The introduction of organizational changes affects consistently the organizational performance as well as performance of each employee. In this regard, the introduction of changes in health care organizations can affect the work of many professionals, including those working in the field of anesthesia. Any changes introduced in the health care environment can affect consistently the performance of health care professionals for they have to adapt to changes. On the other hand, the introduction of changes can raise the problem of the resistance of the health care staff to the introduction of the change. In this regard, the introduction of technological changes become particularly difficult because new technologies may raise substantial barriers for health care professionals as they may have difficulties with using new technologies. In such a situation, they may need to have training to be able to use new technologies. At the same time, whatever the change is health care organizations should follow basic principles and steps, which are applicable to other organizations because all organizational changes raise similar problems and may need similar approaches to their solution. Therefore, the elaboration of the change, its planning and implementation are very complex and need effective approaches from the part of managers, who should remember that the effective communication of the change and close interaction with the personnel can facilitate the introduction of the change and maximize its benefits not only for the organizational performance but also for the performance of each employee.
Traditionally, patients were the primary concern of health care professionals and health care system at large. Nowadays, patients’ needs are particularly significant for the contemporary health care system because the progress of medicine and technologies provide ample opportunities to the treatment of patients and their effective recovery from the most serious diseases. In such a situation, when the contemporary health care can save many lives and improve the daily life of millions of people, the health care still remains exclusive and not available for a considerable part of American population. In this regard, health care professionals working in the field of anesthesia should be particularly concerned with the introduction of changes because their work is crucial for surgeries and functioning of health care organizations at large.
Basically, the necessity of the introduction of changes in the functioning and structure of health care organizations is obvious. Since the wide implementation of new technologies and approaches to patients’ treatment did not demonstrate a stable trend to the improvement of the quality of health care services, the necessity of the structural changes was inevitable. In such a context, health care organizations attempted to increase the effectiveness of their performance by means of orientation on patients’ needs (Pinkerton, 2000). It should be pointed out that, in contrast to the traditional approaches to the organizational structure and culture of health care organizations, the new trend has been developed in recent years. In this respect, it should be said that the main characteristic of changes that are currently implemented in health care organization is the process centeredness which results in the larger focus of health care organizations on their patients and the quality and effectiveness of their treatment (Fuchs and Emanuel, 2005).
Today, many health care organizations focus on the use of patient-centered approach. Basically, the health care organization has made the major strides in patient centeredness and currently it uses evidence-based guidelines, strives to racial disparities in the community and uses data effectively. Data drives the medical center’s efforts to be more transparent both inside and outside the organization about the quality of its care. Data is currently shared with the board and throughout the organization and plans are underway to develop an internet-based reporting system that will share information with the public (July 13, 2007). The organization actively cooperates with the public. For instance, physicians and staff confer with parents or guardians at all junctures of the treatment. Furthermore, the personnel of the health care organization increased and, at the moment, there is a larger number of trained health care professionals that can take care of patients of this health care organization. Moreover, the personnel was divided into units which focused specifically on certain groups of patients which categorized on the basis of their age or health problems.
In general, the process centeredness as the concept that defines the development of contemporary health care organization is very important because it targets at the practical orientation of health care organizations on the implementation of innovations and organizational changes which could primarily target at the improvement the position of patients and their more effective treatment than on the performance of health care organizations proper (Coddington et al, 2000). What is meant here is the fact that the health care organization focused on the improvement of the work of the personnel. For instance, more comfortable conditions for the work of health care professionals were created, the organization provided the supply the most advanced equipment to facilitate their work, introduced a larger amount of assistants, but the ultimate goal of all such changes was the improvement of work or workplace but not the patients’ interests and needs proper, even though it was patient-centeredness that was the formal goal of The health care organization. Probably, the problem of this organization was the lack of understanding the ways and strategies in which this centeredness could be implemented in practice.
On the other hand, it is worth mentioning that the current process centered concept of the health care organization lays emphasis on the necessity of the structural and organizational changes that could improve the position of patients, increase the quality of treatment and health care services. In fact, this concept implies that the patient is the major prerogative in the development of health care organizations. In this respect, the system of sharing of information about customers’ health is probably the most effective innovation of its patient-centered approach since data concerning patient’s health are collected by health care professionals and are share with the board and their colleagues. As a result, the personnel of the health care organization can receive all the information about the current state of the patient and his/her treatment regardless the unit, which the patient is treated by, at the moment.
