Operational Healthcare Management - Coursework Example

Introduction

Ever since the emergence of the management discipline, both academics and practitioners have considered the aspect of change management in their organization. In order to meet organizational change, there are various aspects involved that the manager needs to work with. They include the changing environmental pressure, the various stakeholders within the organization, as well as the changing technologies that are available to stakeholders (Rollins 2003, p.14–16). Others include the complex organizations where teams, as well as individuals, are interdependent such that their objectives are only achievable through reliance of people that seek to attain different objectives. It is also essential to include those individuals in the organization who have experience in change interventions.

Keep in mind that it is not easy to make out the relations between cause and effect relationships as it may not be apparent. Moreover, an intervention that takes place in any part of a health care organization has an effect in many other areas, such that not all of them are anticipated or desirable. Given that change can result to unexpected, along with dysfunctional, consequences it is essential to come up with a reflective model that can assist in the implementation of the change process. This paper looks at the changes involved in the improvement of the patient flow in the accident and emergency dept. Thus, it explores the challenges that may arise during the implementation of the changes with reference to reflective change model (Weick & Quinn 1999, p. 362).

Reflective change model

Using a model during reflection is essential as it will assist me to focus on the learning, along with self-awareness following the changes. Therefore, I will be able to avoid repeating the same mistakes in future. The model that many people tend to use is based on the performance preference. However, I feel that some of the models are oversimplified; thus, may not be able to address all the relevant issues. Others are extremely complex, prescriptive, more structured and difficult to remember without having to refer from textbooks in hand (Forrest 2008, p. 229-232).

As a tool, reflection is extremely used in social and healthcare both in education as well as practice. Even though many find that reflection is a difficult aspect to describe (Stocking 1992, p. 56-60). It can be described as the process of ‘reviewing experience from practice so that it may be described, analysed, evaluated and consequently used to inform and change future practice’ (Craft 2005, p. 53). Using reflection is essential as it acts as part of the portfolio development, along with evidence of practice based learning. It is a beneficial tool for me to use following the occurrence of critical incidents such as change management as it will assist me to reflect on experiences thus be able to generate new knowledge (Gibbs 1988, p. 57)

Most theories regarding reflection talk about learning from the process as being essential and also states that this is one of the reasons why the activity reflection along with its models are essential in healthcare (Hannigan 2001, p. 280). Many reflection models incorporate a planning stage for future events. This acts as a way of illustrating that learning has occurred. Take for instance the REFLECT model. One of the models that I found useful is the REFLECT model that Nick Butcher and Andy Whysall developed.

The REFLECT model

This model entails seven stages:

Stage 1: R - RECALL the events

It entails giving a brief overview of the situation I am reflecting on. This should include the fact that is a description of what is going to happen/happened during the change process.

Stage 2: E - EXAMINE my responses

This involves discussing my thoughts, as well as actions during the change process that I am reflecting on.

Stage 3: F - Acknowledge FEELINGS

The feelings stage involves highlighting what I experienced during the process

Stage 4: L - LEARN from the experience

Underlining what I have learned from the whole situation

Stage 5: E - EXPLORE options

This involves discussing any actions that I would take in future in case I was to face a similar situation.

Stage: C - CREATE a plan of action

Coming up with a plan for the future; this can be for future theoretical learning or action

Stage 7: T - Set TIMESCALE

It involves setting time in which the plan that has been discussed in stage 6 will be completed

Understand the barriers to change

In order to come up with a successful change strategy, it is essential for me to understand the types of barriers that can come up in healthcare. I will then use this knowledge to consider which of the levers and barriers may operate in the accident and emergency dept when looked at in terms of the flow of patients. Following careful consideration, I realized that it is possible for me to come up with a tailored approach, with the help of the REFLECT model, to overcome the challenges, encourage behavior changes not only in patients but also staff as well as implementing guidance ultimately (Burrows 1995, p. 346-350). The REFLECT model’s seven stages are essential as they will ensure that a thorough reflective learning cycle takes place. Moreover, the mnemonic makes it extremely easier for me to understand, as well as remember each of the stages while going through the change management process. Therefore, this model can be used from memory, and this makes it more useful in the practice setting. However, despite the benefits that it presents to the process, it has its potential barriers. One of the barriers on my side as the manager includes the time required to develop the suitable skills along with that needed to record everything thoroughly (Hargreaves 2004, p. 196-201). Moreover, it requires me to have developed the cognitive abilities essential for reflection.

