The report mentions the strategic management issues in Rashid Hospital and aims at developing a change model for the organization by involving the stakeholders. Rashid hospital is one of the best hospitals in Dubai, which is a part of Dubai Health Authority. Rashid hospital was set up in the year 1973 and is one of the oldest hospitals of Dubai. It is a speciality hospital that comprises of the Emergency and Trauma centre. Rashid hospital comprises of more than 771 beds including specialized surgical, medical and intensive care units along with proper clinical support and operating theatres. Rashid hospital has undergone several expansions as the population of Dubai increased and there was an increase in the number of patients. It has been a JCI accredited hospital since the year 2007 (Authority, 2017). The hospital offers several emergencies, in- patient and out- patient services to the patients. Rashid hospital not only provides specialized emergency care and trauma services to the population of Dubai but also to the population of Northern Emirates. It has included an emergency department comprising of more than 73 beds for the patients from Northern Emirates. The emergency department of the hospital offers up to date emergency care to the patients belonging from Dubai as well as the tourists and visitors. Rashid hospital takes into consideration the social, physical and psychological needs of the patients and strives to provide a good environment to the patients and visitors. It aims at providing a family like environment to the patients and respects the multicultural environment of UAE. The hospital services include trauma patients, surgical emergencies, general surgery, medical emergency, psychiatric emergency, neurosurgery, plastic surgery, cardiology, gastrontrology, toxicology, orthotrauma, and many more.
The critical care units of the hospital emphasize upon advocating and implementing safe and quality care to the critical patients as well as the postoperative patients, who require intensive care services. The hospital has its own physical medicine and rehabilitation section, which is committed towards delivering a holistic, multidisciplinary and an individual approach to the patients, who need rehabilitation. The hospital aims at helping the patients to obtain highest level of functional independence and quality of life. The hospital is also committed towards providing high quality comprehensive pharmaceutical care services that shall result in safer and cost effective selection of drugs along with on- time delivery of medical therapy for achieving optimal patient outcomes (Hafeez et al. 20416).
The Dubai Health Authority (DHA) was inaugurated on January 2017 and it is a smart pharmacy with the first robot. It is the first pharmacy in the entire Middle East region for using robot for dispensing and prescribing medication in Rashid Hospital. The robot stores up to 35,000 medicines. It is also capable of dispensing around 12 prescriptions in less than one-minute, which helps in reducing the waiting time of the customers (Authority, 2017). Robot dispensing process is entirely paper free as the robot stores the prescription electronically (Ganasegeran, Rajendran and Al-Dubai 2014). The robot is capable of dispensing the prescribed medicines by clicking a bottom based on a barcode, minimizing any error caused by humans. The hospital’s clinical laboratory offers a comprehensive diagnostic laboratory functions 24* 7. The best practices and scientific techniques are developed and implemented in this laboratory for providing exemplary health care services.
Rashid hospital offers several other convenience services to its patients such as booking appointments and providing health cards, which can be renewed from time to time. The hospital also provides the facility of preparing persona medical reports when requested. The hospital has also emphasized upon the effectiveness of coordinating its public relation activities. The hospital has its own customer relationship section wherein the staff ensues that the customers are provided with the best and timely solution to their doubts and queries (Al-Shaali, Wasfy and Mahdy 2014). The administration team focuses upon coordinating and communicating with the customers and solving their issues after understanding their issues and complaints. The hospital also has its own social service unit, which supports the patients and their companions in line with the legal rules and regulations of the nation. The staffs employed in the social service unit are responsible for ensuring good quality life of the patients and their happiness. They are also associated with various organizations that help the needy patients (van Wee et al. 2017).
The major concern in the health care management is the proper management of change and the health care professionals. The hospitals are required to acquire and retain the proper expertise and to undertake only those tasks in which they specialize (Albarrak, Abbdulrahim and Mohammed 2014). There are continuous changes in the health care sector and the hospital is required to initiate and implement several changes from time to time in order to remain competitive. Managing the change involves handling several complexities of processes. It involves evaluation, planning and implementation of strategies that help in improving the overall efficiency of an organization. Change management is a highly complex, dynamic and challenging task, which involves the use of a combination of technological as well as people oriented solutions (Ancarani et al. 2016). The basic change required in Rashid hospital is to initiate and implement a culture of transparency and enhancing the efficiency of the senior leaders as well as the front line staffs. Another major change required is to involve the stakeholders in the important decisions taken by the organization (Ganasegeran et al. 2015).