In such a context, the understanding of the mechanism of the change and change management along with the elaboration of efficient methods of conducting and implementation the change are of the utmost importance for the overall success of the organizational performance. At the same time, views of specialists on the process of change and methods and approaches that should be applied to change management vary consistently. It is quite natural that views of specialists vary because, while developing and implementing a change, it is necessary to take into consideration a number of factors which vary depending on an organization and its business environment. In other words, it is necessary to take into consideration specificities of business and business environment in order to develop an efficient approach to the implementation of changes within an organization (Mohrman, 1998). On the other hand, it is important to understand basics of change management because it helps consistently to develop and implement changes in different organizations and business environment.
In this respect, substantial technological changes play a particularly important role since they force organizations to adapt changes faster than they have ever done before. In actuality, the development of modern technologies contributes to the emergence of new products and services en masse. As a result, modern companies need to introduce new products and services permanently to maintain their competitive position or to gain the leading position in their competitive struggle. At this point, it is important to lay emphasis on the fact that companies which focus their development on innovations turn out to be in an advantageous position compared to their competitors, who fail to introduce innovations successfully. In fact, the adaptation of innovations contributes to the enlargement of the target market or, at any rate, increase of sale rates because the company introducing a new product or service, which does not have any rivals at the moment. In a way, companies introducing innovations are in the position of monopolists due to uniqueness of their innovations. Consequently, the introduction of innovations is closely intertwined with a strategic competitive advantage of modern companies.
On the other hand, the introduction of innovations is impossible without the change management because innovations inevitably imply changes that have to be introduced within the organization. In this respect, changes may refer to different fields and spheres of organizational operations, but, nevertheless, the efficient change management contributes to the overall success of change and, therefore, innovations. Hence, the introduction of change is a crucial point in the development of modern organizations because it defines the efficiency of innovations and their introduction within organizations.
Furthermore, the change management does not necessarily mean the introduction of technical changes or changes related to the production process proper. In fact, the change management is primarily concerned with human resources since the introduction of changes lead or imply the change of management style as well as relationships within the organization (Peters, 2002). In such a way, changes may lead to change of management style but they definitely lead to changes of relationships within organizations because they imply the change of roles or responsibilities of professionals employed within the organization caused by changes.
In addition, changes within organizations in the contemporary health care environment are closely intertwined with cultural changes. In this respect, it is worth mentioning the fact that modern economy tends to globalization. In such a way, they need to operate in a multicultural environment, where they need to implement consistent changes in the organizational structure, management style and other spheres of organizational performance in order to balance their traditional culture and the local culture. The elaboration of the efficient, positive organizational culture is impossible without consistent changes within modern organizations operating internationally or in a multicultural environment. The development of the organizational culture is particularly difficult in regard to the change management because cultural changes are particularly difficult to implement. In this regard, it is worth mentioning the fact that some researchers underestimate or ignore the problem of cultural changes in the change management, while others, like Thames and Webster emphasize the significance of culture and cultural changes in the management of modern organizations.
Thames and Webster (2009) emphasize the organization’s capacity to introduce changes and they stand on the ground that organizations can introduce changes using all their potential and resources. In other words, according to Thames and Webster, the introduction of changes within organizations involves efforts of the entire organization, including not only managers but also employees and, what is more important, the authors argue that all professionals working within an organization have to unite their efforts in the course of the implementation of changes. Thames and Webster (2009) argue that the ability of the organization to realize its full potential and the use of its human and material resources can lead to the accomplishment of the strategic of the organization related to the change that is being introduced. Moreover, they argue that potentially, organizations can exceed expectations of stakeholders if they can realize their full potential. The latter means that organizations have a great potential, which is not always realized because of the poor change management. Basically, the organization needs to unite all professionals in their efforts to accomplish the change and, if the organization manages to involve all employees and gain the total support of the change of the personnel of the organization, the initial expectations of stakeholders can be exceeded. Thames and Webster (2009) focus on the organizational capability self-assessment process, which they believe to be of the utmost importance for the overall success of the organizational change because it the adequate analysis and self-assessment allows managers to introduce changes respectively to the current needs of the organization. In such a way, through self-assessment it is possible to correct the implementation of changes.
