Healthcare Institutions Skill-Mix Process - Case Study Example

Heading: Skill-Mix Change Your name: Course name: Professors’ name: Date Introduction Health care institutions need a lot of changes in order to improve the quality of services provided to the clients. These changes mostly relate to staffing, equipment, method of reporting, procedures, and roles among others. This paper seeks to identify and address an aspect change in terms of skill mixing. It will also examine the current situation in relation to the aspect of change, reasons for the change, its implementation and integration. Therefore, the problem that the paper intends to examine is the urgent need for skill mix in health care institutions in the world. This is vital in that it will help in enhancing the quality of healthcare provided to patients by nurses and physicians. What is going on currently? Today, most of the healthcare institutions still operate in the traditional way, particularly in relation to the way nurses and doctors function. This implies that nurses have certain skills that limit them to handle a limited number of cases that relate to their qualifications. These changes are motivated by the fact that the hospitals are currently going through many challenges as they try to satisfy customer needs. Some of these challenges include increased costs, ageing population, and shortage of skilled medical providers. Therefore, skill mix is identified as one of the possible solutions to the aforementioned challenges facing healthcare institutions in the modern world. Through the reallocation of tasks and roles among professionals, scarce hospital resources can be utilized more effectively, without any compromise regarding the quality of services. What is the proposed change? In this case, the proposed change relates to skill mix in hospitals. Skill mix is a term that is used to refer to a mix of staff in the labor force or differentiation of tasks and roles among varied sections of staff. A majority of policy concentration on the use of skill-mix to enhance health organization performance involve nurses and physicians. Besides, skill mix changes entail different developments that include improvement of skills among a specific group of staff, delegation of duties in a uni-disciplinary ranking, substitution between various groups, and innovation in tasks. These changes are stimulated by a number of issues that include a need to promote the service delivery cost-effectiveness; quality improvement, labor force shortages, and service innovation. Moreover, the proposed change is motivated by an increase in demand for high quality in hospitals, in severe health care, as an effect of a change to offer more care in long-term and community healthcare. Besides, there is a rise in the need for enhanced career viewpoints for nurses and other health providers. Further, skill mix is motivated by the need to hold costs and to improve effective employment of limited resources, such as, highly-competent labor in healthcare. What is more, Li-Chi et al. (2011, pp. 220-229) note that technological advancement is part of the reasons for an urgent skill mix in health acre institutions. This is because of the demand for high ability and flexibility to adjust. Additionally, the change is brought about by the increase in the number of chronic heath cases in the health care system, as well as the need for education and prevention services. This change is necessary because it will help in addressing most of the problems that currently face hospitals. Technically, the proposed change is appropriate because it will help nurses and health professionals to adjust to technological developments; hence improvement of quality of service delivery. Further, this change is timely in the world health institutions because it will eliminate many difficulties and problems that patients and doctors have faced over centuries. Some of the issues that have been affecting health care provision by nurses and doctors relate to the use of technology. It is also necessary at the point in which health institutions are faced with a lot of pressure to enhance their performance by improving the quality of the services. It is the most effective way of handling the aforementioned pressures and challenges; thus ensuring that effective and appropriate services to customers. This change can be enhanced by encouraging people and hospital staff to give their views on how to effect to implement it; to express their doubts on the effectiveness of the changes; and to contribute input essential in the successful execution of the changes (Li-Chi et al., 2011, pp. 220-229). Describe the role that you would play in initiating the changes you proposed As a change agent, I will make my work mates to fully understand the importance of the changes as well as comparing that with the current situation faced in the process of delivering their services. Moreover, I will ensure that diagnose problems that the health providers, especially nurses are facing in carrying out their duties. It is also imperative that I participate in the building of positive relationships with clients and professionals. This is critical in making them understand and support the proposed change in the system. In addition, I will be charged with a responsibility of ensuring that the vision regarding the proposed change is well articulated. This implies that I should actively interpret motivations and hopes of the labor force through vision statement. Setting a leadership agenda is also vital in order to achieve the proposed change in the organization. A change agent is charged with a responsibility of solving problems that are related to the implementation of the proposed change. For instance, in the case of skill mix, a change agent should recommend solutions to the problems encountered, which are often filled with political and emotional dynamics. Therefore, a change agent should have