Essay: Lessons from successes lessons from mistakes

Lessons from successes Lessons from mistakes

1 Establish a sense of urgency.

The change agent had clearly defined problem and need for improvement. The change was necessary and urgent, and the benefits of change were explained: The present paper system was to be replaced with an electronic health record system. The leader shared the knowledge and views that he had about the situation. Market was examined and competitive relatives were discussed. The potential of change in current organization culture and opportunities of new roles, responsibilities and employment were discussed. The objectives of change were real and relevant; reduce the healthcare cost, improve quality of care and promote evidence based care. Electronic health record was visible and reasonable solution.

To further understand the process and working with new system. The change agent did it in another way of mobilizing team’s commitment and arranged for the team to look outside the box. He took them on a tour of a leading organisation to see other ways of doing the same thing first hand. The team was very much impressed with the work and expressed more interest in knowing the further details. Besides this there were other financial incentives, security of job, better working, and opportunities to develop new skills and extend influence. Workshops were very useful processes to develop collective understanding. This helped the team to reach the same conclusion that the change agent had arrived.

The objectives of change were real and relevant:

The change was necessary and urgent, and the benefits of change were explained: The present paper system was to be replaced with an electronic health record system. The top issues related to the change were, training and further familiarization with the E.H.R-System.

Business benefits EHR-System::

1. Reduce healthcare costs; effective way to avoid duplicating expensive imaging procedures, and reduction of medical errors.
2. Improve the quality of care: It is claimed to help reduce medical errors by providing healthcare workers with decision support. Fast access to medical literature and current best practices in medicine are hypothesized to enable the proliferation of ongoing improvements in healthcare efficacy.
3. Promote evidence-based medicine: EHRs provide access to clinical data for research that can accelerate the level of knowledge of effective medical practices.

The reason for improvement was clear and benefits were measureable. Moreover the project was within clinic’s fund limits.

2. Form a powerful guiding coalition team.

Introduction of Electronic Health Record System was an organizational structural change with consequences of advancement in information technology. The new business frameworks required highly qualified personnel operate new system. The organization hired skilled staff not only to operate the system but also started a training program to retain the existing staff. This effort encouraged group to work together and in result a guiding team was formed. This assisted greatly to execute the change without greater resistance. The hired consultants had experience and reputation of managing Electronic Health record projects. The team had Coordination, Commitment, and Competence. These three components are essential for introducing change

3. Create a clear vision expressed simply.

Getting the vision right, was the leadership, because that was leader who was taking the team to where they couldn’t go on their own. There was a clear and detailed vision of the future. The change vision was aligned with the organization’s strategy of continuous improvement. It involved key stakeholders in defining and detailing the change vision. Again, workshops were conducted in developing the change strategy. High-level benchmarking was conducted to identify best practices, reference sites and competitor information.

At this step learning was kicked into play in this process of change. By having teams with new goals and accountabilities the leader facilitated learning through all members of the team. The changes in roles and responsibilities. Changed patterns of coordination increased employee participation, collaboration, and information sharing. This step helped agents of change to identify those who cannot fit in the new organisation.

The management was able to create positive environment the organizing before implementing the

Effective leadership requires the clear, concise and positive articulation of the change process.

Empowering the workforce to fully understand and implement the new initiatives can help remove resistance and old attitudes. Careful planning is essential to this process.

Formulating a plan and procuring the necessary expertise to assist with implementing a change in organizational culture can increase the likelihood of a positive outcome for the employees and company alike.

There was a good and strong reason behind the change. The leader emphasized positive reasons for change that motivated the workers. And improved the support.

For effective organizational change, you should create a transition management team. The management selected a change leader from every department and conducted regular meetings. This comprised the transition team that can drive the change initiatives and help facilitate and implement the initiatives throughout the various departments. This also provides a support structure for the initiatives. Resources were provided to the transition management team.

Ensure you adequately define the nature of the changes. This will help team members and employees to interpret the core objectives..

The management team set out the “7 S” framework to help diagnose the current health of organisations and to help develop their visions for the future. Intelligent approach was made to organize the followings.

1. Structure (roles, responsibilities, organisation, structure)
2. Strategy (direction)
3. Staff (numbers and skills)
4. Management style (leadership and management approach)
5. Systems and procedures
6. Guiding concepts and shared values (ways of doing things, operating style)
7. Corporate strengths and skills (general competencies).

Developing and presenting a vision had a key role in motivating staff as well reassuring them about the journey and how they might be involved.

A vision can be expressed in different ways and these are important at different stages of change.

High level visions of achievement and outcomes.

High level visions play key roles at the start. They build on the problems and threats that provide the case for change, but address them positively. They can motivate staff by showing benefits.

Outline visions of service that helped move staff from finding problems to building solutions without involving detailed negotiation on changes.

A detailed vision of service and organisation helped staff to imagine their future work life and role. A vision of the journey This provides a structure for communication during the change.

