Proposed Model of Change Implementation at Al Karama for the Local Health Authority - Example

Change Management Name Professor Institution Course Date Change Management Executive Summary Bringing change is becoming difficult for any organization because change itself is taking place in business sectors. In addition, it is difficult to create change in organizations which are considered professional bureaucracies like hospitals which normally have greatly trained and independent professionals such as doctors and nurses rather than just all administrators because they mostly control their core processes. Professional bureaucracies like healthcare institutions also have baby-boomers who are uncomfortable with change since they have been overtaken by this rapid process. Therefore, this report advises the two hospitals Al Razi Hospital and Ibn Sina hospital which were to merge on how to implement change. The report will also discuss the objectives of the change, impacts of the change on employees, type of leadership style required, culture needed to accept the change, change model and how to maintain change. Table of Contents Change Management 2 Executive Summary 2 Table of Contents 3 1.0 Introduction 4 2.0 Objectives of the change 5 3.0 Possible impacts of the change on employees 6 4.0 Type of leadership style required 8 5.0 The culture to accept the change 10 6.0 Proposed Change model 11 7.0 How each phase of the model may be achieved 12 8.0 How to maintain the change 13 9.0 Conclusion 14 10.0 References 15 1.0 Introduction The ability of the organizations to bring change has become more significant in the era of competitive pressure, advanced technology and globalization. A research conducted by McKinsey & Company (2008, p.3) about executives established that a continual change is that major factor in survival. However, bringing the needed change is complex in organization with professional organizations like hospitals that have greatly trained and independent professionals compared to having just administrators because professional like doctors prefer controlling their core processes rather than being interrupted (Zell 2003, p.73). A change in their organization disrupt their flow of work and comfort and would do every to oppose such process. Two hospital, Al Razi Hospital and Ibn Sina hospital which have different work practice and capabilities, needs to merge to create effectiveness, and without prior communication and planning, the employees are likely to totally oppose change. Based on the information, this report will advise the managers of these hospitals on how to implement change. The report will also discuss the objectives of the change, impacts of the change on employees, type of leadership style required, culture needed to accept the change, change model and how to maintain change. 2.0 Objectives of the change I would advise the management that leading the merger to adopt objectives such constructing a big hospital to accommodate large number of patients, setting up an innovation culture, set up change principles, to computerize every department, create innovative strategies, create leaders of change and empower change agents. In the case of the current hospitals that being merged, the objective to create builds a big hospital after the merger with Ibn Sina and Al Razi Hospital to form Al Karama. In my opinion, computerizing health records should be high priority objective in bringing change. This will ensure the records are safer even in future and can be used to research on healthcare trends based on types of diseases and their prevalence. Bartoli & Hermel (2004, p.419) opined that Streamlining means embracing technology in the records department to enable computerizing of such records. A unified and great flow of information in the digital healthcare platform developed by the electronic health records gains technological innovation and changes the manner in which care is provided and paid for (Bahri 2009, p.274). The progress from the paper-based records to electronic health record model is an opportunity for doctors, nurses and other staff in newly built Al Karama to use their core knowledge, skills and capabilities. Advanced technologies enable healthcare staff to process and manage data and to help in the designing of the decision support systems in the hospital for individual (Bartoli & Hermel 2004, p.421). I advise the management Al Karama to embrace change in the organization as an objective of setting up an innovation culture. When change happens in the organization and becomes successful, the manager and employees takes the credit on how effective and hard these stakeholders work. For instance, they get awards as the best performing hospitals. According to (2006), the rewards encourage both the managers and employees to work towards maintaining the trend. The company will be developing new products to offer to the market to gain competitive advantage (Isern & Pung 2007). In so doing, the organization is encouraging innovation culture. 3.0 Possible impacts of the change on employees Employees mostly influenced by any change in two ways; positively or negatively. However, negative impact dominates their reactions towards change. Change has impact such as motivation, efficiency, uncertainty, fear of unknown and stress. When change leads to promotion, salary increment, automatically and efficiency, employees are likely to be motivated. Jarrett (2004, p.248) argued that when an employee’s salary is increased or promoted, they feel appreciated by the company and continue to work hard for more rewards. Westover (2010, p.47) asserted that efficiency is created by a situation where the company moves from the old building to a new building with high tech machines. In addition, Jarrett (2004, p.251) stated that if the change brings efficiency in the area of specialization of an employee, they are likely to be motivated and will deliver. However, in most cases, change impacts negativity on employees. Based on past researches, it has been established that change management creates uncertainty regarding careers and position and anxiety or fear on employees (Gina, Natchez & Meryl 2006, p.26). Every employee would ensure his job security to be motivated. However, change sometimes scraps some position and roles, hence automatically lay-off some employees. Brisson-Banks (2010, p.247) stated that the situation creates uncertainty on employees on whether his or position will be scraped or not. This would have been the situation when Ibn Sina and Al Razi Hospital were merging to form Al Karama. Moreover, group of employees in either of the hospitals that were performing the same roles and assigning the same role in the new formed hospital would create job duplication and conflict. To avoid