Change Management in Health Care - Case Study Example

Change Management: King Fahad Medical City

Introduction

As Meade (2013) asserts, a change management strategy provides an organization or institution with guidelines regarding the process of change thereby providing a framework for budgeting, communication, scope, resources, and schedule. Through a change management plan, the effect of a transition of the employees and other stakeholders is minimized. Recent research has indicated that the number of Chronic and non communicable infections has continued to rise steadily thereby the need to change the strategies and policies used to fight these infections (Cameron & Green, 2012). What the system needs is a change from the current curative model to a system that is both curative and preventive. A system that incorporates prevention as one of its core strategies will go a long way in bringing down the skyrocketing cases of chronic and non-communicable infections. This paper seeks to explore a change management plan from a curative model to a model that is both curative and preventive with reference to King Fahad Medical City (KKFMC). It will clearly define the context and the need of change; it will explore the components of the transformation plan and outline the problems that necessitate the change. The paper also outlines the process of the change, a systematic guideline, and maps out how the change process will take effect to minimize resistance.

Context of Change

KFMC is located in the heart of the capital of Kingdom Saudi Arabia, Riyadh city and is the biggest and best-equipped health institution of the Middle East. The efficiency of service provision in such an institution depends on how smooth the management is run. Due to the rising cases of chronic and non-communicable diseases all around the world, KFMC has received surplus funds from the government to better the management and fight against these ailments. As the senior health manager, I intend to use my office to transform the system from the current curative model to a system that is both curative and preventive to curb the rising cases of non-communicable and chronic diseases. According Miller and Proctor (2016), the top objecting of such a transformation is to improve the quality of services accorded at KFCM and record a significant drop in the number of new reports of chronic and non communicable infections. Unlike the current curative system that waits for patients to be brought or avail themselves at the institution, the new system will go an extra mile and run campaigns that aim at sensitizing residents of Riyadh city on practices that can help them avoid chronic and non-communicable diseases.

The system that needs an overhaul is such that it does not take proper measures to ensure that the disease does not infect the residents of the community. It only assists those who go the health facility, and most members of the community remain ill-informed about the necessary precautions to avoid infection. The proposed change will be such that most services, which are currently only available at the institution, will be extended out to the neighboring community. The new system is an upgrade of the operational model that is majorly curative and has hence provided room for new infections to develop into a system that merges the curative approach and the preventive school of thought (Austin, Bentkover & Chait, 2016). The operational model is made up of health system organization of health care, self-management support, decision support, delivery system design, clinical information systems and community resource centers. Activities that take place include among others active participation in improvement plans by senior leadership, patient training and psychological lessons to clients, extensive dissemination services accompanied by specialist support, patient visits and follow up visits, motoring of results and encouragement of community participation. Due to the organized and well-structured nature of this model, it helps improve the care and health condition of patients suffering from chronic and non-communicable illnesses. Moreover, it equips patients with information that facilitates healthy living and they are able to avoid future infections (Dickson et al., 2012). This current model, though, has one major setback; it primarily focuses the activities of an institution to the confines of the structure itself. The result of this primary focus is that new cases of infection are reported ceaselessly every day as the people of the community lack information about how they can live safe and avoid acquiring chronic and non-communicable infections. The new system aims at incorporating the current curative components of the functional system with elements that will allow proper community involvement in the war against chronic and other non-communicable ailments. As stated by Hewitt (2013), its objectives include; improving individual self and health management, availing a decisive support mechanism, expanding information systems to collect data from the whole community, building a healthy public policy, create conducive environments and bringing to life community action. Through such changes, the proposed model aims at not only curing chronic and non-communicable diseases but also significantly reducing the number of new infections.

