Respect, Introduction and Identification, Management, Medications, Safety and Survey - Assignment Example

Innovation and Change Table of Contents Table of Contents 2 Introduction 3 Leadership 4 Innovation in Healthcare 6 Strengths 6 Weaknesses 7 Opportunities 7 Threats 8 Change and Change Management 8 Evidences to Support Change 11 Conclusion 12 References 13 Introduction Change management, nowadays, is considered as an effective tool to mitigate the problems faced by organisations due to changing external and internal business environment. Change is considered as establishment of new aspects, in response to the past approaches and strategies, which can further be considered as an everlasting process (World Health Organisation, 2007). In the modern day scenario, change is being recognised as one of the most vital aspects of that is prevailing within the healthcare sector. Consistent positive transformation is required for the purpose of ensuring proper healthcare and medical treatment, encircling the patients as well as their families for the deliverance of adequate care. Hence, for managing change in the medical domain, there is a continuous need for effective qualities such as leadership, innovation and change management, which must be possessed by the concerned members. The assignment deals with the concept of ‘Respect, Introduction and Identification, Management, Medications, Safety and Survey’ (RIMMS), and further discusses about the concept of change management while handing over cases from one shift to other at patients bedside (Xian & et. al., 2014). The proposed change in this regard was ‘Clinical Bedside Reporting’, being implemented in the medical ward for the purpose of suitable transfer of the relevant information regarding the patient as well as its responsibility to the next shift. Furthermore, the change is aimed at enhancing the involvement of family members and patient by updating them with comprehensive knowledge about the treatment plans and clinical information at the time of handover (Wakefield & et. al., 2012). The assignment will further introduce concepts of change management, required leadership qualities, innovations that need to be ensured in the field of healthcare further ensuring utmost sustainability within the organisations. Leadership In the field of healthcare profession, nurses and doctors must possess a variety of leadership skills in order to achieve the goals of workplace development along with higher level of outcomes in terms of patient satisfaction at large (Hutchinson & Jackson, 2013). The assignment can be well understood with two diverse theories of leadership, namely the transformational leadership and the transactional leadership theory (Eaton, 2010). Transformational leadership refers to a particular category of leadership, wherein leader has the responsibility of identification of the required change and establishing a future vision that can act as a guidance mechanism for managing change. Finally, leader is also responsible to execute the required changes with the support of his committed team members. Transformational Leadership carries an ‘idealised influence’ requires an ‘inspirational motivation’, has an ‘intellectual stimulation’ along with an ‘individualised consideration’ (Givens, 2008). Transactional leadership is one of the widely known theories of leadership, which lays emphasis on the responsibilities of supervisors and the performances of team as a whole. It encompasses the leaders who believe in the fact that the members can be motivated with the help of rewards as well as punishments, wherein, the subordinates must display high level of responsibility towards the orders delegated by superiors (Lowe, 1996). Furthermore, the theory is also based on the assumption that subordinates working in organisations cannot be self-motivated, and hence the leaders need to continuously monitor their performance, in order to accomplish the desired goals (Judge & Piccolo, 2004). Similarly, with due adherence to the above leadership theories, a person must possess certain leadership traits, which would enable him to achieve organisational goals. One of the traits, which must be acquired by a successful leader, is the recognition of personal accountability and job responsibility. Leaders must be well aware of their required competencies and must engage themselves in making continued progress along with holding the responsibilities of the work of the subordinates (Jeffcott & et. al., 2009). Another trait that must be inherited by a successful leader is positive attitude and sense of integrity with others. Leaders must develop a positive mindset in order to encourage others towards accomplishment of organisational goals within the specified timeframe (Derue & et. al., 2011). Furthermore, to achieve such goals, leader must encompass a sense of integrity with others, such that all the stakeholders in an organisation are benefitted from it and can effectively work together towards attainment of the set objectives (Kirkpatrick & Locke, 1991). A majority of the hospitals in Singapore use a parallel mechanism at the middle level position, which creates a balance among the concepts of exploitation and exploration (Marquis & et. al., 2008). For managing change in hospital with the help of leadership skills, the transactional style of leadership can be considered as successful for managing such changes. Transactional leadership can be well suited to meet the challenges faced while implementing change in hospitals, as it focuses on measuring employee performance by motivating him/her through conditional reward schemes as well as punishments in certain scenarios (Anderson & Mangino, 2006). While carrying out RIMMS, the nurses are provided with compliments, rewards and recognition, in order to ensure that they are able to deliver their optimum performance during application of the initiated change within the workplace. Conversely, punishments and negative feedback will also be forwarded at times to the nurses, if they are not able to maintain the RIMMS handover report in an efficient manner. Moreover, any sort of rewards and benefits will be withheld from the nurses and a proper mechanism will be established for future implementation in case of any misconduct from the same. Furthermore, transactional theory of leadership will be helpful towards managing change, as it will provide