Innovative Change Plan for Medico - Example

INNOVATIVE CHANGE PLAN FOR MEDICO Change Situation This change management plan has been developed for managing the proposed changes in the patient booking system that is currently in use in MediCo. Medico is a middle-sized health centre in Jeddah, Saudi Arabia. With about 30 employees, including medical specialists, general practitioners, administrative and support staff, the institution serves a wide range of clients in the area. Therefore, it can be seen that by virtue of the position of the institution in the Jeddah area, it serves an important role in the lives of the local population. The proposed change in the method of booking patients in the hospital can be understood within the context of the methods that are in current use at the institution. Currently, the members of staff at the hospital use a system that is based on spreadsheets to book patients. A patient who visits the institution for the first time is booked by the reception staff of the hospital. It is the information which is captured in the spreadsheets that is consulted the next time a patient walks into or makes a booking at the hospital. Although this method of booking patients has been relatively useful for some time, there are several challenges that have become apparent from its use. Generally, the method has failed in ensuring that the patient booking processes are carried out quite effectively and efficiently within the organisation. The lack of effectiveness and efficiency has been as a result of numerous errors to which the old system is prone. For instance, cases of double booking of patients are common. Furthermore, with the use of the spreadsheets, there are some instances when certain slots in the sheets are not used. It is in light of this situation that new changes in the way patients are booked in the institution are recommended. What is recommended is a complete overhaul of the current patient booking system that is in use in the hospital. This is to be replaced with a modern computer-based system that will be used to not only book appointments for patients at the hospital but also as a way of recording and storing vital data about patients that can be retrieved for use later. There are several attributes that will make the new computer-based patient booking system for MediCo a highly innovative one. For example, by virtue of the fact that the system will be based on computers, it will allow the patient booking process at the hospital to be managed from a single central place. In addition to this, it will allow patients to make their booking online or even by using their mobile phones since it will be web-based. This innovative approach will definitely ease the booking process. Besides, remote booking will be enhanced by the highly user-friendly interface that the new recommended system will have. Further, the system will allow both the administrative and medical staff of the institution to book patients for appointments in the hospital. This will be made possible by the staff login function which will be included in the system. Once a booking for a patient has been made, the specific time slot that is associated with the booking will be allocated to a specific patient. This mode of functioning will eliminate the possibility of some timeslots being unallocated during the booking process – a problem that is strongly associated with the manual patient booking system that is currently in use at the hospital. It is from these technical features and functions that the new proposed system will be innovative and achieve its most important objectives which are twofold: to improve efficiency and effectiveness of the patient booking process and to enhance productivity and satisfaction at the institution. Lastly, since the proposed change will be big in scope in that it will involve adoption of new working procedures by both the medical and administrative staff members at the hospital, it is estimated that the process of implementing the change will take a relatively longer time of about a year. It is estimated that all the activities that are related to the entire project will be successfully implemented within this time frame. Further, implementing the changes will require a relatively big change management team that will comprise members drawn from both the administrative and medical departments of the institution. This will be so even if experts from the information technology (IT) department of the organisation will play a crucial role in implementing the activities of the project because of the nature of the proposed changes. Such a level of representation is necessary to ensure that implementation of the proposed changes takes place effectively. It should be noted at this point that MediCo will not be a pioneer in the adoption and use of a computer-based patient booking system. Several different institutions in different regions have already adopted such a system as a way of improving their efficiency and service delivery (Bullas & Bryant, 2007, p. 39). Therefore, the proposed change is in line with current innovative trends in the industry. The Change Project Analysis Stakeholder Analysis According to Snyder (2010, p. 14), analysis of the stakeholders of a project is an important process since it enables the project management team to effectively implement and manage the most appropriate strategies of controlling engagements with the different stakeholders. It is because of the different needs and expectations of stakeholders that the need to develop a comprehensive stakeholder analysis matrix for a project arises (Schwalbe, 2008, p. 83). For this particular project, such