Figure 1: Kotter’s change model
(Source: Mishra 2013)
Kotter’s change model is one of the most widely used model for change by the organizations. Kotter’s change model has been applied in case of Rashid Hospital as the organization shall initiate and implement a culture of transparency, which shall involve several structural changes within the organization. The organization shall also involve the stakeholders in the important decisions taken by the organization. However, these changes might create resistance among the employees. Therefore, following the Kotter’s model shall enable the organizational leaders to successfully implement the required changes within the organization. The Kotter’s model comprises of the following eight steps:
Step 1: Create urgency:
In order to implement a change, creating urgency helps when the organizations actually need it. Building up a feeling of necessity for the requirement of change enables an organization to begin the underlying inspiration to get the changes done. This is not just a problem of presenting individual’s weak deals insights or explaining expanded rivalry. This involves opening a genuine and persuading discourse regarding what is going on in the market place and with one’s competitors (Rahman and Mahmoud Salim 2017). On the off chance that many people start discussing the change proposed by an organization, the criticalness can be automatically be built up. The following are the things Rashid hospitalion can do in order to create urgency:
Kotter recommends that for a proposed change to be effective, 75% of an association’s management is required to accept the change. Rashid hospital shall truly emphasize upon step one, and invest considerable time in developing earnestness, before moving onto the next stages (Mishra 2013). The organizations must try not to be frenzy and bounce in too quick in order to avoid short- term losses. In case that the organization acts without any legitimate planning, it might lead to unwanted results.
Step 2: Form a Powerful Coalition
It is necessary to persuade others that the change is vital. This usually requires solid authority and immense support from key individuals associated with the company. Overseeing change is not enough as the organizations need to lead it. Organizations can explore compelling change pioneers all through the association as they do not really follow the customary organization chain of command (Pollack and Pollack 2015). To initiate a change, the organizations are required to form a team of convincing individuals. The power of these individuals must come from a range of sources such as work title, status, skills and abilities, and political significance. Once framed, the “change coalition” needs to function as a group, proceeding to build earnestness and force around the requirement for change. For this purpose, Rashid hospital shall do the following:
Step 3: Create a Vision for Change
When an organization starts considering change, there are most possibilities of numerous extraordinary ideas gliding around. It is necessary to link these ideas to a common vision that people can easily understand and relate to the change and its importance. A proper vision can enable individuals to comprehend why an organization is requesting them to accomplish a particular thing (Chowthi-Williams, Curzio and Lerman 2016). At that point of time when individuals visualize what an organization is endeavouring to accomplish, at that point the changes they are offered tend to bode well. In order to create a vision for change Rashid hospital shall do the following:
Step 4: Communicate the Vision
What an organization does with its vision after is what decides the future of the organization. The message has huge chances of having rivalry from other correspondences inside the association, so the organizations have to persuade it oftentimes and effectively, and include it in everything that the organization does. The organizations must not simply call special conferences to convey its vision rather; they must discuss it whenever they get a chance (Murphy and Haden 2015). The organizations must use the vision in its everyday activities in order to make choices that solve the problems. When the organization keeps the vision alive in everyone’s brains, they get easily recalled and get more reactions. It is additionally critical to “walk the discussion.” This implies that what one does is significantly more vital and conceivable than what one says. Exhibiting the sort of conduct that one needs from others is important. The following are the things Rashid hospital shall do so as to communicate its vision:
Step 5: Remove Obstacles
In the case that an organization follows the steps and successfully reaches this stage in the change procedure, the organization would have been discussing its vision at all levels of the association. The staff is required to gain the proper knowledge of and accomplish the advantages that the organization has been promoting (Chappell et al. 2016). Yet, there are always high possibilities that some of the organizational members oppose the change. Also, there might be some procedures or structures that get in its direction. Therefore, it is necessary to set up the structure for change, and ceaselessly check for barriers to it. Evacuating barriers can engage the people of the organization that is needed to execute the vision, and it can enable the change. For this purpose, Rashid hospital shall do the following:
