Change Management in the National Health Service Hospital - Case Study Example

Change Management Customer name Subject Name Here Instructor’s Name Here October 5, 2012 Introduction This essay sets out to manage change that is occurring in the urology department of a National Health Service hospital that is based in England. The department seems to be facing a lot of pressure from some external factors and based on this there are some changes that may occur in the department. This report will therefore offer the manager of the department with a number of recommendations on how to manage the change that is occurring. This will be done in various section with the first one been an outline of the issues that need attention from the managers and other major parties in the organization. The second part will be a Selection of one or more of these issues which have been outlined in the first section for detailed consideration and justify of why they were chosen. The other section will deal with the identification and critical review of the theories that could aid your understanding of the issue(s) that are been faced by the department. This section will be closely followed by a discussion of how these theories might inform the advice that will offered. Issues that require attention Based on the casestudy of the department there seem to be various issues that are in the department that needs to be dealt with. One of the major issue that needs to be addressed is the shortage of doctors this seem to be a major problem that is facing the department. The other issue that is prevalent in the organization is the lack of enough beds. With lack of enough beds they are not able to house all the patients who may need special care. The department also seems to have few operating theater. Another issue that is evident from the case study is the fact that is the fact that there seems to be a lot of information over load in the organization. It has been a trend that emails are usually cascaded from the senior executive team to all the staff about a wide range of matters within the organization. Over time the employees have developed some ignorance of the messages with the result that even they fail to read important messages thus leading to lack of dissemination of the messages in a more effective manner (Popovich, 1998 34). The other issue that is evident is that fact that there seems to be low level of response from those who have been tasked with the duty of investigating problems as well as offer the executive in the organization either data that they will use in the decision making process. The other issue is that there is poor quality of data that is collected by the members of the department on a regular basis as part of their daily work (Haligan, 1997 90). The last issue is related to the tension that exists between the clinicians and the managers. Some of the nurses and doctors who are working under the department perceive the manager of been motivated by financial aspects as well as to other factors that are not directly related to the care of the patient (Hope, 2001 56). They tend to believe that the manager’s lack specialized knowledge about the needs of patients. Managers, on the other hand, believe that many clinicians fail to appreciate that efficiency improving and cost-cutting measures can be achieved without undermining the quality and safety of patient care, and that often more efficient ways of working can deliver improved clinical outcomes. Selection of one or more of these issues for detailed consideration and justify your choice The two main issues to be discussed in this relation to the urology casestudy are the shortage of staff and lack of enough infrastructures in the department. Shortage of staff seems to be a major issue that is facing the manager of the department and the urology department. The plan to increase the number of medical staff in the organization is been faced by numerous disagreements and this is mainly related to the number of staff to be added and also their grades. In the organization those who are more concerned with the financial position of the department tend to favor the idea that they should stop sub-contracting work to the private hospitals and in its place they should recruit more consultant surgeons in their department (Behn, 2003 99). Other who are against the above decisions are of the view that there are other more pressing issues which can be addressed before this. In their opinion they assert that junior and middle grade doctors in most instances they are not able to offer the required level of support to the existing level of action that is generated by the existing consultant surgeons. They argue that the most preferred decision would be to recruit about three to four junior doctors. They also argue that this will assist a lot in ensuring that the work rotas for the sub-consultant grade doctors comply with the EWTD since it will offer them with a considerable amount of time for training, this will eventually improve the levels of productivity of the current consultants in that they will be able to run other larger outpatient clinics. This issue can be solved by the addition of some few staff members into the department (Bridges, 2003 39). This will ensure that the doctors will comply with standard that