a detailed matrix is included in the appendices section of this plan. From the matrix, there are several important conclusions about the different stakeholders that can be drawn. This is so since the stakeholders vary from each other in terms of their level of awareness of, support for and influence on the proposed project. Furthermore, all stakeholders have important concerns about the proposed project and such concerns are important since they shape the strategies that the change management team uses while implementing the project. From the matrix, it can be seen that the IT department of the hospital has a high level of awareness of and support for the proposed project. However, its influence remains medium in that the key decisions with regard to the adoption and implementation of the project are made by the management of the hospital. This is so despite the point that the IT professionals in the organisation will play a leading role in the actual implementation of the new patient booking system at the hospital. Furthermore, it is a known concern that the department may be out of touch with the actual needs of the employees who may be slow in mastering the use of the new technology. The second stakeholder to the project is the suppliers of the hardware and software that will be used in the system. Although their level of awareness for the programme remains medium, their support for the project is high. In a similar manner, members of staff at the hospital have a high level awareness of the project, can influence the manner in which the project is implemented and are in full support of the project because of its expected benefits. Force field analysis According to Daft and Marcic (2010, p. 277), a force field analysis is an important tool that can be used to identify specific forces that create the need for a change within an organisation and those that act as barriers to the proposed change. By understanding this interaction, the right strategies to reduce the impact of the existing barriers can be instituted as a way of moving the entire organisation towards the proposed change. A detailed force field analysis for the proposed implementation of an automatic computer-based patient booking system at MediCo is included in the appendices section of this report. From the analysis, several conclusions can be drawn. First, it can be seen that the proposed change in the hospital is driven by a number of factors, the most important of them being the desire to have an innovative and efficient patient booking management system in place. This is an important need that creates a high level of demand for the proposed change across the institution. The second force that drives the proposed change within the organisation is the desire by all the members of the staff to offer improved services to patients. Since one of the outcomes of the proposed project is to enable employees offer improved services to clients as a result of effective management of operations, this is an important force that is driving the need to implement the proposed changes within the organisation. On the other hand, there are several factors that act as barriers to the proposed change. In theory, organisations in general and medical institutions in particular experience obstacles to the change process because of the effect of three factors: lack of consensus on the changes, poor leadership of the change process and lack of support for the change process by the employees (Caldwell et al., 2008, p. 125). The factors that act as barriers to the proposed change fall within these categories. For instance, lack of sufficient skills to master the use of the proposed system among the employees in the hospital is related to lack of support for the project by the staff. However, the organization can successfully reduce the impact of the barriers and in the process, make it possible for the project to be successfully implemented. Theoretically, overcoming barriers to organizational change is a three-step process that involves the following stages: identifying specific resistance factors, strategising on how to overcome the factors and implementing the strategies at the right time (Harvey & Broyles, 2010, p. 35). Therefore, it is this approach that will be used in the course of implementing the proposed project. Cultural Web Analysis Cultural web analysis is an important method of analysing the cultural values of an organisation and how these values affect the overall way in which the entire organisation responds to proposed changes (Kachru, 2009, p. 429). Therefore, by using different cultural elements such as stories, symbols, power structures, existing routines, the prevailing organisational structure and control systems, a cultural web analysis makes it possible for one to develop a paradigm of an organisation and in doing so, understand the overall level of acceptability to change that the organisation possesses (Jeffs, 2008, p. 70). This is because the cultural values of an organisation have been deeply internalised by the employees and as such, determine the factors that act either as barriers or facilitators to any form of change within the organisation. All these elements play different roles in determining the level of readiness of MediCo in adopting the new changes in patient booking operations. First, with regard to the stories about the organization that are told by employees to each other, it is said that since its inception, MediCo has emerged as a medical institution that is fully devoted to catering for the medical services of the population around Jeddah. It is this strong association with the local community that has played