The introduction of the change in the health care environment should be carefully planned. At the same time, before planning and implementing the change, managers of organizations should communicate the change to employees and to gain their support. Otherwise, they face the risk of confronting a strong opposition from the part of employees, when the change is introduced. To put it more precisely, managers of the health care organization, for instance, should develop clearly the concept of change. They should understand what the change is and what goals the change should meet. However, to define the goal of the change and to understand its essence, managers should understand current needs of the organization, employees and patients. This is exactly, where the close communication with employees is extremely important. Managers can conduct interviews or questionnaires to obtain detailed information on their needs and needs of the organization. At the same time, employees can help managers to identify needs of customers. In the health care organization, health care professionals work with patients directly. Therefore, managers can obtain valuable information from health care professionals that will help managers to define accurately needs of patients, employees and organization at large. The understanding of current needs of employees, the organization and customers gives insights toward goals and essence of the change that has to be introduced within the organization.
However, the communication of managers and health care professionals should not be limited to the assessment and understanding of organizational needs only. Instead, managers introducing the change in the health care organization should maintain the close communication with health care professionals at all stages of the elaboration and implementation of the change. In fact, managers should encourage the participation of health care professionals in the elaboration of the change. For instance, health care professionals can make their suggestions concerning the improvement of their workplace environment or the improvement of operations conducted within the health care organization or any other improvements. Managers should conduct regular meeting to communicate the change to health care professionals. In such a way, managers will receive feedback from health care professionals, whereas health care professionals will feel their involvement into the change. As they feel being involved into the change, health care professionals would support the change because they would treat the change as their own contribution to the organizational performance. In addition, health care professionals will understand better the essence and goals of the change, if managers communicate with them regularly. In such a way, health care professionals will be certain in their future after the introduction of the change that decreases the risk of the resistance to change and the risk of conflicts within the health care organization after the introduction of the change.
At the same time, it is possible to distinguish three major stages of the development and implementation of change developed by Thames and Webster (2009). The first stage is awareness. At this stage, the authors recommend focusing on the developing of the confidence of the personnel of the organization in the necessity of the implementation of changes. Thames and Webster (2009) argue that the change should be a conscious choice made not only by managers and top executives of an organization, but it should be supported by the personnel of the organization. Otherwise, the change may face the opposition of the personnel when the change is implemented. The second stage is assessment (Thames and Webster, 2009). At this stage the personnel of the organization analyzes, evaluates and assess the change. In such a way, the acceptance of the change is shaped and it can undergo the final stage – the stage of assimilation. The stage of assimilation is the stage when the change is implemented successfully and the organization fully accepts the change to the extent that it becomes an integral part of the regular functioning of the organization.
There are several steps to be undertaken in the course of the change developed by Kotter (1996): The first step is establishing a greater sense of urgency, which stimulates the introduction of the change and justifies the change. This step implies that managers gain the support of the personnel to introduce the change. The second step is creating a guiding coalition, which is the team working on the development of change, which mainly includes leaders and managers of the organization who direct the introduction of the change and develop the major strategies and methods to its implementation. The third step is developing a vision and a strategy. This stage is very important because it defines the ultimate outcome of the change in strategic terms. The fourth step is communicating the change vision. This step implies that managers and leaders communicate the vision of the change to their subordinates to gain the confidence of employees and their support in the course of the implementation of the change. The fifth step is empowering others to act. When the vision of the change is shaped and the personnel accepts the change, managers should focus on practical implementation of the change and encourage employees to act. At this stage, the practical implementation of the change begins. The sixth step is creating short-term wins. This step is essential to keep employees motivated since through short-term wins they grow confident in their ability to accomplish the change successfully and arrive to positive outcomes. The seventh step is consolidating gains and producing even more change. This step accomplishes the practical implementation of the change and increases its role in the organizational performance. Finally, the eighth step is institutionalizing new approaches in the future. This step makes the change an integral part of the regular functioning of the organization, which is inseparable from the organizational culture and functioning.
Thus, contemporary health care organizations focus on the improvement of their structure and services in order to make health care services available to a larger number of people and, what is more, to make health care organizations patient-centered. The introduction of changes in the health care organization should take into consideration needs of employees and patients. At the same time, managers should involve health care professionals in the elaboration and implementation of the change to complete the change successfully.
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