are set by the EWTD and thus will have adequate time to training and with all the required level of training productivity will tend to be rise. Thus the manager ought to consider the addition of the three to four new doctors as been the most preferred decision. The other issue is related to shortage of required infrastructure to meet the needs of the patient who are coming to the hospital. Infrastructure assists a lot in the achievement of the stated goals of a department. The department needs to have the adequate infrastructure so as to achieve the required level of results and also be able to treat as many patients as possible. This will ensure that they do not contract the private hospitals to provide some of the services that the department is supposed to perform. The department seems to be in daring need of more theaters and extra beds. Currently the department has two 18 bed wards and only two operating theaters. Some of the executive team are of the view that with a more better and adequate utilization of the already existing beds there would be a considerable reduction in the number of beds that are required. Another view that seems not to be shared by all the members is based on the fact that measures would be put in place so as to improve the efficiency of the operations of the already existing theaters therefore depicting the non importance of addition of another theater in the departments. According to them it seems that with the measures been put in place there would also be better use of the already existing staff in the organization. The manager ought to implement the decision of adding more beds and also an additional theater this will eventually reduce the congestion in the hospital. Also with addition of the new beds they will be able to house a greater number of patients who are in critical conditions. Thus with the addition of the extra beds which have been recommended as well as the addition of a new theater the hospital will be able o cater of all the patients thus they will not outsource some of their services which will eventually lead to higher profits. This is based on the fact that though initially the plan was more cost effective it started to lose some money on each patient it sent to the private hospital. The other issue is related to the tension that exists between the clinicians and the managers. A number of doctors and nurse working in the department are in the view that the managers in the department are been motivated solely by financial aspects and other aspects that are not relevant or important to the care of patients attending the departments. Based in the doctors the managers also lack the required level of specialized knowledge to deal with patients and therefore in most instances they tend to make decisions that are not beneficial to the patients (Green, 2007 81). The manager also asserts that the doctors and clinicians lack to appreciate that competence in the improvement and cost cutting measures can also be achieved even without undermining the safety and quality of care that is offered to the patients and they are of the opinion that there are other efficiency ways of working that can be adopted in the aim of delivering improved clinical outcomes (Agere & Mandaza, 1999 78). This issue ought to be solved with immediate action since it may lead to a lot of disharmony in the organization. There need to be mediation between the parties so as to arrive into a major conclusion on what to be done. The issues that have been selected under this section need to be solved with a matter of urgency so as to facilitate change in the organization. When they have been solved the department will have a higher level of productivity and profitability (Ferlie et al., 1996 89). This will be based on the fact that they will stop outsourcing some of their operation to the private hospital and at the same time enhance operations since the manager, doctors and the clinician will be working together in the aim of achieving the departmental goals (Polidano &.Nick, 1996 67). Identification and critical review of the theories that could aid your understanding of the issue(s) A move that is centered on new public management in a number of companies and countries in the 1970s and the 1980s mainly revolved around a move towards accountigization. Over time some of aspect that has been adopted by government departments has been termed as wasteful. One of such aspect is the privatization of some public duties (Hood, 1995). Nikos 2000 and McLaren 2002 states that the new public management is currently heavily premised on the notion of service to the customers which in our case are the patients in the hospitals. Hence it is widely believed that most public departments ought to be realigned and reoriented in the aim of embracing a mentality similar to that which is applied by the private sectors. In conclusion Niko 2000 captures the major principles of the public management by outlining that government departments should adopt a business outlook. This can be manifested through various methods and techniques that are closely related to the measurement and evaluation of aspects that are related to evaluation and measurement of performance and this ought to be done in line with some set values for example the competitiveness, productivity, quality