a key role in defining the approach that the institution has taken in delivering its services to its clientele. To augment this story has been the use of symbols such as highly advanced medical equipment and availability of highly trained staff. These, together with the values of the Arab culture which make the organisation’s members behave in a communal and collective manner; have served as symbols that have augmented the story about the institution that has been told by its employees over time. With regard to the organisational and power structure, MediCo is a relatively small hospital with a flat organisational structure. Its small size has ensured that a flat structure having very few levels of authority and a wide span of control has been in place since its inception. The existence of this form of organisation and power structure within the organization is advantageous to the change process. This is because as Francis and de Souza (2004, p. 76) observe, the primary objective of a hospital is to cure patients and achieve financial viability. The structure of MediCo lays much emphasis on highly personalised services. This makes it easier for the organisation to adapt the proposed changes with time regardless of challenges such patients not trusting the Internet and lack of the right skills among employees (Cao et al., 2011, p. 3). Evaluation/Discussion of the Change Programme Stages of the Proposed Change Project The process of adopting a new computer-based patient booking system at MediCo will be carried out in several interrelated stages that correspond to a project life cycle: Project initiation, planning, execution and closure. With regard to initiating the project, there are several activities that will be undertaken by the project team. First, a business case for the proposed project will be developed. It is the business case which will be used to convince the management of the hospital to fund the proposed project. Second, after funding for the project has been approved by the management of the hospital, overall management activities for the entire project will be carried out. This will entail streamlining the different roles that will be played by the project team throughout the life of the project. Third, while reporting to the management, the project team will identify and evaluate the right system to be acquired for the hospital. It is this process that will lead to the last activity under this stage of the project which will be dealing with all contractual needs of the entire project. The right supplier of the product will be identified and the details of the supply contract evaluated. Project planning will entail a number of different activities. First, a detailed risk analysis of the project will be carried out. This will be instrumental in guiding the activities of the project team when implementing the project. Second, a detailed communication plan will be created at this stage. Third, arrangements for the procurement of all the materials that will be used in the project will be made at this stage. Fourth, the financial plan which evaluates the financial requirements of the project will be created at this stage. Project execution will entail actual implementation of the project. It will involve a number of activities that will be carried out with reference to specific management theories. There are several theories of organisational change which have been developed with corresponding models of organisational change. According to (Burke, 2010, p. 163), existence of different theories and models of organisational change is a result of the existence of four distinct schools of thought on the subject of organisational change. The four schools of thought on organizational change include the following (a) life cycle which focuses on organic growth through a linear process, (b) teleological under which organisational growth is seen as a process of purposeful cooperation as a means of adaptation, (c) dialectic under which the process is seen as discontinuous and confrontational and (d) evolutionary which focuses on the competitive nature of organisational change. One of the most common models of organisational change that is used within the healthcare industry is the stage model (Macklem, 2013, p. 99). Since this is the case, this is the model that will be used in implementing the proposed project at MediCo. According to this theory, the process of organisational change unfolds in the form of several distinct stages and each of the stages requires an organisation to use specific strategies to ensure that the process remains on course (Hoogendoorn, Jonker, Schut & Treur, 2004, p. 4 & Petrescu, 2013, p. 2). Therefore, its suitability for this case arises from two things: the fact that the theory combines the work of two prominent theories (stages of change theory and diffusion theory) and its strong focus on organisations as opposed to individuals (Guttmacher, Kelly & Ruiz-Janecko, 2010, n.pag). Therefore, implementation of the proposed project will be based on this theory. The last stage of the process will be closure of the project. At this stage, specific activities that signal the end of the project will be carried out. At the end of this stage, the proposed system would have been fully adopted by the hospital and will be in operation. Changes in the Working Process Implementing the proposed new computer-based patient booking system in MediCo will result into comprehensive changes in the manner in which key activities and processes are carried out in the hospital. Furthermore, adoption of the project will affect a wide range of employees in the institution in that they will be