Step 6: Create Short-term Wins
Nothing is more encouraging than success. It is necessary to give ones organization an essence of success ahead of schedule in the change procedure. Within a short period of time, the organizations are required to show the results to the staff. Without this, the people against the change might forbid the success of the organization. It is necessary to make short- term targets and not only one long haul objective (Guérin et al. 2015). Rashid hospital shall do the following in order to create short- term wins:
Step 7: Build on the Change
Kotter mentions that several change ventures come up short since victory is proclaimed too soon. Quick success is just the beginning of what things must be done in order to implement a long lasting change. In any case, in the situation that an organization can dispatch several items it that implies that the new framework is working. In order to achieve the last element of the several items, the organizations have to continue looking for further enhancements. Every success gives an opportunity to emphasize on what went right and identify what one can improve (Day and Shannon 2015). Rashid hospital shall do the following in order to build on the change:
Step 8: Anchor the Changes in Corporate Culture
At last, in order to implement any change, the change must become the focus of the organization. The corporate culture of an organization continuously identifies what completes, so that the qualities behind the vision are shown in everyday work. The organizations must try constant endeavors to ensure that the change is found in each part of the organization. This will help in giving that change a strong place in the association’s culture. It is additionally vital that the organization’s pioneers keep on supporting the change (Hornstein 2015). This incorporates present staff and new leaders, who are acquired. On the off chance, if an organization loses the help of these individuals, it may wind up back where it began. Therefore, Rashid hospital shall do the following in order to anchor the changes in corporate culture:
Figure 2: Lewin’s model
(Source: O’Mahoney and Sturdy 2016)
Lewin’s model is a change model that involves three steps namely unfreezing, changing and refreezing. The model is a model for understanding a change process. The Lewin’s model emphasizes on making the organizational members aware about the changes to be implemented, obtaining the desired behaviour and support of the members and finally incorporating the change within the organization (Beech and MacIntosh 2017). The model can be utilized generally in different circumstances where an arrangement is required:
The Lewin’s model alludes to the three key steps namely unfreezing, changing and refreezing (O’Mahoney and Sturdy 2016). The model serves as a base for several other models.
Unfreezing: Prior to the implementation of a change, unfreezing is necessary. There are high chances of the situations wherein the organizational members shall resist the change. Therefore, the objective of the unfreezing step is to make the members aware about the change and then provide them complete information about the changes to be implemented so that they can understand the importance of the changes. The previous organizational culture, behaviours, activities, people as well as organizational structures are required to be examined. Post examination, the organizational members must be shown the manner in which the change shall benefit them and the organization. The members must be informed about the positive impacts that the change shall bring within the organization. The manner in which the change shall enable the organization to gain competitive advantage over the others must also be explained to the members. At last, advantages of the change must be communicated to the employees so that they are properly informed about the benefits of the change. This is done because the more the employees are informed about the changes, the more they shall be willing to accept the change.
Changing: After the organizational members are informed about the changes, the actual transition takes place. In this step, the actual changes take place and the organization witnesses several changes. This step is also known as transitioning and moving as the changes are actually implemented. The perceived changes turn into reality in this step. In this step, the organizational members struggle with the changes and this is the most difficult step. The members learn about the new processes, activities, and behaviours. This step becomes easier when the members are more prepared for the change. However, this step is required to be planned and executed very carefully. The organizational members are constantly reminded of the changes that have occurred within the organization so that the changes can be successfully implemented.
Refreezing: Refreezing is the final step of the change model and is also termed as reinforcing. The changes that have been made in the organization are reinforced in this step and it becomes mandatory for the organizational members to follow the change and work accordingly. The changes are refrozen so that there are no chances of reverting back to the older ways of working and behaving. It is necessary to ensure that the change implemented within the organizational culture so that it is not lost.