an insight to identify the problem; sensitivity to perceive its significance to those concerned; the courage to take difficult and honest measures in resolving it; and the reliability to be heard. Lastly, a change agent has a role of implementing plans so as to achieve change objectives and goals. What role do other team members play in the change process? The other team members in the healthcare system include nurses, physicians, social workers and other professionals. Their roles in the implementation of the proposed change include, but not limited to, being enthusiastic and committed to the change; sharing responsibilities and keeping any confidential information to the team; and fulfilling duties assigned during the process of change implementation. Moreover, other health care staff members will maintain respect for positions and opinions of others in the team, even if there are opposing views. They should also ask questions and provide insight on change execution. It is also worth noting that other team members should share expertise and knowledge in relation to the change and avoid withholding information. Additionally, other team members will be involved in coaching, implementing, conducting, innovating, crusading and exploring everything regarding the execution of the proposed change in the unit. Literature review Skill-mix change can be facilitated by task substitution across professional categories, task delegation in terms of highly qualified to lowly qualified staffing in one professional group; and task innovation in terms of new roles for new workers or professionals. On a service level, change in skill-mix can be effected by transferring of tasks and roles from a health institution to the community (Laurant et.al. 2005). Laurant et.al. (2005) says that there are various issues that facilitate the need for skill mix change in the healthcare system. One of them is technological advancements that require all health professionals to adjust and employ them in the carrying out their roles. The incorporation of skill mix change and employment of information technology appears, in theory, to be very efficient. For instance, information systems can be used in the organization of all kinds of data gathered in the course of patients’ trajectory and can attach structure to it; hence improving its information content. Moreover, Duckett (2005, pp. 1-5) maintains that information systems are vital in the sequencing and structuring activities; this facilitating coordination amid many professionals in many areas. Nevertheless, there is limited knowledge on problems and promises that IT-aided skill mix reform in daily practice. What is more, Duckett (2005, pp. 1-5) says that cost-containment is part of the drivers of skill-mix in health care systems today. This is aimed at improving management of organizational costs, particularly labor costs. The change is likely to cut on costs of labor or enhance productivity by changing staff mix or level. Another major reason for the proposed change is to ensure quality improvement in healthcare systems in the world. This implies that there is an urgent demand for quality services delivered to patients in hospitals by health providers. The change will promote the use and deployment of skills of staff by attaining best blend of roles and staff. In addition, skill-mix reform is necessary in the healthcare institutions because it translates changes in the medical sector. Impliedly, there is a need to attain cost-containment, enhancement in the quality in performance and care, as well as responsiveness of healthcare institutions. This is achievable through evaluation of cost effective staff mix required; initiation of new tasks; and improvement of present staff’s skills (Laurant et.al. 2005). Evidence base on new roles and skill-mix There is a large body of evidence that study the efficiency of nurses developing their extent of work to incorporate tasks and roles, which were customarily carried out by physicians. Notably, there is a huge majority of information that has arose from a comparatively fewer countries, particularly in Australia, North America and United Kingdom. Some of the factors that facilitate success of the skill mix change include introduction of treatments of proven effectiveness; proper training and staff education; elimination of non-beneficial limit demarcations between service sectors or staff; suitable reward and pay systems; and appropriate human resource management and strategic planning (Pei-Lin, 2011, pp. 230-235). Nonetheless, there are unexpected effects in relation to coordination of care, staff workload or morale, cost, and care continuity (Duckett, 2005, pp. 1-5). Implementation The proposed change is likely to be resisted by some individuals or groups in health care sector. Some of these groups include social workers and physicians. They might resist skill mix change because it will involve carrying out extra duties apart from their responsibilities. These groups might resist change because it will require retraining of the personnel so as to adjust to changes, such as, use of technological innovations. Moreover, physicians may feel overtaken by nurses if the latter are allowed prescribing or referring patients to special care. Finance departments in the hospital will view the proposed change as a threat to their career since most of the staff might lose jobs if nurses are allowed to do reimbursement and billing in healthcare institutions (Li-Chi et al., 2011, pp. 220-229). Some groups or departments might also consider the change as time-consuming since it will require reorganization and retraining of staff; hence affecting the performance of the hospitals involved. Skill mix can also be stressing to the members of staff because the change is complex. Members of staff will feel disrupted from their normal work and overloaded with new skills and roles. Some of them are likely to feel that the