Leadership, Change Management, And Organizational Culture In The Health Sector

Leadership and Change Management in the Health Sector

Discuss about the performance improvement or theoretical discussion of the role of the leader in facilitating a change process.

Dinh et al.(2014) mention in their work that leadership is quality of individuals to lead a group of followers towards attainment of goals. The leaders play an important in leading their teams of followers towards attainment of goals which in turn enable organisations meet their goals. The leaders are said to have to certain qualities like focus and decision making power which enable them to lead their followers. The leadership in business organisations exist at several levels and enable successful execution of business strategies. The directors and the CEO provide leadership at the apex level while the departmental heads provide leadership at the departmental levels of the department(s) they head. The team leaders lead teams within the departments. Antonakis and House (2014) point out that the role of leadership in organisation is not limited to leading subordinates towards achievement of targets. Roberts (2015) mentions that the macroeconomic conditions are continuously changing at very fast rate. These changes require the business organisations to adapt to them and incorporate them in their strategies. The managers at apex, middle and lower level have to lead the organisations to adapt to these changes so that the organisations as a whole can adapt to those changes and sustain in the market. The health related sectors like nursing are undergoing tremendous changes due to drivers like technological advancements, changing economic developments, increasing power of consumers and new discoveries in the health related sectors. This requires the nursing organisations to embrace these changes in their day to day operations. This necessitates the leaders in the nursing organisations to ultimately involve the staffs in embracing the changes. Thus, the scope of leadership embraces change management. The paper would visit this change management aspect of leadership through the lenses of health. The researcher would explain the concepts through various leadership theory like transformative leadership theory and participative leadership style. As far as change management model is concerned, the researcher would Lewin’s change management model.

The leaders according to Cameron and Green (2015) in the present era have to play the significant role of leading the staff towards embracing the changes and management the change processes within the organisation. The changes in the external economic scenario today are far more dynamic than in any single business organisation or even an industry can regulate or resist. The nursing is one such sector which is experiencing drastic changes in the current period. The technological advancements in the medical science and pharmaceutical have required the management of the firms operating in the sector to install these new technological processes in their manufacturing process. The countries like the United States which house several leading nursing organisations are automatically forced to enact laws to protect the intellectual properties of the nursing firms continuously bringing about these advancements and discoveries. For example, the health sector in the country is helmed by US Food and Drug Administration (fda.gov, 2018). The firms irrespective of their countries of domicile have to comply with these norms and laws enacted in their host countries as well. Another factor which is driving changes in the health sector is environmental aspect. The governments of different countries are enforcing steps to curb environmental damages are enacting various laws. For example, the nursing organisations operating in Australia irrespective of industries have to comply with the Environment Protection and Biodiversity Conservation Act 1999 (environment.gov.au, 2018). These laws apply to health sector due to various reasons. First, the health sector provides goods like medicines and medical equipment and services like pathological tests, all of which are basic necessities of life. These products have direct impact on the health and welfare of the end consumers not only on short term and long term. The health sector companies acquire immense amount of raw materials. For example, the pharmaceutical companies acquire chemicals to make medicines whereas the pathological equipment manufacturing companies acquire immense amount of steel and metal pieces. This means these nursing organisations acquire their raw materials from the environment. Similarly, the health sector companies release immense amount of wastes as bye-products of their production process. The health sector segments like hospitals release immense amount of wastes like cotton, glass and medical wastes as a bye-products of their treatment services. Chudasama et al.(2017) in this regard point out that biomedical wastes released by health sector organisations like hospitals have fatal effects on the environment. Bio medical wastes contains immense amount of chemicals which can poison water resources and soil. They undergo putrefaction and chemical breakdown to release dangerous gases. The chemicals from these wastes mix with the soil as they breakdown and makes it poisonous. These wastes harbour and release germs which spread in the society, thus causing havoc to social health. These critical and far reaching effects of the health sector on the environment have made the health sector companies come under scanner of environmental laws (Singh, Gupta & Tomar, 2016). There have been cases when leading multinational pharmaceutical companies have been fined for violating environmental laws. For example, Pfizer was fined $ 190000 by the Government of Puerto Rico for violating Clean Air Act (statnews.com, 2018). This discussion clearly shows that the business organisations need to change their modes of operations to adapt to these changes and macroeconomic consequences which means the employees need to align their operating ways. It is also clear that the changes cannot be brought about without management support because they require immense investment. For example, switching over to more environment friendly requires installation of waste management plants which is extremely expensive. Thus today management bodies of the nursing firms are not only responsible for forming strategies but also recognise the changes in the macroeconomic environment and lead the employees in the right direction towards embracing the changes. However, introducing and implementation of changes in the organisations functioning in the health sector companies would attract resistance from certain section of employees since changes create feeling of insecurity and fear among certain employees. This requires the apex management to manage the change and deal with conflicts. Thus, conflict management is an integral part of change management activities of the apex management bodies (Helms & Oliver, 2015). They require to apply an appropriate change management models the three step change management model by Kurt Lewin to bring about changes effectively.