Figure 3: The change curve
(Source: Masrom and Rahimli 2015)
The basic change required in Rashid hospital is to initiate and implement a culture of transparency and enhancing the efficiency of the senior leaders as well as the front line staffs. Another major change required is to involve the stakeholders in the important decisions taken by the organization. In order to initiate and implement a culture of transparency within the organization, it is necessary to create a sense of urgency so that the change can be implemented as soon as possible. The organization must identify the leaders within the organization, who are capable of driving the change. The organization must develop a proper vision and strategy in order to make the change clear to the organizational members. The leaders of the organization must convey the change to the other organizational members and make them understand the importance of the change. It is necessary for the leaders to identify the potential risks and obstacles that would prevent the implication of the change and try to create short term wins by emphasizing upon continuous improvements. Lastly, the organization’s leaders must incorporate the change within the organizational culture. However, before implementing the Kotter’s model of change within the organization, it is necessary to follow the Lewin’s model in order to ensure a successful change management. The Lewin’s model shall ensure unfreezing by making the organizational members aware about the changes that shall occur within the organization. When the members shall be aware about the changes that shall take place within the organization, they shall accept the changes without showing any resistance towards the changes. This shall be the most appropriate time to implement the changes within the organization. Lastly, in the refreezing stage, the changes shall be reinforced within the organization and the employees shall have to work according to the changes.
The change required in Rashid hospital is to initiate and implement a culture of transparency and enhancing the efficiency of the senior leaders as well as the front line staffs. This is only possible when the organization adopts a proper change model and Kotter’s model shall help the organization to plan and implement a step- by- step change process. On the other hand, the Lewin’s model of change management helps the leaders of the organization to identify the manner in which they shall achieve the goals. Another major change required is to involve the stakeholders in the important decisions taken by the organization. This is possible only when the organization integrates its soft and hard elements. The unfreezing, changing and refreezing shall help it to initiate and implement the change accordingly. The Lewin’s model helps an organization to analyze the present situation and a proposed future situation so that the organization can identify the gaps and inconsistencies between them. The model helps the organizations to adjust and tune the elements of the model in order to ensure that the organization is able to work efficiently.
In case of Rashid hospital, the Lewin’s model shall be more effective that Kotter’s model in ensuring the successful change management. However, both the models can be considered to bring about the desired changes. The Lewin’s model shall help the organization to determine its strategy and the manner in which it shall achieve its objectives. The model shall help the organization to deal with the competitive pressure and help the organization to deal with the changes in the demand of the customers. The model shall help the organization to determine its present hierarchy and the manner in which the various departments can be coordinated. The model shall help in appropriately aligning the team members and determining whether the decision making shall be centralized or decentralized. It shall also help in determining the appropriate lines of communication. The present main systems of the organization such as the HR system can be easily identified along with the way in which the systems are monitored and evaluated and the changes required. The model shall help in identifying the rules and processes that shall help in keeping the team on the right track. The present and the required core values and organizational culture can be determined along with measuring the strength of the values. The model shall help the organization to determine the present leadership or management style used by the organization and the best leadership style that shall make the employees more cooperative. The specializations required and the gaps in the required competencies can be easily determined using the model. It shall help in ascertaining whether the current employees are capable of performing their job roles or not. The model helps in determining any skill gaps and the ways in which the skills can be monitored and assessed.
There are continuous changes in the health care sector and the hospitals are required to initiate and implement several changes from time to time in order to remain competitive. Rashid hospital is also required to implement the necessary changes in order to remain ahead of the competitors. These changes involve both internal and external changes. The external changes involve change in the technologies and medical equipments along with the changes in the demands and requirements of the patients. On the other hand, the internal changes involve changes in the structure, strategy and management of the organization. The internal changes usually involve changes related to the organizational employees. Rashid hospital is also required to enhance the efficiency of the senior leaders as well as the front line staffs and implement a culture of transparency. This can be possible only when the organization follows a proper change model as a guide to successfully implement the changes within the organization. The other changes required can be easily understood by carrying out a SWOT analysis and PESTEL analysis of the hospital.