According to Cameron and Green (2012), several models of change can be showcased by facilities such as King Fahad Medical City. The first example of such a transformation is strategic change. This kind of change occurs in an organization that requires a shift in its mode of operations. In other words, the strategic types of change are embraced by organizations that need to adjust specific parameters in their day-to-day activities. Such changes need effective planning and preparations. They also require a keen consideration of the consequence of each alternative before they are put into practice. In some situations, institutions may have to adjust their vision, values and mission statement in the process of implementing the new strategic practices. Heldman (2012), however, showcases that the remodeling a company’s strategy may transform its logistics of running business. The company may begin to focus on other aspects such as a different market share and other valuable partnerships.

The other type of change is the structural change. Structural change in this context refers to the change of the orientation of the company’s resources. This could be its staff and the management systems. The change of structure main revolves around the modification of the level of authority and administrative privileges. The objectives and physical orientation may also change while undertaking the structural type of change. A case study of structural change is about enforcing an anti-smoking policy within an institution and its environs (Parkin, 2009). Structural changes are brought about mainly owing to external forces.

The process-oriented change is another type of modification that organizations may adopt in their attempt to meet their objectives effectively. This nature of change is characterized by a change in productivity and workflow of the company. The organization may shift its approach to production in a way that greater output is realized using the same amount of resources. The process-oriented change mainly addresses problems associated with the factors of production. For example, a company may realize that its present workflow results to delay the arrival of inputs hence production is decelerated. The business institution may then devise a means to abolish the brokers and acquire the raw goods straight from the producers (Meade, 2013). In a setting such as this, the company would have undertaken a process change. Acquiring machinery and advanced security systems are other examples of process-oriented change.

A company can as well adopt the people-centered approach to change. This is the kind of change that is take places mostly in the individuals than the organization. It involves changes such as the attitude, motivation, and nature of socialization of the employees (Parkin, 2009). Such a type of change is elemental in an institution where productivity is minimized by the communication flow between the employees. The change can also be exhibiting in enterprises where there is a poor interaction between the employees and the customers. The people-oriented type of change aims at modifying the way in which problems are tackled in the organization the perspective of the employee concerning various aspects of their jobs.

The King Fahad Medical City requires the structural and people-oriented aspects of change. To begin, the facility needs to change its focus thus a strategic change is needed. The current focus of the organization of is to provide better treatment for its patients. This perspective is not strategic to the business side of the company. If the patients keep getting ill even after treatment, they may opt to visit other health facilities or look for other alternatives. As a business venture, the facility needs to acquire a new strategy thus modify its focus. The new focus of the company should be to utilize more preventive than curative measures. This will significantly reduce the number of illnesses in the society thus creating a good impression for itself. Consequently, patient-turnover will increase to great levels thus increasing revenues.

The organization also needs to undergo the people-centered change to motivate its employees on the new line of operations. The shift of the company’s focus from curative to preventive measures may offset the motivation of clients due to change resistance. A huge probability exists that the employees might be unwilling to take the new direction of the company. For this reason, the King Fahad Medical City should ensure that it motivates and supports its worker throughout the entire change process. The people-centered type of change will also be necessary for solving problems that will erupt during the change process

Need for Change

Vukotich (2012) states that despite the pros of the current curative model, the number of chronic and non-communicable infections has continued to rise and this calls for the reinforcements of the model to curb the trend. This rise in the numbers of new chronic and non-communicable infections is due to the over focus on the curing-rather-than-preventing mechanism of the current model. A void exists in the functional model; whereas the model trains on healthy living and how to avoid infection, its main target group is the patients; it fails to provide elaborate measures that can prevent the spread of these infections. It hence becomes imperative that the system is changed or improved to accommodate for extensive sensitization of the masses on preventive measures against such infections. The current Chronic Care Model (CCM) is too rooted in curing rather than striving to prevent new infections. The model needs to be developed to incorporate community participation into policy development, resources allocation and massive educational campaigns on the importance and means of avoiding chronic and non-communicable diseases.