Environmental Regulations and Technological Advances in the Health Sector

The apex management bodies of nursing firms operating in the health sector can use different leadership styles like participating leadership style and transformative leadership style in leading the changes. The departmental heads actually take into account different factors while using appropriate leadership styles. For example, they should take into account the eligibility and experience of a certain group of employees. The experienced and senior employees can handle more responsibilities than junior employees. Moreover, the senior managers heading various departments have employees working under them. Thus, the apex management has to ensure that it gains their participation and support while implementing changes. Moreover, a conflict with these departmental heads may lead to loss of support of employees reporting them, thus bringing the entire change implementation process to a halt (Singh, Gupta & Tomar, 2016). Thus, the apex management should use participative leadership style and encourage them to participate in the change implementation strategy formation. They must gain participation of the departmental heads in forming strategies for bringing about the changes. This corresponds with the first step of Lewin’s change management model, Unfreezing. The apex management should explain the importance of embracing the change. For example, the apex management can point out the advantages of adopting a modern waste management in order to reduce expenditure due to environmental penalties. The apex management can also point out to the necessities of adopting a more employee centric organisational culture and giving decision making power to lower level employees to a certain extent (Helms & Oliver, 2015). It can be pointed out that all the manager may not view these changes as positive and some may view them as challenges to their position. The authoritative managers may consider empowerment of lower level employees as a challenge to their own power. Again, the departmental heads following transformational leadership may view this empowerment as an opportunity to gain more support from subordinates, thus reducing their job pressure to a certain extent. Thus, the first group of managers would conflict with the apex management while the second group of managers would support the change. Thus, the apex management in order to gain support of both the groups of managers and ultimately embrace the changes, must follow participative and transformative leadership style (Chudasama et al. 2017). The junior employees having less experience should however be led using authoritative leadership style. The management must also establish system of staff training and counselling to deal with the fear and insecurities of the departmental heads. The departmental heads in turn should mentor and coach their subordinates in order to help cope with their fear and insecurities revolving around the changes. The apex management in order to the change effectively establish and maintain a smooth communication between itself and the employees. This would effective use of leadership style combining participative, transformative and authoritative leadership styles by the apex management would lead to the next level, Change (Singh, Gupta & Tomar, 2016).

Leadership Styles for Change Management

The culture of the workplace which the apex management creates using appropriate leadership style plays a great role in bringing about the next stage of organisational change management, Change. Pollack and Pollack (2015) while elaborating on the role of organisational culture and change management, point out that appropriate organisational culture which stands on participation of employees from all levels enables smoother change management. The rate of this relationship between organisational culture and change management is dependent to a great extent on leadership style prevalent in health sector organisations. Binder (2016) point out a very significant point in the regard, especially applicable for the health sector organisations operation across borders. The multinational health sector organisation use participative leadership style to gain cooperation of the branches spread across the countries while leading changes. The apex management while leading the change implementation train and mentor the lower level employees as well. For example, the employees working in pharmaceutical factories are trained to use more advanced machinery. Petrou, Demerouti and Schaufeli (2018) mention that these training actually boost the capability of employees to cope with the change which boosts their feeling of self-importance and motivation. They as result support the apex management in embracing the changes which in turn leads the health sector organisations implement the changes paving way to the third step of the Lewin’s change management model, freeze or refreeze. Thus, an employee centric culture where employees play a significant role in change management makes it easier for the apex management to implement workplace changes.