The following is the SWOT analysis of Rashid hospital:
|
Strengths · Special expertise · Positive reputation · Technological advances · Cost effective operations · Superior location (Masrom and Rahimli 2015) · One of the best hospitals in Dubai · Specialized and experiences doctors and surgeons · Brand loyalty |
Weaknesses · Limited lines of service · Marketing deficiencies · Improper management of staff · Gaps in the skills of the staff · Inefficient senior managers and front line staff · No involvement of the stakeholders in the important decision making processes (Matlakala, Bezuidenhout and Botha 2015) |
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Opportunities · New technologies · Lack of dominant competing hospitals · New markets and services · Preventive and disease management services |
Threats · Increase in the competition · Dissatisfaction among the stakeholders · Changes in the insurance plans · Adverse government policies · Economic slowdowns · Adverse demographic changes · Rising cost of the health care facilities |
The following is the PESTLE analysis of Rashid hospital:
Political: The Government policies of a nation have huge impacts upon the health care sector of the nation. Similarly, the government policies in Dubai have huge impacts upon Rashid hospital as well as the other hospitals in the area. The government policies in Dubai favour the health care sector and have helped the hospitals to grow tremendously over the past few years. The government has not only helped the hospitals in stabilizing their operations but has also encouraged their development. The health care sector has got a good space for development in Dubai with the support of the government (Hussein 2015).
Economical: The economic condition of Dubai plays an important role in the success or failure of an organization. UAE has exceptionally high GDP per capita along with a very slow rate of unemployment (Saleh et al. 2015). The country has one of the highest amounts of foreign direct investment, which offers positive economic conditions for the health care sector to bloom.
Social: The citizens of UAE and especially Dubai live comfortable lives as a result of high paid job opportunities. Globalization has also resulted in making the place a mixture of different cultures. People from around Dubai as well as other countries have the opportunity to get their medical treatments in any of the hospitals of Dubai. As a result of globalization, Rashid hospital has included an emergency department comprising of more than 73 beds for the patients from Northern Emirates (AlShaali 2015). The emergency department of the hospital offers up to date emergency care to the patients belonging from Dubai as well as the tourists and visitors.
Technological: With every passing day, the technologies have become more prominent that ever. UAE comprises of people with abundant wealth and mostly middle- aged population, technology has never been an issue. The young population of Dubai is tech savvy, which has enabled the organizations in Dubai to leverage the technology (ALKRAIJI, Osama and Fawzi 2014). The abundance of wealth enables the country to invest highly into purchasing new technologies and equipments. This has helped in the technological advancement of the health care sector. Rashid hospital also uses the latest technologies and equipments for handling and treating its patients, which has helped in the growth and development of the hospital.
Legal: UAE has specific laws, rules and regulations that must be followed by every hospital in the country. Any breach shall land the hospitals into legal troubles. These laws have been formed in order to safeguard the rights of the citizens as well as ensure that the hospitals conduct an ethical business. All the hospitals are required to follow certain norms and regulations in order to continue its business operations (Moonesar 2015).
Environmental: UAE has a hot and dry climate, which might result in several health issues among the citizens. The conditions of the hospitals in Dubai are much better that those in the other parts of the world. Rashid hospital has a comfortable environment, clean equipments and has won the praises of the patients. The specialized treatments offered to the patients in Rashid hospital have helped the hospital to obtain positive reputation. The hospital has aimed at providing friendly environment to its patients so that they can stay comfortably in the hospital (Lear et al. 2014).
Reasons for change management:
Change management helps an organization to improve its functions and activities and to gain sustainable competitive advantage, which enables them to remain successful in the long- run. The complexities of the changes and the difficulties in the implementation of the changes are the major reasons behind change management in the organization. Managing the change involves handling several complexities of processes. The complexities involved in the change process largely impact the organizations and therefore, needs to be managed properly. Change management helps the organizations to remain ahead of the competitors and increase their overall efficiency. Change management enables the organizations to obtain benefits of lower costs. Therefore, change management helps the organizations to achieve their long- term goals and objectives. Many a time, the change to be implemented is highly risky and complicated, which calls for proper management. Change management helps in successful implementation of the complex and risky changes.
Implications of the change on the organization:
The change required in Rashid hospital is to initiate and implement a culture of transparency and enhancing the efficiency of the senior leaders as well as the front line staffs. This is possible only when proper training and development facilities are provided to the employees and the senior staff. The company is required to bring several changes in the internal management and leadership style in order to improve the efficiency of the operations. The organization is required to implement transformational leadership style in order to enhance the efficiency of the employees and to develop a positive image of the senior staff. Proper coordination and cooperation among the team members is necessary in order to ensure that the patients get the proper treatment within time. These changes in the internal processes of the organization shall improve its overall efficiency and shall increase the level of satisfaction of the patients and their families. This shall help the hospital to remain ahead of the competitors by offering superior services (Hornstein 2015). These changes would ultimately increase the profitability of the organization along with the improving the reputation of the hospital. Involving the stakeholders in the important decision- making processes shall help the organization to develop trust among the stakeholders. This shall help in improving the goodwill and reliability of the organization. The use of latest technologies and equipments shall enable the organization to attract more patients and remain competitive in nature.