The service model was made for building support for change. That outlined the change and also the benefits at the end. The benefits were; improved outcomes for patients, and better futures for staff. The service model helped subsequent translation of change in terms of:

� Structure (new roles and responsibilities across professions)

� Staff (changes in skill mix)

� New skills (multidisciplinary working)

� Systems and procedures (new protocols for referrals)

� Management style (focus on outcomes as well as process)

� Shared values (the emphasis on assessing and responding to the full range of patient needs).

The leader formed a task force of champions to shape ideas into practical solutions.

At this step learning was kicked into play in this process of change. By having teams with new goals and accountabilities the leader facilitated learning through all members of the team. The changes in roles and responsibilities. Changed patterns of coordination increased employee participation, collaboration, and information sharing. This step helped agents of change to identify those who cannot fit in the new organisation.

The management was able to create positive environment the organizing before implementing the

4. Communicate the vision.

Involvement of all members in proposed change encouraged participation and created environment of cooperation and support. This helped to facilitate the company’s strategies and planning. The management involved all stakeholder, medical societies, and NGOs in healthcare, and also some international hospitals. The co-operation and pro-active support of stakeholder was important. Workshops were conducted to address the issues and stake holder agreed to support and commitment. There was a good communication and common understanding amongst the stakeholders about the degree and scope of change needed. Change was communicated in a clear, concise way to capture the minds and hearts of the entire organization

The essential of change were communicated. Simply as:

� Electronic health records will become a “must-have” for healthcare organizations

� EHR adoption will be inevitable due to internal as well as external factors

� Improving the quality of care is a priority for healthcare organizations

� Other healthcare players will “encourage” late adopters to implement EHRs

� An overwhelming market is difficult for hospitals and physician offices to navigate

Change is the external manifestation of transition .while Transition is the psychological aspect of change: how people feel towards change, their attitudes, their internal plans, and their personal vision of change.

Win Commitment to Change

Change was determined as its actions were consistent with the change vision. Therefore, effective Stakeholder Communications and Management are vital components of winning commitment to and delivering change. Ongoing effectiveness was traced through Staff Surveys.

• Stakeholders were managed on an on-going basis. Communication was established through weekend updates, emails, letters and also mobile phone msgs.
• The resistance was small and was professionally managed.
  Questionnaire and staff satisfaction surveys were quite effective in determining the views of employees and allowed people to voice their opinions about the change program.

5. Empower others to act on the vision.

Empower action – Remove obstacles, enable constructive feedback and lots of support from leaders – reward and recognize progress and achievements.

The staff was empowered with new skills, and encouraged for open dialogue and communication. The staff committee was formed to monitor performance and reward them on success. Staff regularly took in continue education and was awarded with credits. Obstacle of jobs dissatisfaction removed and security of job and reward was in place. A continuous support from top and feedback system was in place.The management was able to create positive environment the organizing before implementing the

Generating optimism and enthusiasm is part and parcel to this. People learn and bond together during the socialization process. This was done by taking staff to tour of well known organization to see the new system

Empowering the workforce to fully understand and implement the new initiatives can help remove resistance and old attitudes. Careful planning is essential to this process.

Formulating a plan and procuring the necessary expertise to assist with implementing a change in organizational culture can increase the likelihood of a positive outcome for the employees and company alike.

6. Plan for and creating short-term wins.

delivering change is the crux of the change management program.
Change is realised when it becomes the normal way of working, this requires proof that performance has improved and will continue in the future. Quick wins were identified in the forms of electronic health records being printed and stored in one location. That saved time and efforts that were used in compiling paper records.

Senior management communicated results delivered through quick wins to the organisation.
The quick wins increased the momentum and also early positive feedback was very encouraging. That was essential for the on-going success of a change management program. First milestone was celebrated and, People were rewards for their improvement with recognition, promotions and money.

7. Consolidate improvements and producing still more change.

Having the credibility and success of quick wins, the management looked for further improvements. Hired more professionals, and rewards for existing employees and more change agents were created. People as new roles, responsibilities and skills felt honored and wave of courage emerged for further improvement.

8. Institutionalize the new approaches. To articulate the new behavior corporate success a leadership development seminars were in place. So the leaders create more leaders.

Step 5: institutionalize change through formal policies, systems, and structure

At this stage it is the responsibility of the agent for change to ensure change is entrenched, the right people are in place, and the new organisation is up and running. As mentioned before, when it comes to change timing is everything. For this step timing will make or break the whole process.

This is particularly relevant to change when it involves introducing new systems. Any formal system will have some disadvantage: nothing is perfect. You can minimise these imperfections once people have worked in an ad hoc team structure and learned what interdependencies are necessary.

Step 6: monitor and adjust strategies in response to problems in the change process

The purpose of change is to create a learning organisation that did not exist before. This new organisation has to know how to monitor its ability to learn. While performance monitoring is a basic managerial task, what is really important here is that this task is shared among all those participating in the process. This will create a long term capacity for continual learning.

This six step process aims to elicit renewal without imposing. In other words, team members need to change first in order for the team as a whole to change.