contingent rewards to the nurses, which would finally lead to a positive effect on the outcomes in terms of job satisfaction, enhanced performance along with clarity of job among others (Chaboyer & et. al., n.d.). Innovation in Healthcare Strengths One of the key strengths of the concept of RIMMS change is to utilise a patient centered approach for establishing proper treatment and care plan for patient. The RIMMS framework focuses upon providing care that can ensure benefit for the patients and ensure higher satisfaction for their relatives. Furthermore, to enhance the level of care, RIMMS is executed at the bedside of the patient with the clinical handover of the documents (Lewis, 2011). Consequently, clinical handover at the bedside of the patient, allows the nurses to ensure proper time efficiency while managing appropriate information of patients to be shared with the relatives and maintaining required responsibility at the time of handing over the medical documents. Furthermore, RIMMS requires limited use of resources owing especially with regard to optimum use of resource in hospitals. Hence, there are limited requirements of external resources while executing RIMMS that further result in cost efficiency (MacPherson & et. al., 2013). Weaknesses Apart from the strengths, there are several weaknesses that prevail with the use of RIMMS. One weakness with regard to the implementation of RIMMS includes the aspect of resistance from the end of the nurses. A majority of the nurses can be observed in Singapore hospitals to be depicting resistance towards adopting and implementation of the RIMMS mechanism. Another important weakness of RIMMS is that there remain certain key areas of improvement for the hospitals involved in pilot testing working in the field of bedside reporting. In addition to this, the nurses working under ‘Specialist Outpatient Clinic’ (SOC) would be unable to make use of the RIMMS for the purpose of handover activities to patients and relatives. Another weakness in implementation of RIMMS can be understood with the help of the ‘theory of diffusion’. As proposed by Rogers, people decide to adopt a particular change based on their knowledge towards the same. In case of being unable to understand efficiently with regard to the process of working within the RIMMS framework, the nurses would resist implementing RIMMS in organisation (Rogers, 1995). Opportunities One of the potential opportunities of utilising RIMMS is to raise the awareness levels of RIMMS among the nurses besides reporting in Singapore. Opportunities at the level of organisation, also includes the degree of compliance, wherein bedside reporting is in conformity with the standards set by the ‘International Patient Safety Goal’ (IPSG). Another important opportunity of RIMMS is that it helps in improving the exactness in identification of the patients and enhancing the communication mechanism at large. Furthermore, RIMMS allows encouraging the patients to participate in self-care approach, which again can be regarded as quite efficient in the later scenario (Butao & et. al., 2010). Use of RIMMS can further ensure an increased satisfaction among the patients, as they can get adequate information about their own treatment status, which will further reduce their dependency on the healthcare professional. Above all, one important opportunity will be that RIMMS would lead to an increasing awareness among the people of Singapore to the concept of bedside reporting (Timonen & Sihvonen, 2000). Threats Apart from the variety of opportunities, the implementation of RIMMS can result in certain potential threats, which must also be discussed. One of the threats that Singapore General Hospital (SGH) might face while implementing change via RIMMS can be the increase in the levels of competitions received from other hospitals in Singapore. These hospitals will try to enhance and emerge with new concepts and utilise the RIMMS framework, so that they are able to attract patients, before SGH does (Kassean & Jagoo, 2005). This will encourage the clients towards selecting the best available hospital for treatment. SGH would also have to deal with the threat, pertaining to the fact that once the RIMMS mechanism has been instituted and put into effect, competitors of SGH can get a better understanding of the concept, which will further allow them to emerge with new concepts and ideas within the RIMMS (VandenBerg, 2013). Change and Change Management Change can be defined as a process involving that ensure positive alterations for an existing scenario. A change can result in either positive outcome or create negative outcome at large (Quattrone & Hopper, 2001). The hospital can further ensure that change is properly implemented in the organisation, keeping in mind, the fact that without proper change, the hospitals will be unable to implement the RIMMS framework. The two change theories in coordination with the concept of change management have been proposed by ‘Havelock’ and ‘Lewin’. Kurt Lewin, in the year 1951, introduced the concept of ‘Force Field Analysis’ for the purpose of planning and implementing sustainable changes. In the field force concept, there are two different kinds of forces where one of them includes the driving forces, who are inaugurating the change in the organisation and helps it to grow continuously while the others include the restraining forces that act as barriers to prevent successful change. The driving forces can result in increased benefits from the changes, whereas, the restraining forces will act as drawback towards the implementation of RIMMS. The driving forces would enable the workers to become motivated and change their existing practices. One of the most important factors of RIMMS is efficiency of time, apart from presence of active patients. Furthermore, one of the driving forces is partial lapse of the relevant information. The restraining forces would be resistance from the nurses on account of change and lack of confidence prevailing among the same. Furthermore, the restraining forces would also include continuous disturbance from the healthcare staffs while focusing upon the RIMMS mechanism. To overcome situations of resistance by the nurses, change agents are being recruited who would devise strategies and motivate the nurses, further developing a feeling of trust among them such that they are able to recognise the