In the year of 2003, the government started pressurizing the hospital authorities to improve the performance parameter and services by reducing duplications. The NHS trust felt that King Edgar Hospital also requires making modifications to the hospital policies and procedures to improve the performance scale. One of the major problems was found in keeping the patients on the waiting lists. The NHS trust started receiving many of the adverse media coverage that highlighted the issues with the £30 million financial deficit and the long waiting list.
After recognizing these specific problems, the Trust Board started conducting the internal audit of the hospital performance. It has been observed that the hospital has been facing the wide range of problems that include the high admission rate, wait of the patients during emergency, bottlenecks of the medical admissions, and delays in discharge. In addition to this, it is also noticed that the patients are placed in wrong ward, increasing complaints of the patients, and poor relationships with the social services. Issues with the inefficient management of the hospital authority are the major concern to be taken into account for developing the change management program.
With the lead of Tracey Burns, the Executive Director of Nursing took the initiative to undertake the change management program. She welcomed this opportunity for two major reasons. She is quite aware of these issues since she was a former matron in this hospital. One of the major reasons for undertaking this initiative is to develop the secure and safe environment for the patients. She claimed that she would place herself in the position of the patience to understand their conditions and improve the hospital services.
It is quite difficult for the patients to spend 12 hours in a trolley and keep on waiting during the emergency cases. Another major reason for developing this change program is to extend the role of the nurses who are usually dominated by the medical personnel or professionals. She wanted to provide the nurses enough empowerment for the motivational purposes and improve the performance of the patients’ services. It would be beneficial in improving the relationships with the patients and treat them in a better way. The systematic approaches undertaken for bringing the changes in the hospital scenario would mitigate the issues and enhance the performance level.
There are various solutions being discussed by the trust in regarding to the issues being faced by them. One of the key solutions being discussed by them is the initiation of the flow cost quality improvement program. This system is being initiated in order to enhance the relationship between the hospital staffs and the patients along with the associated cost and outcome.
Moreover, another objective of this flow chart is to reduce the queue of the patient by effectively matching the demand with that of the infrastructural capacity. The flow chart is being designed in such way that it will identify the movement of people, equipment and sharing of knowledge among the internal stakeholders in a sequential process. Thus, in view of the fourth industrial revolution, initiation of the automation will be helpful in enhancing the efficiency and effectiveness of the flow chart.
Another solutions being discussed by them is the initiation of the review and rating system for the trusts in order to enhance their productivity. Stars will be provided to them in regards to their performance in various metrics such as hospital cleanliness, motivational level of the employees and satisfaction level of the patients. Thus, more review and ratings for the internal stakeholders will help them to identify the areas of improvement and work accordingly. It will also help the trusts in identifying the benchmark in improving the service quality of the hospitals. For instance, if the five stars are being considered as the most favorable ratings, then the target for all the trusts will be to achieve the five stars and they will work accordingly. Thus, it will automatically enhance the productivity of the organization.
Another measures being discussed by them in regard to the improvement of the patient discharge is the effective discharge planning. According to this initiative, a holistic approach is being taken, which will cover the patients as well as the nurses and matrons. This initiative includes providence of a booklet to the patients, which will state the patients about the rules and regulations regarding the discharge from the hospitals. Thus, it will make the patients ware about the regulations, which will in turn help the organizations to prevent and potential issues. This initiative also includes encouraging the staff regarding the use of the lounge for the discharging of the patients. Using the lounge for the discharge patients will help to reduce the occupancy in the ward. Thus, more ne patients can be inducted in the hospital.
According to the Kotter’s 8-Step Change Model, the entire change process has taken place in the hospital that has been led by the director of the nursing as well as her team. The proper change process is essential in nature to be taken place in the different hospitals as this helps in understanding as well as analyzing the different issues that has to be properly taken care of and this will help in identification of the different potential threats that are faced by the respective hospital (Tan et al. 2016).
There are different as well as important steps that have to be followed in order to analyze the different changes in the hospital that are required to be followed by the management of the hospital. The steps are discussed as follows:
Creating urgency is essential in nature in order to make the required change happen in the hospital as this will help in developing a proper sense of the urgency around the different needs as well as requirements for the entire change to happen and take place as well. This will help in sparking the initial motivation in order to make the things moving in the direction of the required change. The change that is required in the hospital does not mean simply the statistics of the sales along with discussing about the increased competition in the respective organization (Small et al. 2016).
This kind of communication will help in analyzing the entire marketplace along with other issues that are required to be changed in the hospital. This will be dependent on the happening of the competitive companies in the market along with making the individuals of the organization talk about the desired change that is required in the hospital as well. This will help in proposing the change management and build urgency and feed on itself as well. The different steps to make the change management happen are:
Creating a powerful coalition is essential in nature as well as this will help in convincing the individuals about the desired change that is required to make the organization more effective as well as efficient in nature. Proper leadership skills as well as support that is visible in nature is essential in nature in order to support the individuals of the entire organization. There are different change leaders who are effective in nature who do not follow the hierarchy of the company that is traditional in nature (Rajan and Ganesan 2017).
In order to generate proper change management in the respective hospital it is essential in nature to bring the entire team together in nature of the different influential individuals wherein the power comes from different kinds of sources that includes title of job, status as well as expertise (Goyal et al. 2017). The coalition of change that has been formed has to be worked as a team as this will help in creating sense of urgency to identify the weak areas that require proper change in order to make the change successful in nature as well.
