PHASE1: Creation of Vision forthe Change
Avision was developed by the health care manger and the guiding teamand impacted on the vision rightly on employees. It tookconsideration of the following dimensions staff support, health careprofessionals, patients care, competitors, revenues and action steps.
Thevision considered the following questions
Whatdoes it mean to become
Wireless healthy facility?
Incorporated with EHR documentation
Quality sensitive to HCO?
Increation of a vision, the whole organization or physicians wasinvolved in this scenario so that they won’t feel obsolete and feellike their power is being reduced. Usually, fear anxiety and panicgets instilled in employees and the guiding team formed developedmethods of communication to address these feelings of employees(Savage,2009).The communication had strategies to enhance the vision, overcomeresistance and initiate commitment toward changes (Brown,1992).
Itdeveloped communication model which identified individuals or groupsinternal or external to the organization to be affected by thechange. A guiding team monitored the changes on the feelings based onawareness, collaborations advocacy, understanding and commitments.The vision was then communicated through engagement story of a videoon an interview of a patient who got injured through medical error.This illustrated how electronic system is better used to reducemedical errors and improve treatment. The stakeholders were alsoengaged continuously to monitor the effects of changes at specifictime to determine if there is resistance. Hence, the guiding teamcame up with methods of building commitment and trust to those groupsresisting the change. The team built a question and answersapproaches on the changes and administered to the resistant groups orindividuals.
PHASE2: Following theChange
Thiswas by building the urgency. In this HCO, people were made to actsufficiently in urgency by ensuring they developed behavior whichlooks for opportunities and problems, which motivates employees andurges its continuity. In the development of this change, a videopresentation of a angry parents were created, whereby their son haddied in a facility due to medical error which could have been avoidedif his information could have been stored in electronic versioninstead of paper (Savage,2005).
Anothermethod used was video on physicians using electronic and paperwork totreat patients with multiple problems. Electronic means enabled quicksearch of information and establishment of trend data while paperworkhad to peruse several papers (Buchbinder& Shanks, 2012).
Inaddition, a visit to a facility using EHR was made to ask moreinformation on how to use it in their organization. A guiding teamwas formed by the manger to oversee this management change. This teamhad skills on health care changes mainly on EHR implementation,declining medical errors and costs. In addition, they possessed:skills in the ability to bring trust on the team and employees,experience on working in departments or division having managementskills dealing with planning and control to achieve wins andleadership skills to motivate employees to achieve vision (Kavaler& Spiegel, 1997).
Theorganization was then enrolled in change efforts. This was done bythe guiding team to increase the commitments towards change throughportal, web casts, screen savers and wallpapers to relay theinformation on how technology improves care of patients and improvepatient-physician communication.
Also,every day at 8 o’clock in the morning, the groups discussed theprototypes for one hour. Later, they would ask their colleagues attheir departments to comment on the prototypes. In the following daythey would comment on the observations of others till the chosenpathways was completed.
Sometimes,the physicians with time could not complete their tasks due tocertain obstacles from change management. The obstacles were fromsupervisors and systems and lacked information or mental effects(Swayne,Duncan & Ginter, 2006).This was averted by training and providing physicians or supervisorswith paper charts and electronic forms of patient.Incentiveswere given to those embracing changes to reward them. Due to mentalbarriers, reliance on other organizations was encompassed.
Theshort term wins was achieved through achievements of quick completedtasks. This was aided by employing a consultant to create short termwin to show that the changes are successfully incorporated and makephysicians work together to ensure possible change (Horowitz,2010).
PHASE3: Implementing the Vision ofthe Change
Whenthe change occurred, people said that had successfully incorporatedchange but they lost the urgency. The guiding team looked for moreexternal factors to examine at the current state in contrast tocompetition from paper work. They then acquainted the physicians thatthey enable the patients to create personal health records, bookappointments, look at lab outcomes and pay fee online. Thisre-energized the individuals.
Later,the changes were made to stick by proving to employees that EHR worksand rewarding those embracing change. In addition, a Post Livepractice was developed whereby an expert with a physician movedaround to ensure the EHR systems works well. The change from manualpaper work to EHR led to transitions which were noted and managed. Itwas managed through three stages namely ending, neutral zone andbeginning stages. Ending is the outcome that is EHR implementationwhereby the paper work is left to go and a new identity assumed.
Asnoted by Fottleret al (2010), theneutral zone is unknown space created from ending to beginning of newsystem. In neutral zone, physicians had to shed old patterns of usingpaperwork. Beginning is a phase where physicians embrace new identitywith a purpose. Afterwards, primary determination will be on methodsthat mangers need to use to assist employees pass through the threestages without difficulty.
PHASE4: Following Through onthe Change
Theguiding team then demonstrated how EHR could enablethem perform their work efficiently. In addition, it addressed whatthe physicians lose by adopting EHR. The physicians had differentbeliefs, assurance and various intentions that if they will beadopted, something could happen in their work. Therefore, the guidingteam and the Health facility manager documented these beliefs. Inaddition, they acknowledged loss and tolerated the overreactions.
Theloss was compensated in form of team membership, status andcompetence. They were compensated through choosing physicians asconsultancy to gain status and involving physicians on pathwayprototype to gain control.
Lastly,the signal of an ending of a change was made through a clear sign.The guiding team provided words on what to change and making suchchange occur. Later, physicians were told at the end that in thisworld nothing remains permanent and there is always a transition.
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Kavaler,F., & Spiegel, A. D. (1997). Riskmanagement in health care institutions a strategic approach.Sudbury, Mass.: Jones and Bartlett Publishers.
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