required to change the manner in which they carry out their daily activities. Under the new system, the patient booking process will be carried out in a series of interconnected activities. First, a patient, while away from the hospital, will be able to book an appointment with medical personnel at the hospital. This will be achieved by logging into the system either using their mobile phones or computers. Second, the patient will be able to get an appointment at the institution, assisted by the members of administrative staff who will be able to track the appointment and make changes such as cancellation and rescheduling when a need arises. Third, after the appointment process has been completed, a patient is able to get to the hospital and get the required reservation. The technical nature of the system will make it possible for a patient, with the help of the medical and administrative staff at the hospital, to do a number of things which cannot be done using the traditional booking system that is currently in use at the hospital. This will be the essence of the innovative nature of the system. For instance, a patient will be able to get feedback information in the form of reminders and other forms of information about the reservations that have been made at the hospital. Furthermore, a patient will be able to get referrals to specific specialists within the hospital after reservations with general practitioners at the hospital have been made. Evaluation of the Project Evaluation of a project of organisational change is usually done to determine whether the specific objectives of the project are met after a particular period of time (Myers, Hulks & Wilgins, 2012, p. 307). A detailed evaluation framework for the proposed project is included in the appendices section of this report. From the framework, there are several conclusions that can be drawn. First, the project will be implemented as a way of achieving two major outcomes: improvement in efficiency and improvement of service delivery. With regard to improving efficiency, the new system will be evaluated in terms of the extent to which its implementation has eliminated all the errors that are associated with the current system, the most notable ones being double booking and misuse of the slots in the spreadsheets. The second outcome that will be evaluated after the project has been initiated will be the extent to which the project leads to an improvement in overall service delivery. Using the number of complaints lodged and the total number of patients that are successfully booked and served, the level of productivity and overall satisfaction will be determined. These measures will be taken on an ongoing basis, unlike those for the first outcome of the project which will be taken after the project has been successfully implemented. Communication plans Effective communication with all the stakeholders of the project is important because it makes it easy for the change process to be successfully implemented (Erskine, 2013, p. 95). By updating all the stakeholders about the most important information with regard to the course of implementation of the project, the organisational change management team will ensure that all stakeholders remain engaged in the process of implementing the proposed changes within the organisation. A detailed communication framework for this project is included in the appendices section of this report. From the framework, it is clear that the organisational change manager who will be leading the team tasked with the responsibility of implementing the proposed project will use effective communication strategies to not only minimise the impact of any form of change resistance within the organisation but also ensure that the process of implementing the project runs smoothly. Second, by effectively communicating with the stakeholders, the project management team will ensure that it creates a unique identity and image of the project as a way of driving interest among individuals across the entire organisation. It is this form of interest, coupled with the existence of a formal point of contact for all information related to the project that will be instrumental in reducing the impact of barriers and catalysing support for the project. Further, it is clear that the project team will make use of different types of communication tools to manage the information that is passed to the stakeholders of the project. For instance, internal communication tools such as memos, newsletters and bulletin boards will be used to effectively pass specific messages to different stakeholders during the life of the project. Also, formal presentations will be done during specific stages of the life of the project to pass specific messages to stakeholders. Therefore, the decision to use particular communication tools and strategies will be determined by several factors, the most important ones of them being the actual message to be transmitted, the target audience and the frequency of the communication that is intended. CHANGE PLAN The proposed change process is expected to last for 12 months. Below is a change project milestone diagram that identifies specific stages and outcomes of the project. Time in Months Activities 1 2 3 4 5 6 7 8 9 10 11 12 Project initiation Business case X Feasibility study X Project team X Terms of reference X Project planning Project plan x Finance plan x Risk plan x Communication plan x Procurement plan x Project execution Contracting x Training x x x x Procurement x Installation x Piloting x x Evaluation x x x Project closure Closure x x Review x From the diagram, it can be seen that the process of implementing the