In case, the organization does not implement the changes, the organization might lose its competitive advantage and incur huge losses. It would directly affect the market share and brand value of the organization. The loss in the goodwill might be beyond repair as it would become very difficult for the organization to improve its market position in future. This shall not only involve loss of customers but might also involve loss of productive employees,.
The following is the change management strategy for Rashid hospital:
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Activity |
Months |
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M Jan |
M Feb |
M Mar |
M April |
M May |
M June |
M July |
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Deciding on the change goal |
ü |
||||||
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Consider timings |
ü |
ü |
|||||
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Being aware of the culture |
ü |
ü |
|||||
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Creating visible short- term wins |
ü |
ü |
ü |
||||
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Communicating the change |
ü |
ü |
Figure 1: Gantt chart
(Source: Author’s work)
Stakeholder management is defined as “the processes required to identify the people, groups, or organizations that could impact or be impacted by the project. It involves analyzing stakeholder expectations and their impact on the project. Developing appropriate management strategies for effectively engaging stakeholders in the project decision and execution are essential.” At first it is necessary to identify the key stakeholders, who shall be affected by the change implementation (Carroll and Buchholtz 2014). This might involve the customers, suppliers, shareholders, labour unions, and several others. In case of the change implementation in Rashid hospital, the internal changes in the management and organizational structure shall mainly affect the employees (both front line and senior employees). The basic change required in Rashid hospital is to initiate and implement a culture of transparency and enhancing the efficiency of the senior leaders as well as the front line staffs. Another major change required is to involve the stakeholders in the important decisions taken by the organization. Therefore, the major stakeholders affected shall be the employees, shareholders, suppliers, patients and the labour unions. The second step involves identifying the tools and techniques for stakeholder analysis. This involves identification of the potential stakeholders, the potential impact of the changes on them and assessing the manner in which the stakeholders might react to the change (Berrone, Cruz and Gómez-Mejía 2014).
Stakeholder Analysis (SA) is defined as “a methodology used to facilitate institutional and policy reform processes by accounting for and often incorporating the needs of those who have a ‘stake’ or an interest in the reforms under consideration. With information on stakeholders, their interests, and their capacity to oppose reform, reform advocates can choose how to best accommodate them, thus assuring policies adopted are politically realistic and sustainable.” Marketing attempts at connecting an association with the outside world (Mok, Shen and Yang 2015). While considering a marketing campaign, the organizations need to consider all the stakeholders, who might influence its effectiveness or get influenced by it. The stakeholders are categorized into a framework known as 4 C’s of engaging stakeholders. The 4 C’s are as follows:
There are several issues associated with implementation of change within an organization. One of the major issues is the resistance offered by the employees of an organization. Mostly, the employees the organizations believe that the changes might adversely affect their job roles and positions, which makes them resistant towards the changes. Therefore, it becomes necessary for the organizations to make the employees understand the importance and advantages of the change. The resistance to change shall be overcome by properly informing the organizational members about the changes and the benefits of the changes at an early stage that is in the unfreezing stage. The members shall also be provided proper guidance and support from the managers and the leaders of the organization so that they do not face any issues during the changing stage. This shall help the organization to overcome resistance to change.
Conclusion:
The basic change required in Rashid hospital is to initiate and implement a culture of transparency and enhancing the efficiency of the senior leaders as well as the front line staffs. Another major change required is to involve the stakeholders in the important decisions taken by the organization. The Kotter’s change model shall help the organization to determine its strategy and the manner in which it shall achieve its objectives. The model shall help the organization to deal with the competitive pressure and help the organization to deal with the changes in the demand of the customers. The model shall help the organization to determine its present hierarchy and the manner in which the various departments can be coordinated.
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