To reduce the number of new chronic and non-communicable infections, the current CCM needs to re-invent its delivery system design that primarily focuses on a large field of practice and team effort towards chronic care to a system that expansively provides for a more holistic support to the community and the affected individuals. The current system only provides guidance, counseling and psychological mentorship to the patients who avail themselves at the institution, a majority who do not avail themselves, however, remain at a risk of being infected due to ignorance on the subject. To fight these infections effectively, it warrants a new system installation that will put effort to take these informative programs out of the confines of the healthcare facility and to the community. Decisive support also needs to be expanded to not only incorporate evidence-oriented directions for the health institution but also give priority to emancipating the community to stay healthy. According to Suchman, Sluyter and Williamson (2011), a well-informed community will be in a position to steer itself from practices that encourage the spread of chronic and non-communicable infections.

Whereas the current model includes the creation of an information system to highlight client data, it is purely dependant on patient numbers; there exists a need for an information system that covers broad data, a system that accommodates data collected from the community of the health facility beyond the institution itself. This kind of data is elemental in understanding chronic and non-communicable disease trends to allow proper planning, resource allocation, and adequate personnel dispatch to work effectively at reducing new infections and curing existing patients. To intensify the fight against these non-communicable and chronic diseases, it is elemental to have in place a system that provides for the elaborate collection of statistics of not just the patients of the health institution but the immediate community too. With correct information, health institution and the government is in a position to react to the chronic and non-communicable infections with adequate measures to curb their rise. As asserted by Sare and Ogilvie (2010), this need for an elaborate information collection and management system demands for a change management plan to be mapped; a plan that will satisfy all parties.

Map Process for Change

Developing a map for the change that is needed at King Fahad Medical City is imperative as it enhances a deeper understanding of the problems affecting the facility as well creating a vision for its expansion. Reiß (2012) quotes that a map for change is one of the most effective methods to planning the change is any organization. It gives directions and guidelines that should be taken to drive an enterprise towards the desired direction. An example of map process is the ‘Theory U’. This model identifies an existing problem and the factors that lead to the situation. It then tests the willingness to drive change and defines the strategies that should be adopted to realize such modifications. The end goal of Theory U is to provide a new resolution that will permanently tackle the problem at hand.

The capacity for change is another critical aspect that is highly considered while planning for change. The capacity for change refers the organization’s ability to embrace the strategic change as well as sustain it. It incorporates factors such as the company’s resources, organization’s ability to understand the forces underlying the change process, and the willingness to pursue the desired course of change. Assessing factors that determine the capacity for change is essential as it determines the anticipated level of success of the change that the organization requires. Nonetheless, Ray (2011) counsels that the capacity for that change is not the only establishing factor. Other elements that are related to the capacity to induce a change in an organization also play a crucial ensuring that change is embraced.

The action steps towards mapping for change begin with reaffirming the need for change. This process is followed with the recognizing the steps needed to induce the change. Thirdly, a theory for implementing the modifications is identified. The organization then devised the frame it would utilize to pursue the changes. In this stage, the frame outlines the development goal of the modifications required the capacity levels that may be achieved with the frame. Lastly, the change process activities consider the time taken to embrace all the required modifications comprehensively. In this step, it is important to acknowledge that change might take a varied length of time for it to take effect. According to Heldman (2012), certain changes require years while others demand up to a decade before their impacts are felt.

As mentioned in the earlier section, King Fahad Medical City is facing a threat of not having the ability eradicate infection hence diseases in the society. The facility focus on treatment measures rather than preventive practices hence it is difficult for the institutions to eradicate diseases in the society. One of the major objectives of health institutions is to bring down the number of new infections in the society (Ray, 2011). The process of mitigating the risk of infection can be effectively conducted using preventive strategies rather than curing the individuals who have already fallen victims. It is known that prevention is better than cure. Thus, the institution needs to allocate a huge section of its resources to preventing the occurrences of infections to mitigate the risk of infection thus eradicating diseases in the society.