of service and profitability. Business logic is therefore seen as a dominant aspect which relates to the core values of the administrative culture within the organization (efficiency, quality and effectiveness) exclusive of replacing the conventional values such as quality, legality and impartiality (Muldrow, Buckley & Schay, 2002 90). Another theory that guides in the understanding of the issues been raised is the move from traditional public administration to the public management since it tend to push the various government departments towards managerialism (Larbi, 1999 67). According to Larbi 1999, the traditional model of delivery and organization of the various public services is slowly been replaced by a market-based approach to enterprise culture (Larbi, 1999 12). The other theory will be based on the concept of how things get done in the government departments (Partridge, 2007 56) The supporters of the new public management argue that the issue is not mainly of what the departments do, but the issue lies in what they do to it, they assert that most public manager ought to be freed from the oppressive bureaucratic system that is characterized by ridiculous red tape so as to improve their respective department productivity levels (Nunberg, 1995 56). Thus the departments are supposed to implement long term solutions to the problem that they are facing and thus there seems to be a need to adopt the management strategies and techniques that are adopted by the private sectors. How these theories might inform the advice you will offer The theories which have been discussed in the above section inform the advice offered to the manager in various ways. One of the major ways is based on the fact that I will tend to offer the advice of moving from the traditional model of delivering services in the organization and propose the adoption of a market based approach to the enterprise culture (Box, 2001 92). Another way in which the theories will assist in offering the advice is that through the theories I will be able to advice the managers on how to do thing with the department. In regard to the manager will understand the importance of been freedom the oppressive bureaucratic system that is used in various government departments and in its place adopt aim at implementing measures that will assist in solving the issues been faced by the department (Box, 1999 45). And the best way to do this through the adoption of the strategies as well as the techniques that are mainly adopted by the private sectors operating in a similar industry or business line. The theories will also guide in offering the advice in that they will assist me in knowing what the current departments ought to adopt in the aim of aim attaining a business outlook towards their operations. References Agere, S. Mandaza, I. Enhancing Policy Development and Management in the Public Service, London: Commonwealth Secretariat, 1999. Behn, R.D. “Why Measure Performance” Different Purposes Require Different Box, R. Running Government like Business: Implications for Public Administration Theory and Practice, American Review of Public Administration, 29 No. 1, p 19-43, Sage Publications Inc, 1999. Box, R.C., Marshall, G.S, Reed, B.J., & Reed, C.M., New Public Management and Substantive Democracy, Public Administration Review 61, No. 5,(2003) : 608-617. Bridges, W. Managing transitions: making the most of change. Massachusetts: Da Capo press, 2003. Ferlie, E., Ashburner, L. & Fitzgerald, L. Pettigrew, A. M. The New Public Management in Action. Oxford: Oxford University Press, 1996. Green, M. Change Management Master class: A step by step guide to successful change management. Australia: Kogan page, 2007. Haligan, J.’ New Public Sector Models: Reforms in Australia and New Zealand’ in J.E Lane (ed) Public Sector Reform: Rationale, Trends and Problems. London: Sage, 1997. Hood, C. The “New Public Management” In The 1980s: Variations On A Theme, Accounting, Organizations and Society, Vol. 20, No. 2/3, p 93-109, Elsevier Science Ltd, Great Britain, 1995. Hope, K. R. ‘The New Public Management: Context and Practice in Africa’, International Public management Journal 4, no 2 (2001). Larbi, G.A. The New Public Management Approach and Crisis States, United Nations Research Institute for Social Development Discussion Paper No. 112, 1999. Measures, Public Administration Review 63, No. 5 (2003):586-606. Muldrow, T.W., Buckley, T & Schay, B.W. Creating High-Performance Organizations In The Public Sector, Human Resource Management, Vol. 41, No. 3, (2002): 341–354, Wiley Periodicals. Nikos, M. Trends of Administrative Reform in Europe: Towards Administrative Convergence? Paper presented at First Regional International Conference of the International Institute of Administrative Sciences, Greece, 2000. Nunberg, B. ‘Managing the Civil Service: Reform Lessons from Advanced industrialized Countries’. World Bank Discussion Paper no. 204.Washington, DC: World Bank, 1995. Partridge, L. Managing change. UK: Butterworth-Heinemann, 2007. Polidano, C &.Nick, M. Redrawing the Lines: Service Commissions and the Delegation of Personnel Management. London: Commonwealth Secretariat. 1996. Popovich, M.G. Creating High-Performance Government Organizations. California, USA: Jossey-Bass Inc., Publishers, 1998. Read More