organizational conflict, the management will be forced to lay-off some employees or find new roles to perform (Jarrett 2004, p.253). At the period of change, some staff might also experience some problems freeing themselves from the previous organizational order, since they undergo some loss with ‘letting go’ to embrace new ways of doing things. Gina, Natchez & Meryl (2006, p.24) affirmed that this happens especially when organizational members were oriented to stick to the old norms and values, organizational history and beliefs which were shared across the organization. At the time of introducing change, employees can be in the emotional state, which might not be externally apparent (Todnem 2005, p.372). In first stage of reaction to change, employees normally experience fear, since they feel removed from their comfort zone. From my study, Abraham Maslow contended that apart from the basic survival highest need of human being is safety, emotional and physical needs (Jarrett 2004, p.28). When individuals face change they often become very careful, which considered as a good thing, though if the feeling take so long, it changes to suspicion and create negative impact. At the point, the employees need answers and information on the objective of the organizational change. Jarrett (2004, p.253) held that when the required information and answer is not provided, employee behavior turn out less or more frozen. During this time, employees often lose control of their behaviors. The process leads increase in stress and less productivity. Erwin (2009, p.31) opined that at the period change, organization is full or rumor mill since employees may become skeptical concerning whether the process will favor them or not. Being in doubtful situation will always push employees to seek for the truth about change and its intentions. There are common risk management practices, which the contemporary managers can use to mitigate the negative impacts such uncertainty, fear of unknown and stress (Jarrett 2004, p. 249). I advise that the management should create a proper communication channels and allow employee’s involvement as some of the risk management practices to enable the managers eliminate uncertainty (Westover p.2010). Gina, Natchez and Meryl (2006, p.26) argued that open communication with employees enable them to understand the need for change and to adjust their behavior. Similarly, I would advise the managers of Al Razi Hospital and Ibn Sina to involve employees in the decision-making to make them feel valued by the hospital. Involvement will enable them welcome change and be ready to bring new ideas. 4.0 Type of leadership style required Leadership is highly required not only to lead the management, but it also needed to develop new ideas, which will bring the desired change. Therefore, to carry out a successful merger between Ibn Sina and Al Razi Hospitals, I recommend that the hospital should adopt participative leadership. Smid, Van Hout & Burger (2006, p.36) Participative leadership is characterized by employees’ involvement and empowerment in various decisions made by the top-level management. Nikolaou et al., (2007) stated that participative involves communicating change to employees and explaining why change is important. In the process, also employees allowed to share their views concerning the matter. Some leaders know that employees of teams might have ideas and skills, which can benefit the managers in making decisions (Nikolaou et al., 2007, p.303). It is obvious in the case study both the employees and managers were uncomfortable with the change management the local Health Authority had proposed. This is a sign that the process was never communicated in time or it was just the normal case where employees feel intimidated with the consequence of change. In my opinion, I believe that to reduce fear in employees, participative leadership styles can be use enable a leader operates closely with the organization team, and to focus on creating strong relationships with the employees (Mohr, Burgess & Young, 2008, p.26). When staff are involved in the decision-making, especially change management, they feel valued by the organization and not just used to make profits. Researchers have established that participative leadership leader several positive aspects of organization behavior such as jobs satisfaction, organizational commitment, organizational support, organizational citizenship actions, good labor relations, organizational and job performance, and organizational profits (Gina, Natchez & Meryl 2006, p.25). A team is needed to implement to ensure that the process runs effectively to conclusion and the objective is achieved. For that reason, I would propose a team of nine people headed by the CEO is the project manager. The eight remaining people will be in team of four people tasked with insuring all required machines are installed and transition takes place smoothly. Each team will consist of two middle level managers, a supervisor and an employee. A team managing transition will ensure a new organization structure is defined with roles and remuneration. 5.0 The culture to accept the change Organizational culture has a huge impact of change management. Mohr, Burgess and Young (2008, p.25) argued that companies have often created organizational cultures, which reflect what they stand for, their values and behaviors. Such culture has become part of all employees making it hard to change. Therefore, bring organization change normally affects how operate. For instance, both Al Razi and Ibn Sina Hospitals had created a culture on which its employees had settled. While Al Razi had created an innovative culture based on high technology and “smart” organization, Ibn Sina was operating organization culture, which is aligned with the traditional roles of the organization and less innovation. A change has created uncertainty. Employees from both organizations felt uncomfortable and could be confused from their comfort zone. Such circumstances can lead to employees’ resistance. Zell (2003, p.77) claimed that new culture also brings fear of unknown and as a result can lead to employees’ resistance. However, Bahri (2009) p.279) argued that for an organization which is dealing in the healthcare industry which is highly demand, innovative is greatly recommended to continue the process of bringing on board the new ideas. Healthcare facility is highly affected by the external forces such as technology, economy and social factors (Heine & Maddox n.d, p.4). Countries now compete on the level of technology; therefore, health establishment managers must attempt to implement the same. With innovative culture, Janićijević (2012) asserted that managers set up flexible structures, which can adapt and respond rapidly to the external