The apex management of the health sector organisations require to take appropriate steps to ensure successful implementation of the changes and incorporated the new policies in the day to day operations, the step which is known is freeze. The apex management of the health organisations like pharmaceutical companies should uphold their vision and mission while implementing the workplace changes. They changes should enable them to embrace their strategic goals to a greater extent. For example, after a medical instrument manufacturing company changes its manufacturing process and trains its employees on it as   part of its workplace change strategy, the change should enable the company to manufacture more instruments at comparatively lower price (Singh, Gupta & Tomar, 2016). The organisation should also be able to save on time and fuel cost by embracing new methods of operations. The changes should drive the organisations towards creation of higher customer satisfaction and revenue generation, thus attaining the visions and missions. Thus, it can be summarised that organisational change aligned with the mission and vision helps in boosting business generation.

Organizational Culture and Change Management

The analysis of the change management model by Lewin shows that it is important for the management of organisations to plan and implement the changes. The management of the organisations require to plan the entire change management process at all the three stages namely, unfreeze, change and freeze. The planning in the unfreeze stage consist of recognising ways to gain maximum support of the employees. The apex management initiates the change process by holding meetings with the departmental heads to inform them about the changes and the need to them. The departmental heads receive advanced level training and mentoring to enable them to make decisions under the new conditions. The departmental heads in turn mentor their subordinates and arrange for their trainings. The second step, change involves the employees embracing the changes. The apex management and the departmental heads at this stage provide counselling to employees suffering from fear and insecurity. The planning of strategy at this stage also embrace conflict management and provision of further training to employees, if required. The planning in the next stage consist of freezing. The planning at this stage involves implementation of new strategies adopted as the consequences. The management should implement steps to enable employees acclimatise to the new ways of working providing them with further training if required. The management and the departmental heads from time to time must measure the outcome of the new processes adopted as the result of the changes. They must take steps to rectify and change the strategies if required.

There are several factors both within and outside the health sector organisations which act facilitators and barriers to change. The technological advancements taking place in the pharmaceutical sector like use of ecommerce to acquire raw materials for medicines and continuous the suppliers provide to the companies over the digital space encourage the business organisations embrace changes like installation of new manufacturing plant. Again, market opportunities like entering new markets act as strong drivers of changes within the entire organisational structures of multinational health sector companies. Grant (2016) provides evidence to this driver in his work, “Contemporary strategy analysis: Text and cases edition”. He pointed out that multinational pharmaceutical and healthcare companies integrate their global strategies which they frame for their global market and local strategies which they make for individual markets. These companies form local strategies adapting the local market conditions which means the apex management and regional managers have to exhibit a great deal of flexibility as well during planning. Thus leadership during change is not limited to implementation but embraces the ability to modify plans whenever required. The multinational companies in order to meet this newly emerging business have already started flattening their structures to make their decision making process more dynamic. Thus, it can be inferred that leadership in change management also embraces making decision making more dynamic. However, the factors which drive changes in one company may turn out to be barriers (Petrou, Demerouti & Schaufeli, 2018).

Conclusion

Financial resources prove to be one of the greatest barriers to implementation of changes in the health sector firms. The organisational changes like changing to flat decision making mechanism and installation of advanced machinery require immense initial investments. The multinational firms can amass immense financial resources to bring about these changes. They train and mentor their employee beforehand to prepare them to accept the changes. They have global markets where they can relocate their excess manpower instead of sacking them. The small firms on the contrary have limited resources and cannot take these steps to embrace changes effectively (Berends et al. 2014). Thus finance though acts as drivers of changes for big companies, prove to be impediment for small health sector firms.

The second barrier to change management is technological change which can be attributed to financial barrier. As Goeschl and Perino (2017) point out, modern technology renders previous versions of technology useless and redundant. As pointed out by Singh, Gupta and Tomar (2016), multinational corporations carry out continuous market research. They as a result are able to predict future technological trends and are able to make strategies well in advance. They have contingency plans in place to manage unexpected rebounding of changes. The small firms in the health do not have the advanced technology and cannot invest in continuous modernisation. Thus, technology proves to be a barrier in effective implementation of change management, especially in companies which are financial and technologically weak. The leaders of the smaller organisations can counteract this barrier by taking loan from banks and also from governments.

