is one of the most important processes in the care of the client or the patient; it is either not completely done or it is often neglected. Evaluation is defined as the planned and systematic comparison of the objectives identified in the planning process and the health status of the client (Humphrey and Milone-Nuzzo 1996, p38). Evaluation also entails the effectiveness of the medical treatment and the proper use of the resources. It is an act that determines the patient’s or the client’s progress in achieving the long-term goals and meetings the results/outcomes of the care. The evaluation process offers an accurate benchmark for quality improvement processes (Rice 2006, p55). It is imperative to note that the evaluators must be capable of offering a distinction between the goals and objectives; “goals … are the desired end states for a program, and objectives, the measurable criteria for success” (DeJong, Monette and Sullivan 2010, p329). There are basically two approaches to evaluation design; (a) evaluation using the applied research methods, and (b) evaluation framework for the assessment of the organizational policy and systems. The first approach is traditional and the second approach plays a critical role in the program context and the evaluation play out. Evaluation is categorized into three levels; process, outcome, and the impact. Program delivery, the quality and the recipient are covered within the process evaluation. Impact evaluation offers a measure of the immediate impact of the program and outcome evaluation, provides a measure of the program’s long-term effects (Fleming and Parker 2008, p204). Success in change management is evaluated on the basis of the pre-determined criteria which were written by the planning team. The reasons for transformation plan failure are usually as a result of the resistance to change and imperfect implementation. If poor leadership is responsible for the failure then more effective leaders have to be appointed to execute the plan gain. On the same note, the organization the organization may feel it is necessary for it to include the employee or get advice from the management consultant to solve some of its problems (Chinyio 2010, p341). Satisfaction is a criterion that is used as a guarantee of an effective or a successful outcome; if the approach used by both the provider of care and the resident meet their needs, then the outcome is bound to be good (Kitchener and O’Donohue 1996, p293). The criteria for the identification of a good outcome of care is not difficult; the residents are supposed to be maintained in conditions that allow proper mental health, physical functioning, cognitive functioning, and quality of life (Mozley 2004, p6). Action Plan Inform all the stakeholders of the probable hitches during the implementation of the changes and how to cope with them for a sustainable change. Involve all the residential care home stakeholders in decision making and more specifically the residents and the staff. Re-shuffling and re-placement of the present staff. Create a position for the quality manager. Create a program that will monitor and harmonize all the activities within the care home. The program will assist in the evaluation of the changes made to the care home. Offer proper training to the staff. Motivate the staff through rewards and make them aware of the challenges in the workplace and how to handle them. Timeline Months 1 2 3 4 5 6 7 8 9 10 11 12 Inform all the stakeholders of the probable hitches in the process of change Involve all the stakeholders in decision making Staff re-shuffling and re-placement Create a position for the quality manager Create a program for monitoring and evaluation Provide proper training to the staff Motivate and create awareness among the staff Conclusion Change does not come the easy way and it is important to note that there are factors that contribute to change and others that lead to a successful change. Barriers are a must in any organization attempting to change some of the elements (the staff, method of service delivery and others) within the organization. The success of the change is determined by the outcome of the whole change process. If the outcome is positive, then change must have taken place; the opposite applies to a negative outcome. 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