Another challenge is in terms of knowledge and awareness. An essential first step towards making it possible for the change to occur is having knowledge, as well as awareness f what it is that needs to change. There is evidence to suggest that healthcare professionals lack familiarity and are always unaware of the latest evidence-based guidance. As a result, features such as the REFLECT model will act as guidance. Additionally, many of the healthcare professionals in the accident and emergency dept may be aware that new guidance has been issued; however, they may not be able to connect the manner in which their current way of working needs to change in order to ensure that they offer the patients the best care in line with the guidance.

Moreover, some of the professionals may have a feeling that guidance is inapplicable to their department or undermines their autonomy, therefore; they may not refer to it consistently (Hannigan 2001, p. 278-283).Motivation is also a challenge. This is a fundamental aspect of nearly all the things that I do. Sometimes it is easy for external factors such as the provision of penalties or incentives as part of the regulatory checks to drive change of behavior and motivation (Elliott 2004, p. 281-283). However, internal factors, like an individuals’ self-motivation, the desire to improve, along with drive are essential factors too. Goals and intentions have the capability of affecting how much people are willing to embrace change.

When it comes to Acceptance and beliefs, a person’s attitude has a significant impact on the manner in which they behave. Some of the aspects that can be important here are the perceptions of the benefits that any proposed change will bring versus the cost both practically and financially. I realized that I may face challenges from the health professionals as some of them may find it difficult to accept any new guidance if they feel that it is in contrast with any of the guidance that other professional bodies have issued. It may also be hard for other professionals to believe the recommendations put across to aid in the improvement of patient flow reflect the evidence or that they will assist in achieving better patient outcomes (Ginter, Swayne & Duncan 2002, p. 110). The beliefs that people have in their ability to adopt a new behavior may also have an impact on whether change I have succeeded in implementing the change.

A further barrier may be in the form of skills. In order to ensure that change has taken place, I have to ensure that people are aware of the things that need to change, as well as the best manner to completely carry out the stipulated change. Healthcare professional in the accident and emergency dept may require further training so as to ensure that they develop the best skills essential in the delivery of the better practice. These professionals may require time to not only learn the new skills but also practice them. Thus, it is essential to ensure that they get support from mentoring or peers. However, it is essential to reflect on aspects such as interpersonal skills, individual abilities, and coping strategies as the also have an effect on how difficult or easy it will be for individuals in this department to learn new skills (Zabada, Rivers & Munchus 1998, p. 57-66).

Furthermore, practicality stands out as a barrier. Practical barriers include the lack of personnel, resources or having difficulties in establishing service delivery. The accident and emergency dept may require new equipment in order to increase the flow of patients and ensure that they follow the new guidance. In some case, I may need to alter the infrastructure or services of this department so as to allow the change t take place. Another practical difficulty may be in the maintenance of the change in the long run. If the priorities of the departments shift or key members leave, it will be a difficult process to ensure that the change that I introduced is maintained (Wood, Ferlie & Fitzgerald 1998, p. 1729-38).

There are also those barriers that are beyond my control as a manager. They include the external environmental aspects. Political, along with financial environment have a massive impact on the desires, motivation, along with the healthcare professional’s ability to make a change. When it comes to the organizational level, financial systems may not be able to facilitate payment to the department of new interventions and the resources may also be constrained. Regulatory processes along with incentive mechanisms may fail to align with what is needed for implementing the changes. I found that regulation, as well as the national target setting, may bring about improvements in the quality of healthcare. In addition, mandatory reporting can also bring about patient care improvement. Evidence also suggests the continued professional development is connected to improved care thus; ensure better patient outcomes (Bulman & Schutz 2008, p. 89).

Conclusion

When it comes to identifying the barriers to change, it is essential to consider those individuals that will be affected such as clinicians, and support staff along with the manner in which people work with one another. Putting the REFLECT model in mind, the potential effects of the new recommendations can be described in the form of the type and a number of staff required, equipment and training, relevant established forums, networks or meeting along with the ongoing education incentives (Taylor 2010, p. 37). Since I will be equipped with the understanding of the kinds if barriers that healthcare faces, it will be easier for me to identify the kind of barriers that the accident and emergency dept will face during the implementation of the change necessary for improving patient flow.

When implementing a new guidance or policy, baseline assessment is essential. This can be achieved through reflection. Reflecting ion this assessment will assist in identifying the actual and potential barriers to change; thus allowing me to pinpoint the practical actions effective to implement the change. It will also assist me to understand the groups of professionals who will assist in bridging this gap. The REFLECT model is essential as it will assist me to remember each of the stages of change management with ease.