The next barrier is more applicable for multinational health sector companies operating in several host countries. The multinational companies operate in several countries each having different market conditions. As Francois et al.(2015) point out, differences in economic development rates between two host countries pose threat to full organisational changes. For example, the technology that may be available in the US and the UK may not be available in a poor African host markets. Thus, if a health company aims to install the technology, it would be able to do that for its first two branches at economies of scale but not in the third branch. Alternatively, it can import the technology to its African branch but bear high costs (Petrou, Demerouti &Schaufeli, 2018). Thus differences in technological development prove to be a barrier for organisational changes.  

Business organisations need to adapt to the changes taking place in the market. The apex management should train and coach the employees to embrace changes instead of forcing them. The apex management in order to bring about the change must form a strategy and gain participation of all the staff. They must first gain support of the departmental heads and then their subordinates. The managers should in turn gain support of their lower level employees. The business organisations should align the change with the mission and vision of the organisation. Moreover, the objective of the change should be strengthening of the organisation.

References:

Antonakis, J., & House, R. J. (2014). Instrumental leadership: Measurement and extension of transformational–transactional leadership theory. The Leadership Quarterly, 25(4), 746-771.

Berends, H., Jelinek, M., Reymen, I., & Stultiëns, R. (2014). Product innovation processes in small firms: Combining entrepreneurial effectuation and managerial causation. Journal of Product Innovation Management, 31(3), 616-635.

Binder, J. (2016). Global project management: communication, collaboration and management across borders. Routledge.

Cameron, E., & Green, M. (2015). Making sense of change management: A complete guide to the models, tools and techniques of organizational change. Kogan Page Publishers.

Chudasama, R., Rangoonwala, M., Sheth, A., Misra, S. K. C., Kadri, A. M., & Patel, U. V. (2017). Biomedical Waste Management: A study of knowledge, attitude and practice among health care personnel at tertiary care hospital in Rajkot. Journal of Research in Medical and Dental Science, 1(1), 17-22.

Colombo, M. G., D’Adda, D., & Pirelli, L. H. (2016). The participation of new technology-based firms in EU-funded R&D partnerships: The role of venture capital. Research Policy, 45(2), 361-375.

Department of the Environment and Energy. (2018). Retrieved from https://www.environment.gov.au/resource/local-government-and-australian-environment-law

Dinh, J. E., Lord, R. G., Gardner, W. L., Meuser, J. D., Liden, R. C., & Hu, J. (2014). Leadership theory and research in the new millennium: Current theoretical trends and changing perspectives. The Leadership Quarterly, 25(1), 36-62.

Francois, J., Manchin, M., Norberg, H., Pindyuk, O., & Tomberger, P. (2015). Reducing transatlantic barriers to trade and investment: An economic assessment (No. 1503). Working Paper, Department of Economics, Johannes Kepler University of Linz.

Goeschl, T., & Perino, G. (2017). The Climate Policy Hold?Up: Green Technologies, Intellectual Property Rights, and the Abatement Incentives of International Agreements. The Scandinavian Journal of Economics, 119(3), 709-732.

Grant, R. M. (2016). Contemporary strategy analysis: Text and cases edition. John Wiley & Sons.

Helms, W. S., & Oliver, C. (2015). Radical settlements to conflict: Conflict management and its implications for institutional change. Journal of Management & Organization, 21(4), 471-494.

Petrou, P., Demerouti, E., & Schaufeli, W. B. (2018). Crafting the change: The role of employee job crafting behaviors for successful organizational change. Journal of Management, 44(5), 1766-1792.

Pfizer fined again for violating environmental law at Puerto Rico plant. (2018). Retrieved from https://www.statnews.com/pharmalot/2016/10/26/pfizer-epa-puerto-rico/

Pollack, J., & Pollack, R. (2015). Using Kotter’s eight stage process to manage an organisational change program: Presentation and practice. Systemic Practice and Action Research, 28(1), 51-66.

Roberts, M. R. (2015). The role of dynamic renegotiation and asymmetric information in financial contracting. Journal of Financial Economics, 116(1), 61-81.

Singh, A., Gupta, R., & Tomar, A. K. (2016). Current concept of biomedical waste mangement and dental practice. International research journal of clinical medicine, 3(1), 8-12.

U S Food and Drug Administration Home Page. (2018). Retrieved from https://www.fda.gov/