change in the patient booking system that is used in the hospital will take a total of 12 months. It is expected that the allotted time frame will be sufficient for the implementation of the project, given the fact that this is the first time that a project of such nature and magnitude is being undertaken at the institution. Also, from the time line diagram, it can be seen that the most important activities that will form the milestones of the proposed project represent four key phases of the project: project initiation, project planning, project execution and project closing. References Bullas, S. & Bryant, J. (2007). Complexity and its implications for health systems implementation. In J. I. Westbrook, E. W. Coiera, J. L. Callen, & J. Aarts (Eds.), Information technology in healthcare 2007: Proceedings of the 3rd international conference on information technology in healthcare- social technical approaches. Amsterdam: IOS Press. Burke, W. W. (2010). Organization change: Theory and practice. London: SAGE. Caldwell, D. F., Chatman, J., O’Reilly, C. A., Ormiston, M., & Lapiz, M. (2008). Implementing strategic change in a healthcare system: The importance of leadership and change readiness. Healthcare Management Review, 33(2), 124-133. Retrieved from http://faculty.haas.berkeley.edu/chatman/papers/05_StrategicChangeHealthcare.pdf Cao, W., Wan, Y., Tu, H., Shang, F., Liu, D., Tan, Z., Sun, C., Ye, Q. & Xu, Y. (2011). A web-based appointment system to reduce waiting for outpatients: A retrospective study. BMC Health Services Research, 11, 318-322. Daft, R., & Marcic, D. (2010). Understanding management. Hoboken: Cengage Learning. Erskine, P. (2013). ITIL and organizational change. New York: IT Governance Ltd. Francis, C. M., & De Souza, M. C. (2004). Hospital administration. New Delhi: Japee. Guttmacher, S., Kelly, P. J., & Ruiz-Janecko, Y. (2010). Community-based health interventions. Hoboken: John Wiley & Sons. Harvey, T. R., & Broyles, E. A. (2010). Resistance to change: A guide to harnessing its positive power. Plymouth: Rowman & Littlefield. Hoogendoorn, M., Jonker, C. M., Schut, M., & Treur, J. (2004). Modelling the organization of organizational change. Retrieved from http://www.cs.vu.nl/~wai/Papers/AOIS04orgchange.pdf Jeffs, C. (2008). Strategic management. London: SAGE. Kachru, U. (2009). Strategic management: Concepts and cases. New Delhi: Excel Books. Macklem, G. L. (2013). Preventive mental health at school: Evidence-based services for students. New York: Springer. Myers, P., Hulks, S., & Wiggins, L. (2012). Organizational change: Perspectives on theory and practice. Oxford: Oxford University Press. Petrescu, R. (2013). Organizational change process – steps to a successful change. Retrieved from http://feaa.ucv.ro/AUCSSE/0038v3-025.pdf Schwalbe, K. (2008). Introduction to project management. Mason: Cengage Learning. Snyder, C. (2010). A project manager’s book of forms: A companion to the PMBOK guide. New York: John Wiley & Sons. APPENDICES A. Stakeholder analysis matrix for the proposed implementation of modern computer-based patient booking system at MediCo Stakeholder Name Awareness (H/L/M) Support (H/L/M) Influence (H/L/M) Known Concerns Administrative staff H H H The need for new training Medical staff H H H The need for new training System Suppliers M H M None IT Department H H M The technical requirements The patients L M L None Shareholders L M H Total cost of the project B. Force field analysis for proposed implementation of a modern computer-based patient booking system at MediCo C. Cultural web analysis for proposed implementation of a modern computer-based patient booking system at MediCo ELEMENT COMPONENTS Stories Belief in offering highly specialised services to clientele Strengths lie in highly skilled and motivated force All the employees have participated in the success Symbols Formal dressing and mannerisms have been developed Typical jargon of using technical words in conversations The jargon is remained largely accessible to professionals Organizational structure A completely flat organizational structure is in use The structure encourages collaboration at all levels This supports an informal power structure at all levels Power structure Real power lies with the administrative staff They’ve a strong influence on the decision making process Leadership believes in employees giving their best always Routines and rituals Very strong rituals embedded in longstanding practices Training programme that emphasises on rigour Teamwork and cooperation highly encouraged Control systems Strict controls have developed alongside the institution Emphasis laid on follow the right procedures at all times However, less emphasis laid on reward and punishment D. Evaluation framework for proposed implementation of a modern computer-based patient booking system at MediCo Expected outcome Indicators Measures (No. of) Time of Measurement Improved Efficiency/ effectiveness Reduced unused slots completed bookings Post implementation Reduced double booking successful bookings Post implementation Improved service delivery Increased satisfaction complaints from patients Ongoing Increased productivity No. of patients served Ongoing E. Communication framework matrix for the proposed implementation of modern computer-based patient booking system at MediCo Target Audience Communication Type Message Timing Admin. Staff Announcement Training/ updates Repeated Medical staff Announcement Training/ updates Repeated All staff Announcement/updates Requirements/expectations Repeated General public Project announcement Launch of new system End of project Management Progress updates Progress so far Repeated Read More