Service Improvement Change Management - Case Study Example

1.0 Introduction There is a compelling case for applying organisational quality improvement approaches to health care. The evidence that applying these quality improvement approaches can reduce costs is inconsistent, although there are growing indications that some can be effective if used appropriately. Once an organization has gone through the process of identifying what its services are, while developing and implementing the IT service management processes to allow those services, many believe that the hard work is covered (Cadle & Yeates, 2008). Electronic medical record (EMR) deployments do not involve about technology. They involve about preparing organizations to reach critical business objectives by providing people with technical capabilities that make new things possible and by engaging people in changing their behaviour to effectively use the new capabilities to generate results. This paper will introduce EMR to demonstrate a comprehensive and critical understanding of change management and provide a reasoned justification for the identified service improvement area. Further, will integrate, synthesise and critically evaluate the key concepts and theories pertinent to the identified tool or technique. As such, the paper integrates, synthesise and critically evaluate the NHS Change Model and Kotter's eight steps to successful change that need to be identified to bring about this change. 2.0 EMR Change Management Change management is a vital component of information system development and execution of projects, and, additionally, to risk management and appropriate techniques increases the chances for success of a project. Hence EMR implementation done right meaning the technology mechanism, was executed on time and within budget, and the people adjust their behaviour and developments to achieve the equal value of the investment is more transformative than anything else a healthcare organization could apply (Kotter & Cohen, 2002). The overarching purpose of change management is to accelerate the speed at which people move successfully through the change process so that anticipated benefits are achieved faster. Further, through optimizing the efficiency and efficacy of users, an effective EMR change management program will improve organizational outcomes and performance, enhance employee satisfaction, morale and engagement, and improve service quality (Baca, 2005). Therefore, it will help achieve hoped benefits and create higher levels of openness, trust, involvement, and teamwork. In addition, build change capability and capacity in the organization, resulting in improved ability to respond quickly and effectively to new situations. Utilizing EMR change management has enabled the implementation and leadership teams to provide a positive experience during the period of significant change. By utilizing a solid EMR change management the organization promotes team communication, a safer environment for the patient, a work environment that promotes trust and an environment where people are allowed to talk about the fear of change. All of this promotes a better human experience and a much stronger workforce. This implementation of EMR change was initiated by the radiology department need of evaluation. The technology was not yet adequately implemented within the radiology department to allow patient information to be shared across multiple health facilities and hospitals. Thus the idea was committed to the ideal of improving patient care through better health information management. Radiology services should transform changes in labour force, increasing ability, new technology and insistently increasing demand for difficult investigations. Radiology services improvement is essential to the care of patients and as a service provider one need to understand the quality and release of the service. This involves knowledge of customer service, customer fulfilment and all its linked issues as well as quality assurance and improvement strategies. Such strategies can help to improve performance and increase overall customer satisfaction (Hoe, 2007). According to Neumeier (2012), the high incidence of preventable medical errors in health care is a key factor that has led to pressure on health care organizations to implement electronic medical records (EMRs) as a means to mitigate the issues antecedent to these adverse outcomes.  But, despite the possible benefits of implementing an EMR, the implementation of this technology has been sluggish. 3.0 Evaluation of Theories Initiating a change is a complex process, and following a theoretical framework can give a directive for making conversant decisions that allow for better management over the outcomes of accomplishment (McEwen & Wills, 2007).  There are two theories on change and innovation that have been used effectively to facilitate the implementation of technology in health care organizations and they are NHS Theory and Kotter’s Change Management Model (Campbell, 2006).  These models provide steps and guidelines for engaging individuals and organizations to support both motivation and ability, consequently helping to improve the likelihood and the EMR would be adopted. 3.1 NHS Model The NHS Change Model was developed to provide a single, integrated, evidence-based toolkit for achieving change in the National Health Service, in a way that attends to the full range of aspects of change: organisational, technical, psychological, social. It indicates that transformational leadership support transformational change needs transformational education and support. Thus, transformative learning is about developing leadership attributes its purpose is to produce enlightened change agents. (Lomas, 2007). The leadership framework for Clinical Commissioning Groups (CCG) leaders is structured to follow the change model. The programmes are presented in a way that allows progress through the competency levels of the leadership structure, allows organization of time and learning outcomes and authorize flexibility of approaches and learning technique (Martin, 2007). The model brings together collective improvement knowledge and experience from across the NHS into eight key components. In the course of applying all eight components change can occur. This indicates that no matter whom or wherever you are in the NHS, you can make use of this approach to fit your own context as a way of making sense at every level of the ‘how and why’ for delivering development, to always make an improved change. The NHS Change Model is a way of guaranteeing that we are using all the evidence and approaches available to support systems and individuals to change (Batem, 2000). 3.2 Kotter's eight steps to successful change John Kotter’s eight-stage process of transformational change addresses the adoption of technological innovations.This dynamic model is comprised of eight stages that can be organized into three phases.  The first phase is creating a climate for change and includes establishing a sense of necessity, creating a guiding association, and developing a vision and approach.  The second phase implies to engage and enabling the organization and consist of communicating the vision, allowing action, and creating short-term success.  The final phase advocates the implementation and sustaining the change and it involves consolidating gains and creating more change, and fixing new advances in the way of life (Kotter, 1996).  According to Campbell (2008), the first stage establishes a sense of urgency as the biggest mistake in attempting change is to allow complacency.  This is a critical step because without a sense of urgency people will cling to the status quo and refuse to accept change.  Creating need involves helping people see and feel first hand why a change needs to occur. Second stage creates a guiding coalition where the guiding team members need to have the knowledge, influence credibility, and skills needed to allow the change (Kotter, 1996). Finally, the third stage involves developing a vision and strategy. At this stage you need to create a clear and defining vision that is shared by all stakeholders.  The outcome should be a credible statement that clearly articulates what you are trying to achieve that can be explained in five minutes or less. The vision needs to include a collective sense of what a desirable future lead to, in understandable and measurable terms that all stakeholders can maintain (Clark, 2010). References Baca, C. (2005) Project Manager’s Spotlight on Change Management. Alameda: Sybex Bate P. (2000) Changing the culture of a hospital: from hierarchy to networked community. Public Administration. 78(3):485–512. Campbell, R. J. (2008) ‘Change management in health care’. Health Care Manager, 27(1), 23-39. Cadle, J., & Yeates, D. (2008) Project Management for Information Systems. Harlow: Person Education Limited. Clark, C. (2010) From incivility to civility: Transforming the culture. Reflections on Nursing Leadership, 36(3). Hoe J.(2007)Quality service in radiology.Biomed Imaging Interv J.; 3(3) Kotter, J.P.and Cohen, D.S. (2002) ‘The heart of change: Real-life stories of how people change their organizations’. Boston: Harvard Business School Press. Kotter, J.P. (1996) ‘Leading Change’. Boston, MA: Harvard Business School Press. Lomas J.(2007) The in-between world of knowledge brokering. British Medical Journal.; 334(7585):129–32. Martin G.(2012) A critical account of the rise and spread of “leadership”: the case of UK healthcare. Social Science & Medicine. 2012;74(3):281–8 McEwen, M, and Wills, E.M. (2007)  Theoretical Basis for Nursing 2nd Edition. New York, NY: Lippincott Williams & Wilkins. Read More