Proper creation for vision for bringing change is essential in nature as to determine the different values and this will help the director of the hospital in creating proper strategy to execute the respective vision and the proper practice is required of the vision speech to describe the vision for the change and the requirements are urgent in nature as well.
Proper communication of the vision is essential as well as this will help in determining the entire success of the organization as well. The vision that has been set has to be utilized as this will help in making the decisions properly and solve the issues urgently as well (Cooney et al. 2016). Proper demonstration of the behavior is essential that is required from the other individuals in the hospital by the director as this will help in addressing the concerns of the individuals in the organization. The vision has to be applied for the different aspects of the organizational operational activities from proper training to the reviews on the performance of the individuals as well.
Proper removing of the obstacles is essential as well in nature as this will help in recognizing as well as rewarding the individuals for making the entire change to take place in the hospital. The director needs to properly ascertain as well as identify the individuals in the organization to make the change happen and proper action has to be taken by the director and the higher officials to make the change happen quickly in nature as well. Proper identification of the change leaders is essential in nature as this will help in identifying the roles to deliver proper change in the hospital as well (Teixeira, Gregory and Austin 2017).
Proper creation of the short term wins is essential in nature by the director of the respective hospital as this will help in analysis of the different potential pros as well as the cons of the targets that has been set up by the officials of the hospital in order to make proper changes in the goals as this will help in rewarding the individuals who has helped in meeting the goals.
Lastly, proper change has to be build and anchoring the changes in the corporate culture is essential as well in the respective hospital as this will help them in learning about Kaizen and this will help them in learning about continuous improvement that is required in the hospital. Proper plan has to be created in order to replace the leaders as per the requirements of the change. This will help in analyzing that the legacy is not forgotten or lost in nature (Chappell et al. 2016).
Lessons and Pitfalls highlighted by the approach to change management at King Edgar Hospital NHS Trust
The change management model was undertaken for improving the hospital performance of King Edgar Hospital. However, this change management model has some of the specific pitfalls that highlighted in initiating the approaches. The senior level executives need to agree upon the approaches undertaken for implementing the changes. For example, Burns wants to develop nurse empowerment for the betterment of the performance parameter. It can be noticed that the senior executive management and the medical professionals may oppose such decisions.
Hence, lack of proper establishment of the enough guiding coalition can be one of the major drawbacks for this approach. Another most specific pitfall is found in identifying the appropriate vision and transparent communication. The changes are undertaken to develop the performance level in a better way. In such cases, it is essential to communicate with the different department. The lack of clearance of the vision would lead to the failure of the change management initiatives.
The lack of systematic planning is another major concern for this approach undertaken for the change management process. It is to be notified that the development of the proper organization culture is necessary for implementing any change. In such cases, the cooperation from the senior management level is essential. It is necessary to provide the nurses enough empowerment for the motivational purposes and improve the performance of the patients’ services. It would be beneficial in improving the relationships with the patients and treat them in a better way.
NHS trust is mainly concerned about mitigating the issues with the financial deficit and developing the secure environment for the patients who have been waiting in the trolley during their emergency situations. Understanding the situation of the patients is necessary to develop the better hospital culture and performance parameter. In addition to this, it is also necessary to develop the concern within the organization by establishing the effective relationships. Accordingly, the organization can mitigate the emerging issues in a significant way and develop the better environment.
References
Chappell, S., Pescud, M., Waterworth, P., Shilton, T., Roche, D., Ledger, M., Slevin, T. and Rosenberg, M., 2016. Exploring the process of implementing healthy workplace initiatives: mapping to Kotter’s leading change model. Journal of occupational and environmental medicine, 58(10), pp.e341-e348.
Cooney, M.A., Pernick, J., Rice, K. and Monago, E.A., 2016. Utilization of Change Theory to Implement an Appreciative Advising Model. Journal of Research, Assessment, and Practice in Higher Education, 1(1), p.8.
Goyal, S., Goyal, S., Sergi, B.S., Sergi, B.S., Kapoor, A. and Kapoor, A., 2017. Emerging role of for-profit social enterprises at the base of the pyramid: the case of Selco. Journal of Management Development, 36(1), pp.97-108.
Rajan, R. and Ganesan, R., 2017. A critical analysis of John P. Kotter’s change management framework. Asian Journal of Research in Business Economics and Management, 7(7), pp.181-203.
Samara, K. and Raven, J., 2014. A Readiness For Change Model For Dubai e-Government Initiative.
Small, A., Gist, D., Souza, D., Dalton, J., Magny-Normilus, C. and David, D., 2016. Using Kotter’s Change Model for Implementing Bedside Handoff: A Quality Improvement Project. Journal of nursing care quality, 31(4), pp.304-309.
Tan, S.Q., Lim, W.W., Liu, S.L., Phoon, W.L.J., Tan, T.Y., Viardot, V., Chan, J., Nadarajah, S. and Tan, H.H., 2016. Kotter’s Eight-Step Change Model: One Centre’s Experience for Transition to the GnRH Antagonist Protocol. Journal of Womens Health, Issues and Care, 2016.
Teixeira, B., Gregory, P.A. and Austin, Z., 2017. How are pharmacists in Ontario adapting to practice change? Results of a qualitative analysis using Kotter’s change management model. Canadian Pharmacists Journal/Revue des Pharmaciens du Canada, 150(3), pp.198-205.
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