importance of change. The change management stage will require the agents to have a lucid understanding of the handover report of RIMMS along with providing them an understandable representation of the change and its benefits. It is implemented in various shifts within the hospitals, once it has been utilised in a particular shift. At the final stage, the nurses after being familiarised with the concept of ‘RIMMS handover Report’, the change agents are required to emphasise and preserve the desired changes owing to the fact that nurses may shift over to the previous positions as they were prior to the change. Hence, it will allow the hospital to implement the RIMMS mechanism by ensuring optimum contribution received from nurses. Havelock, in the year 1973, introduced another theory of change, which focuses on the key areas requiring planning and understanding in the process of change management within any particular organisation. The theory has been devised considering the effects of change among the individuals who may depict resistance towards successful change. Havelock lays emphasis upon implementing change in hospitals with the help of six steps. The first stage focuses on creation of positive relationships in situations and within the system wherever change is required. This may be accomplished with the help of change agents. The second stage gives significance to diagnosis of the problem, wherein, the change agents will needs to carry out an analysis and consideration of the need for change in the workplace. The third stage includes identifying the procedures of developing certain resolutions, which begins with the consolidation of the possible evidences that are relevant to the change mechanism. Furthermore, it enables the change agents to grab adequate knowledge of the change so that they could be able to provide firm knowledge with regard to the change concept. The fourth stage deals with selection of a relevant choice from various alternatives available to implement change and finally implementing the change. The fifth stage discusses about the fact that once change has been implemented, it must be established and acknowledged. Finally, once the change has been successfully implemented and acknowledged, the sixth change converses the need for proper management of the change process. The change agent must ensure that RIMMS has been successfully placed in the organisation and is maintained as a newly established norm, after which the change agent can leave the organisation (Havelock, 1973). Nurses can be considered as an agent of successful change, as they act as an advocate to the patients and they possess the responsibility for meeting the requirements of the patients (Oliver, 2006). Furthermore, they are also regarded as the agent of change as they play a crucial role in the healthcare systems. Additionally, they play a vital role in improvement of the patient safety, which is quite crucial in this particular sector. Furthermore, nurses can act as change agents as they are the actual resource of the organisation, which can enhance the policy and practice standards (Wooten & et. al., 2006). Evidences to Support Change According to Thomas & et. al. (2013), findings related to change suggested that a structured approach for handover is being used with the provided set of information, which will ensure that important components of the change are not missing and hence are not required. This will help in improving the safety of patients, apart from delivering holistic handover (Thomas & et. al., 2013). As per the views of Matic & et. al. (2010), clinical handover is regarded as a fixed process of nursing and is widely known in terms of being an advantageous tool of communication, which offers high level of nursing care with the help of competent and efficient support (Matic & et. al., 2010). As per the views of Ahmed & et. al. (2012), clinical handover is regarded as important because it will helps in ensuring continuity of patient care. Furthermore, RIMMS enhances the level of communication amongst the patients as well as nurses, which is again a beneficial aspect at large (Ahmed & et. al., 2012). As per Chin & et. al. (2011), many of the patients has knowledge of the process of handover. Hence, those who possess adequate knowledge of handover have positive understanding regarding teamwork and communication (Chin & et. al., 2011). Conclusion As can be understood from the above analysis, implementation of RIMMS is regarded as one of the latest clinical handover procedures that involve not only a systematic and structured progress, but also enables the hospitals to make sure that patient safety standards and proper communication amid the concerned parties are maintained. The fact can also established that nurses play the role of change agents in introducing and retaining change, who further play a vital role in improvement of healthcare services provided to the patients, further advocating and acting as a successor of change management. The assignment has also focused on the theories of change proposed by Havelock’ and ‘Lewin’, which stresses upon the implementation of certain stages in order to achieve a positive change. To analyse innovations in the field of healthcare, this assignment has discussed the SWOT framework, which can depict the factors that have an affect over the internal and external environment of the hospital implementing RIMMS. Finally, various theories of leadership along with suitable references have been discussed in the assignment for gaining a more comprehensive understanding with regard to the topic. References Ahmed, J. & et. al., 2012. Impact of a Structured Template and Staff Training On Compliance And Quality Of Clinical Handover. International Journal of Surgery, Vol. 10, pp. 571-574. Anderson, C. D. & Mangino, R. R., 2006. Nurse Shift Report Who Says You Can’t Talk in Front of the Patient? Nurs Admin Q, Vol. 30, No. 2, pp. 112–122. Butao, R. & et. al., 2010. 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Patient Safety Solutions, Vol. 1, No.3, pp. 1-4. Xian, J. L. H. & et. al., 2014. Enhancing Safety and Quality through Effective Clinical Handovers. Singapore Health Management [Online] Available at: http://www.singaporehealthcaremanagement.sg/Abstracts/Poster%20Exhibition/Documents/OP072%20-%20Ang%20Shin%20Yuh%20(Teo%20Kai%20Yunn)_SGH.pdf [Accessed February 18, 2015]. Read More