influences and factors. This form of culture usually is embodied with a matrix structure, which emphasizes on roles by functional activity and subject area. Innovative culture also emphasize of forming teams to carry out various projects (Mohr, Burgess & Young 2008, p.29). Teams are important because members normally come up with new ideas, which can be improved and implemented by the whole project team. Experts have argued that making employees training prior to change is vital idea in facilitating an environment where employees accept change. Training present employees with what they will be needed to do when the change is implemented (Warren, Nielsen & Saccoman 1995, p.35). For instance, employees who were formerly working for Ibn Sina hospital could have been having insufficient knowledge of technology due to the fact that their hospital was not a high tech as required in the technology and communication era. Smid, Van Hout & Burger (2006, p. 42) claimed that training them before engaging them in a new technology savvy makes it easy for them to adopt the new policies and way of operations. In addition, telling stories about where change has worked and its importance convinces employees to accept change (McKinsey & Company 2008). The stories about should be clear and use known example to convince the employees. Training and telling stories about change promote communication as employees are given a chance to ask question and offer opinions. 6.0 Proposed Change model Various models have been developed by researchers and scholars of change management to help managers undertake the change process. One of such effective models which I recommend in this report is the ADKAR Change Model which was developed in 1998 by Prosci. As the name initializes, Hiatt (2006) posited that this model hold that for effective change to take place in an organization level, employees require to go through five phases including awareness, desire, knowledge, ability and reinforcement. It must be noted that ADKAR Change Model is for self reflection towards change hence I would advise managers to prepare their employees through communication and communication to ensure they are equipped well for such process. In so doing, the employees are likely to reduce employees’ resistance by some level. Hiatt (2006) contended that ADKAR Change Model is best for merger because since it help employees to prepare for major shake-up in the company by creating awareness. In additional, I would advice for adoption of this model in mergers because if it’s implemented before, it enables employees to accept change rather than oppose. This is because the model creates desire and reinforcement for change. Training can be used to confer employees with knowledge and skills required for change (Hiatt 2006). 7.0 How each phase of the model may be achieved ADKAR Change Model has five phases consisting of awareness, desire, knowledge, ability and reinforcement. These phases have different approaches in execution and the way of achieving them. The first as the name suggest is about creating awareness of why change in needed. Awareness can only be done through communication but in different ways. Janićijević, (2012, p.33) argued that writing memos, email and even making can be used to communicate change to employees. Another approach can be calling for a meeting where employees will be advised on why the company ought to make a change and its benefit to the employees and hospital. The first phase will lead to the second phase. It must be noted that ADKAR Change Model holds that it is the individual to change to make change happen (Hiatt 2006). In phase one employee are convinced of why change is needed. Persuasion through stories brings the desire for employees to implement change (Janićijević 2012, p.36). The third phase which is knowledge about change can be achieved through training. Training must focus on the area change will cover. Hiatt (2006) affirmed that just like impact knowledge about change, ability can also be brought by training of the areas where change will impact. For instance, in the new hospital, employees will be required to use more technology to handle issues. This means these employees must be taught how to operate the machines. The last phase which is reinforcement can be achieved by ensuring sustainability of change. Reinforcement can be achieved by involvement and continuous training about change (Janićijević 2012, p.29). 8.0 How to maintain the change Bringing change and sustaining change is a dream of every manager in the contemporary organizations. Crawford & Nahmias, (2010, p.408) stated that even though many companies have introduced change into their operations, many have fallen due to lack of sustainability strategies. Managers leading the change process at Al Karama must first recognize that creating change in one thing and sustaining it is another. In my studies found out that that sustaining change takes five major principles including customer involvement, prioritizing on the important latent and potential, or problems, empower and create change agents, seeking ideas from outside the company and application of rapid-cycle to taste the improvements (Bateman 2005, p.268). For Al Karama, involving customers is the most important issues in sustaining change. Involvement ensures that customers inform companies on their needs. Bateman (2005, p.271) the managers leading change must prioritize on potential problems which could hinder the change process of firm. 9.0 Conclusion The objective if this report was to advice the local Health Authority on how to implement the change at Al Karama. The change started with merge between Al Razi and Ibn Sina Hospitals. As any change process, the report has established that the situation created uncertainty and fear of unknown due to disruption of comfort zone which comes with change process. To help reduce the pressure that emerges during change, the paper recommends that leadership must adopt participative style of leadership because it will involve employees in creating rapport and involvement in decision making. As an institution which operates in highly competitive healthcare sector, technology has proven to be the most important change the hospitals seek to make so as to create efficiency and effectiveness. However, since the change process takes place fast, Al Karama ought to adopt sustainability strategies so as not to be overtaken by events. 10.0 References Armstrong, M 2006, A Handbook of Human Resource Management Practice, 10th ed, Kogan, London, pp. 343-57 Bartoli, A & Hermel, P 2004, Managing change and innovation in IT implementation process, Journal of Manufacturing Technology Management, Vol. 15, No. 5, pp. 416-25. 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