Change Management In Health Care

Change management.

Building on the analysis of a problem in your organisation (used in assignment 1), analyse what changes are needed. What processes will you use to implement changes?

The issue I discussed in assignment 1 involved the implementation of a project that, although the clear aim was never articulated, could be assumed to be an attempt to streamline the operational processes.1

Solutions to this problem were multifaceted, …………clear goals, communication
However creating a structure and framework with which practically to implement change is more difficult because of the differing agendas of the protagonists. The approach of all concerned nonetheless should be to continue to develop and maintain quality health care services
which meet the identified needs of the community.
With the underlying aspect of change management trying to manage a change and to still maintain a strategic vision, it is important to clarify the strategic vision for everyone. The core function of a hospital is to service the health needs of the people in the surrounding area and also to provide teaching and research. Therefore the strategic vision should be one that encompasses the hospital as a leading health service where the highest standards of care are supported by education, research and teamwork. Instead of service delivery being adapted around problems as they arise, it needs to be strategically developed in line with service demands and efficient design principles. Changes are constantly occurring in the health care system because of politics, infrastructure development, systems implementation, changing models of care and changing processes and technology.

It is crucial to align the needs and resources of communities to ensure that health care requirements are met. Health care providers and managers need to manage services in an open manner and be accountable for

One of the main issues, and one that should be foremost, that was badly handled in this case was a clear definition of the problem. It possible was clear to the health administrators but for successful implementation of change all parties involved need to be aware of the aim. This was aggravated(?) by the lack of communication between the
When changing models of care there are a few principles that must be maintained for efficient and smooth transition
These arte
- constant an consistent collaboration, communication and collaboration and consultation
- facilitation of joint decision making between the health care providers and the consumers
- based on the most appropriate evident
- use of a quality framework to facilitate continuous clinical improvement
- planned evaluation

In this scenario managing organisational change fell at the first hurdle.
The problem was not clearly defined. Whilst it may have been to the systems administrators, it was not communicated to the rest of the people(?) involved. The staff it affected the most had no idea what the issues with the current model of care were and why changes were necessary. Without a clear definition of the problem there was no understanding of why the current model of care needed to change. Assuming from the health care administrators view the problem was that the time patients on our ward were spending in hospital was consistently longer than expected for the relevant DRGs.

Underlying the implementation of this project was the streamlining of the process of treatment. The process is a complicated one with many opportunities to change management. In order to develop implement a plan for organisational change, evaluation of the current process of care is essential. These can be broken down into inputs, processes and outputs.
Inputs include:
1. Patients - members of the community that have active health care requirements
2. Labour - Medical, Nursing and Ancillary staff, including
management
3. Infrastructure/Facilities - Buildings, wards, bays of beds, elevators, electricity/gas/sanitation supply, computers, other machines etc.
4. Materials/Equipment - medications, therapies, medical supplies (bandages, needles etc.), linen, papers, case notes
5. Suppliers - providers of goods and services (e.g. nursing agencies, medical supply companies, maintenance tradespeople), financiers (Federal and State Government, private donors)
6. Knowledge - individual, interpersonal, intrapersonal and collective knowledge of staff members and suppliers, library access to internet, international research literature and best practice guidelines
7. Time - dedicated shifts for permanent and contracted employees, occasional hours for casual employees, limits and constraints mandated by Administrative and Regulatory authorities
8. Technology - new treatment/medication options, improvements to communications and information sharing, advancements in automation/instruments etc.
9.
Operational process that are conducted within the hospital include receiving and admitting patients, updating clinical records, clinical assessment and examination of patients, treatment provision, communication with patients/families and other community networks, cooperation and teamwork within hospital units and with other hospital departments, equipment maintenance and supplies inventory and provision of advice/discussion regarding ongoing care.

The outputs that are desirable to be achieved include;
1. Optimisation and maintenance of appropriate levels of health for treated patients
2. Patient satisfaction with treatment and levels of information/communication
3. Good rapport with community, including other health agencies/hospitals, general practitioners and with people in general
4. Ongoing financial viability whilst maintaining adequate standards of care to patients

Possible factors that could be looked at that affect inputs, outputs and operational processes would be
- values and principles
- care delivery process:
- referral patterns
- patient outcomes
- outside comments and perceptions
- staffing profile
- communication structures
- cost of service delivery

After defining the current model of care it is important to define the population group and the demographics of the people in the community as well as those accessing the hospital.
At this hospital it was well known for having and older population as it was the old repatriation hospital. In this case the ward generally catered for patients with respiratory illnesses. This experiment was trialled during winter which is usually a busier time for a respiratory ward. However like any ward, there were often patients who were known as “outliers”. Patients with non respiratory illnesses and there fore not the specialty of the nursing staff and often the medical staff tending to them were based on other wards. This meant they were not around and had to be paged, answer and come to deal with their patients when they had time.

After assessing what services are required and what are delivered, the quality of the services and the problems encountered with the current model it would be possible to identify the deficits between the current model and that required.

Strategies and activities

People and communication and consultation

Key
stakeholders

From meeting with the stakeholders it will be possible to see the factors which are critical to success of the project from the stakeholder perspective and the training needs of each stakeholder group. Communication processes need to be clarified so that for all stakeholders are satisfied with the information to be provided, the forum/format for delivering information and the frequency of communication exchanges.
Overall health outcome implications need to be evaluated and these would need to be compared with the current model of care

Evaluation of the
It is important to establish how the new model of care would be evaluated at the the beginning of the change including a a timeframe for evaluation, comparisons of the old and new models summarising strengths and weaknesses