Managing Knowledge at an NHS Trust: Reddix Hospital - Essay Example

MANAGING KNOWLEDGE AT AN NHS TRUST Reddix Hospital Executive Summary Reddix Hospital is seeing a continuous fall in its reputation and the recent report by NHS is evidence highlighting the reason for the decline. The customer satisfaction is extremely low, there is no interoperability between departments, information systems used aren't integrated, staff is short and the motivation levels are low. To overcome these problems a radical change management strategy is proposed where a new distributed system will be applied. This system will integrate all the departments and the local intranet will be sharing point of information. Through this portal knowledge can be shared which will help the hospital store and retrieve important knowledge and train new and upcoming staff members. For this change to take place, the management needs to follow a change management process and provide incentives to the employees to stick with this change. Hopefully with this change, Reddix hospital can stand back on its feet and shine once again. Introduction Reddix Hospital is a trust hospital under national health services (NHS) in the United Kingdom serving over 900,000 patients in the area. It caters to many different medical fields and hence has to cater to an annual 7000 patients in admissions. With only 200 doctors whose expertise includes breast cancer, cardiovascular diseases, musculoskeletal diseases and pediatrics, the hospital finds itself short on employees and due to the recent nurse shortage, it finds itself unable to cater to all the patients are diligently as it like to. Also due to the inefficiencies and conventional systems, the hospital cannot cope up with the demands of the patients and the employees alike. Strategies for a Successful Change Process Being a big hospital, Reddix faces many problems in the daily operations which it tries to address. In all its problems the integration between the departments was considered the biggest challenge. Since the hospital has many different departments that provide specialist information to the customers and as well as other departments, it needs to integrate its systems used in each department like Radiology Information Systems (RIS), Patient Administration System (PAS), Laboratory Information Systems (LIS), Clinical Patient Record (CPR), Pharmacy Systems (PS) and Nursing Systems (NS). Without the proper management and collaborative working, these departments can never truly achieve the desired efficiency and therefore effectiveness. Analyzing the situation, it is apparent that the hospital will needs an overhauling of the entire systems and the processes. Therefore a change strategy needs to be used in the scenario to free Reddix out of the crunch situation. It has to interoperate between the departments. In this context, it means that all business units must work in unison to create synergy and lead the organization to achieve operational efficiency. Recommendations The change process described by the psychologist Kurt Lewin in the early 20th century must be followed here. Let's see how this can be done (Lewin & Gold, 1999). 1) The first part of this change process in the unfreezing of the current norms of the organization. This means to change the people's sense of safety and feel a sense of control. The employees at Reddix have become used to the hospital norms and like that norm to remain the way it is. Breaking this norm is the key to success however due to non-commitment and resistance to change, this break though needs a systematic strategy. First of all the employees at the hospital must be made aware of need for change. This involves sending the employees to seminars, or having meetings where the need for change is discussed (Isaac, 2006). When the employees understand the need for change, then the actual changes must be brought along. 2) After the initial education of the employees, the actual changes must be enforced on the employees by giving them goals and objectives (Fred, 2006). According to the report by National Health Services, the hospital administration had kept the patient record stored for no good reason and many had become outdated. On the other hand, the records that are required immediately cannot be found on time. The inefficiency is the IT department has left the hospital unable to meet the IT needs that are needed so that the doctors, nurses and care givers can easily access all patients' files electronically whenever they need them. We all have heard that doctor-patient relationship is confidential, thus it is the new system's job to add this security feature so that no personal information is compromised. Cameras, email filters, anti-viruses, firewalls and daily logs must be kept on-site so that secure sensitive clinical information can be kept away from the wrong hands and restored only when needed. (Stefanelli, 2002) Since change is considered as a never ending and a complex journey, it must be invigorated in the hospital quickly yet systematically (Fred, 2006). The management, who faces the major IT problem by using a centralized structured computing system to integrate all its IT applications, must be replaced by a new client server system. Bids from different software vendors should be invited and the best option should be selected. Since applying enterprise wide information systems is extremely strenuous for the employees, care must be taken in providing ample time to the employees to get used to the new system. At such a hard hour, mentoring, coaching, counseling and other psychological support is often helpful for the people to take the scary first step towards change. At this stage employee morale must be given high priority since most employees tend to get disheartened and lose interest in the change process and refuse to take part in the process (Isaac, 2006). The management should follow these guiding principles when trying to motivate their staff. (Accel Team, 2008) Treat People Fairly: Treat employees according to merit and deservedness Positive Reinforcement: Give some reward when job is done well (AECB, 2008) Setting Work Related Goals: Set targets, goals that are achievable and practical as well as related to the working conditions (Taylor, 2007) Satisfying Employees Needs: Satisfy the basic needs of the employees (Maslow, 1987) (Herzberg & Mausner, 1993) Effective Discipline & Punishment: maintain discipline by rewarding and punishing employees for the work they do Restructuring & Redesigning Jobs: Continually redesign and restructure employees job so that they don't feel as if they are doing monotonous work (Taylor, 2007) Base Rewards on Job Performance: Give