Being a well-established institution, King Fahad medical city requires a transformational change to solve the problem identified above. The institution has the required resources that are necessary to induce preventive measures in a considerable section of the society but lack the will and principles. The organization needs transformative change to alter the pre-existing mindset, which acts as an obstacle to realizing the change that is needed. Some the principles that the institution adopted also need to be modified to tackle the identified issue. The management of the institution needs to be informed about the benefits of using preventing measures compared to the treatment method to induce the change that the facility needs. King Fahad Medical City should also show greater willingness to help the society reduce the number of infections through participating in community sensitization programs and providing support for the resource need to mitigate the transmission of infection between individuals.

The change theory that King Fahad Medical City should adopt is the Lewin’s Change management Model. In Lewin’s change management model, change can be implemented through unfreezing, transition and refreezing processes (Hewitt-Taylor, 2013). The institution can unfreeze its operations to make them flexible so that their schedule can allow the integration of community sensitization programs. The changing structure should include the changing their principles, practices, and willingness to prevent infections within the community would have a greater impact on the lives of the ordinary citizens with a comparison to its current approach. The institution will then undergo the transition and refreezing stage to regain its stability. This change theory will also make the work of the institution easier as they number patients will significantly reduce.

Consequently, the facility will be able to provide superior services to its clients, which will also favor the business side of eh institutions. Besides, preventive mechanisms that King Fahad shall adopt will result to a desire Public Relations (PR) impression that will favor the different stakeholders associated with the operation of the institution. The leadership of the institution needs to sensitize its employees on the relevance of change models as well as stress on the importance of the workers to portray greater willingness to support preventive mechanisms in the society (Parkin, 2009). Nonetheless, the impact of this change process may take long before the society realizes the impact of the change. This may take up to five years.

Techniques for Sustainable and Innovative Change

The change that King Fahad Medical City needs to implement should be sustainable for its fruits to be realized. According to the Lewin’s change management model, change can be sustained through motivating and supporting the employees. In the freezing stage, the company gives room to the implementation of the key modifications. However, the employee needs constant motivation for them to endure the change that is being observed. As in the case of King Fahad Medical City, the staff can be motivated through job promotions, salary increments, bonuses, and off times to offset the burden associated with the change of structure. The motivation of the employees will also encourage innovation and creativity that is also important for sustainable change.

The second step of the Lewin’s Change Management model is the transition stage. This step is marked by instability and change in the practices of the organization. Dickson et al. (2012) explain that the transition stage covers the period from which change was introduced to the time in which it is fully embraced. King Fahad Medical City can pass through this stage with the help of adequate leadership. The management needs to reinforce its employees by providing the necessary support and guidance whenever challenges arise. The institution also needs to reassure its employees that the process will be successful hence; they should not be worried. King Fahad Medical City can, for example, assure its employee that using the preventive measure would neither result to shrinking the organization nor layoff off some of the workers. This reassurance is likely to induce great levels of energy that will invoke innovation and creativity among the workers.

The refreezing stage will reinforce the sustainability of the change process. At this stage, the organization refreezes its operations to regain stability. The operations normalize as the organization operates under the new principles. King Fahad Medical City will regain its operation by refreezing its activities. The employees will be expected to return to their ordinary pace despite the changing atmosphere. By this time, the worker would be used to the new environment hence the level of innovation would still be maintained. Nonetheless, the institution can upgrade the level of innovation by giving opportunities to employees who are experienced in some position that may require improved knowledge (Ray, 2011). For example, the institution can employee experienced personnel who would give vaccines and lecture the community about the need of embracing preventive cure.

Conclusion

The problem of chronic and non-communicable diseases has been on the rise despite the use of the curative approach. This has led to debates that have brought to board the need for a change in the tactical approach to the fight against these infections, a system that incorporates both preventive and curative measures. The change theory that King Fahad Medical City should adopt is the Lewin’s Change management Model. According to the Lewin’s change management model, change can be implemented through unfreezing, transition and refreezing processes. According to Lewin’s Change model, the change that is realized is sustainable through employee motivation and good handling of the employees. These activities not only lead to sustainable change but also encourage innovation that is imperative for the change process.