change agents have hidden agendas behind the proposed change. Besides, there are many other changes that might taking place in the healthcare system; hence it will be stressful for the staff and patients involved. How to reduce resistance to change As a change agent, I will ensure help members of staff reduce stress levels by explaining the importance of change, counseling them and acting as a role model so as to motivate them embrace change. It is vital to involve the interested groups and ask them for ideas and suggestions for the change; clearly defining the importance of change through communication of strategic rule in a personal and written form. Honesty and openness is also essential in the management resistance to change. It is imperative to emphasize on the positive aspects of change and delivering training programs that will help other members develop primary skills. It is crucial to address their needs as well as designing flexibility into the change. Holding regular meetings are also vital in the implementation of change since it helps reduce people’s resistance to change (Griffin, 2012, pp. 187-200). Describe the phases of the change process as it specifically relates to your project Unfreezing (comfort zone) - here, members of staff are preparing to take change since they have understood the significance of skill-mix change in healthcare. Besides, the feel that it is necessary and urgent; hence, they are motivated to embrace it (Cameron, 2009, pp. 111-112). Change (Discomfort Zone) – here, staff members are moving out to the new way of operating. It is the hardest phase since people will feel insecure and fearful of the new system. They take time to learn about the reform and need ample time to understand and operate under the new system (Cameron, 2009, pp. 111-112). Refreezing (New Comfort Zone) – in this stage, the people will have understood the change and can comfortably work with the new system. Here, change has become the norm and they seem to be enjoying the change (Cameron, 2009, pp. 111-112). Timeline of change process Stage Time (Months) Remarks Unfreezing (comfort zone) 5 Change (Discomfort Zone) 14 Refreezing (New Comfort Zone) 12 Integration In order to effectively measure the results of the proposed change, appropriate methods should be used. First, it was important to conduct a survey on the integration of the change in health institutions. An interview will also be conducted among certain hospital staff members to find out the effects of the change in their institutions. Some of the studies conducted demonstrated that skill-mix change in hospitals increased patient satisfaction and improved the quality of healthcare. This implies that there is a 100% increase in patients’ satisfaction and quality of healthcare. Effects Before integration of skill-mix (%) After integration of skill-mix change (%) Customer satisfaction 100 50 Quality of healthcare 100 40 Lower infection rates 100 45 Describe methods used to measure groups of departments acceptance of the change proposed In order to measure the acceptance of the change by departments, it is vital that a survey be conducted. Here, a questionnaire will be designed to examine the acceptance levels of the departments. Moreover, interviews and focus groups can be employed so as to find out the departmental acceptance to the proposed change in the health sector after 12 months. The expected results of the studies will indicate a 100% decrease in the rates of infection, and 100% decrease in cost of supply use. These results are analyzed as follows: Table and graph Departments Before implementing skill-mix (%) After implementing skill-mix (%) Remark IT 45 100 Excellent Finance 40 100 Excellent Nursing 30 100 Excellent Physician 50 100 Excellent HRM 50 100 Excellent Social Work 40 100 Excellent Conclusions Change is inevitable in the healthcare system in the modern world. The project addressed the issue of the skill-mix change in the health sector. Explicitly, some of the drivers to this change which include technological innovations, healthcare reforms, high demand for quality healthcare, legal and regulations environment, increased enhanced career perspectives, rising number of seriously ill people, staff shortage, substitution and value for money. This change is essential in the current healthcare system, especially in improving quality of healthcare. Following the results of the studies, the process has been effective in that it resulted in 100% change in the quality of healthcare. The process took place in three phases; unfreezing, change and freezing zones. It has also helped me advance my leadership and innovative skills. Nevertheless, similar future process should be assigned adequate time for implementation and evaluation so as to achieve more accurate results. References Cameron, E. (2009). Making sense of change management a complete guide to the models, tools & techniques of organizational change. London Philadelphia: Kogan Page. pp. 111-112. Duckett, S.J. (2005). Interventions to facilitate health workforce restructure. Australia and New Zealand Health Policy, 2(14), 1-5. http://www.biomedcentral.com/1743-8462/2/14 Griffin, R. (2012). Fundamentals of management. Mason, OH: South-Western Cengage Learning. Pp. 187-200. Laurant M., et.al. (2005). Substitution of doctors by nurses in primary care (Review). [http://www.thecochranelibrary.com] Website. The Cochrane Library. Li-Chi, H., et al. (2011).The Skill Mix Model: A Preliminary Study of Changing Nurse Role Functions in Taiwan. Journal of Nursing Research, 19 (3), 220-229. http://journals.lww.com/jnrtwna/Abstract/2011/09000/The_Skill_Mix_Model__A_Prelim inary_Study_of.9.aspx Pei-Lin, H. (2011). A School-Based Health Promotion Program for Stressed Nursing Students in Taiwan. Journal of Nursing Research, 19(3), 230-237. http://journals.lww.com/jnr- twna/Abstract/2011/09000/A_School_Based_Health_Promotion_Program_for.10.aspx Read More