performance related rewards, commissions or bonuses if a job is done well (McGregor, 2005) Empower the Employees: The employees must be given a high but limited degree of empowerment that allows them to take decisions and own their actions (McClelland, 1967) 3) Refreezing is the final goal described by Lewin (Lewin & Gold, 1999). In this process, the new organizational culture needs to be refrozen. It involves putting down roots again and establishing the new place of stability. A concept of burning the bridges is used here, meaning that once the employees have accepted the change, they should not be allowed to revert back to their old ways. This is most important because by this stage a lot of effort from the administration would have been put already therefore the return on this investment must be successful at all costs. Reinforcing a Pervasive Knowledge Culture Knowledge is the key to understanding all situations. Problems are faced by all people, rich or poor, knowledge about it helps to solving it. Knowledge comes from the data being analyzed to give information which is then applied to give knowledge. For an organization, knowledge about the workings of the systems, best practices, skills, human resource etc. form the knowledgeable assets. These assets are so important for an organization that without it, an organization would seem as an infant in the industry (Dalkir, 2005). For Reddix, which already has this knowledge, needs to capture and store it for future purposes. Due to Reddix's complaints rate of over 60%, this is even more important for Reddix to become acceptable by NCH's standard. The new system should integrate patients' right from their entry into the hospital and would follow it all the way through their time there. The new KM system would also integrate the patient electronic patient records (EPR) that are with NHS with the process of physicians and general physicians ordering medical tests or medications. The current working conditions of Reddix are such that most of the work done on computers is based on a centralized system that doesn't allow sharing of information. To make the employees realize the value and importance of a knowledgeable culture, systems like the one discussed in the preceding paragraph must be installed. This can happen when knowledge is shared between the employees thus promoting organizational learning. Tacit knowledge is described as that knowledge that is typically intangible, comes through intuition and hence is difficult to record to teach (IDM, 2008). For a hospital this includes the skills of a surgeon, intuition of a general physician to diagnose the symptoms, compassion of a nurse, etc. This knowledge can be taught to an extent, only after which the individual has to make an effort to succeed at understanding it. For Reddix, it is important to translate this tacit knowledge into explicit knowledge that can be easily transferred to other employees (Busch, 2008). Recommendations Several ways can be used to convert this knowledge. These include Communities of Practice As described by the literature, 'communities of practice' are in reality groups formed by people of similar attitudes and interests who try to share their personal experiences and try to teach others about certain new developments in their field. When we talk about the medical profession, a team of doctors may regularly meet up to discuss new technological developments in cardiology. Similarly a team of surgeons may hold a meeting where they discuss special patients and how effective their operations have been though a certain methodology. The best part of this process is that all people agree to share their knowledge voluntarily and everybody enjoys it as a past time. (Wenger, 2004) Creation of Knowledge Maps A knowledge map is a visual diagram that depicts knowledge for the purpose of sharing, codifying, protecting, using and applying knowledge to create new knowledge. In lay man terms, it can be defined as a map that shows the location of many different knowledge points in a certain area. Taking the hospital premises as an example, the knowledge map will tell the user the location of a particular data, case etc. hence making it easier to gain information and then increase it through sharing it. (Smelcer and Carmel, 1997) An Intranet System The new proposed client-server computing system will be very beneficial for the employees at Reddix. The hospital's personalized intranet can be built where the doctors, nurses and all other staff would need to enter information at the end of each day detailing the day's events. This should be mandatory process and employees should be given rewards putting genuine and helpful entries on the intranet. Other users on the intranet can view those entries and gain valuable firsthand knowledge about the jobs of others. Cameras Installing and using cameras to record the processes at the hospital is yet another way to gain knowledge. In an operation theater for example, the camera can record the entire proceedings of the operation while the viewers who late see the taped operation can learn from it and point out mistakes so that the problem is not repeated again. Conclusion By studying the case, it becomes apparent that the management at Reddix hospital is under a lot of stress because of the recent report by NHS. Due to many non-compliance acts, Reddix is losing its reputation and NHS is pressuring it for making some radical improvements in their working processes that increase the patient satisfaction. Several strategies including the change management to adopt a new information system is proposed that is expected to yield huge benefits to the Reddix. Apart from the Information System implementation, the proper management of the knowledgeable resources inside the organization is considered very important for the sustenance of quality medical staff that has knowledge about proper workings and hence can increase the quality of cure provided at the hospital. WORKS CITED 1) Accel Team (2008). Motivation, Accel Team, Accessed on April 26, 2008 from http://www.accel-team.com/motivation/index.html 2) AECB (2008). Positive Reinforcement, Definition, AEBC, Accessed on April 26, 2008 from www.aebc.com.au/Definitions 3) Busch, P. (2008). Tacit Knowledge in Organizational Learning. IGI Publishing. 4) Dalkir, K. (2005). Knowledge Management in Theory and Practice. Butterworth-Heinemann; 1 edition. 5) Haux, R., Winter, A., Ammenwerth, E., & Brigl, B. (2004). Strategic Information Management in Hospitals: An Introduction to Hospital Information Systems. Springer; 1 edition. 6) Herzberg, F., & Mausner, B. (1993). The Motivation to Work. 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