Change Management at King Edgar Hospital

This assignment examines the approach to change management at King Edgar Hospital NHS Trust, focusing on the leadership of Nurse Burns. It asks students to analyze the successes and challenges faced during the implementation of new initiatives. Students are required to identify key lessons learned, potential pitfalls, and propose how they would handle similar situations differently. The case study emphasizes the importance of communication, stakeholder engagement, and adaptability in successful change management.

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CHANGE MANAGEMENT
By (Student’s Name)
Professor’s Name
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Date

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Conduct the diagnoses of change that led King Edgar Hospital NHS Trust to launch an
organizational change program and map the problems. (10 Marks)
The industrial revolution have led to the advancement of the world and has greatly
contributed to the ongoing growth as well as development. As a result of the unique 4th Industrial
Revolution, the government had mounted massive pressure for Hospitals to improve their
services while reducing the duplication. This forced the three Hospitals to merge and
subsequently formed the King Edgar Hospitals Trust. The Trust received massive negative media
coverage as a result of its waiting list challenges alongside thirty pound million financial deficit.
The Trust’s credibility plunged deeper and this occasioned the need for change management. The
identified problems facing the Trust then included surged trolley waits for the patients in both
A&E (Accident and Emergency) department, bottlenecks in medical admission ward, higher
rates of admission, patient put on wrong wards, surged durations of stays, discharge delays, poor
relationships with social services as well as surged patient complaints.
The King Edgar Hospital NHS Trust was never left behind due to these change especially
the 4th industrial revolution that has been increasingly contributing as well as challenging the
norm. The revolution is never merely about smart and associated machines alongside ecosystem,
it is instead a fusion of both and their respective interactions crossways the digital, biological as
well as physical domains which make it fundamentally distinct from the predecessors. This
implies that industries including the King Edgar Hospital NHS Trust must find novel forms of
operating their businesses. This has subsequently led to the Hospital need for a major
transformational change crossways the industry. This is because the Healthcare Industry is
amongst the most critical to the 4th Revolution and this challenged with complexities of
propelling key transformational change.

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King Edgar Hospital was as a result marred with financial crises, hurdles meeting the
government waiting list targets as well as negative media coverage. The hospital was thus
propelled to launch an organizational change program against this backdrop of a genuine crisis.
It adopted the end-to-end chain which meant from the admission to discharge being the focal
point earmarked for change. The change was thus meant to be the novel norm as the healthcare
sector copes with the effects of the 4th industrial revolution.
After deliberations on the issues identified above, it was apparent that many problems
were related to inefficient patient processing that bared the capability of the Trust to decrease
their waiting list. Provided the governing scrutiny of long waiting list, alongside resulting
autonomy repercussions for the Trust, sorting out such capacity as well as throughout challenges
became a top notch priority. The Trust realized that someone had to drive and accept
accountability of the Trust to enhance the performance of the admission-to-discharge chain
besides the turnaround strategy. The CEO of the Trust then asked the executive director of
nursing (Tracey Burn) to take lead. Burns was aware of each problem. Albeit her roles and
responsibilities were wholly managerial, she was never a stranger to hands-on-nursing, as she
knew that the Trust beds were frequently blocked by patients that were medically stable yet had
nowhere else to leave for like nursing home. She thus welcomed the opportunity for two key
reason. One reason was the professional caregiver gut response to an unacceptable condition as
she thrived to place herself in the position of the patient having spent up twelve hours on the
trolley in the A&E department when one has had nothing to eat or even drink and one has likely
got the sore bottom due to one being laid on the tiny and little thin mattress without dignity. For
her, it was all about saying that the Trust could make a change to that menace then by merely
moving certain of systems. Her second reason was that past patient viewpoint, Tracey saw the

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opportunity to expand her role of nurses in the environment marred with medical profession. She
therefore wished to attempt to boost the voice of nursing and illustrate that nurses could
contribute immensely to the agenda. Thus empowering nurses could assist recruit as well as
retain additional nurses in what had turned out to be a very tight labor market. With the extra
potential to relieve the waiting list, the change project was a high stakes undertaking on each
angle. She thus saw the opportunity to introduce a systemic approach to the discharge of patients
which would start at the pre-admission phase and hence nurtured plans to usher in nurse-led
discharges that imply the nurse assuming the responsibility from specialist physicians to make
the ultimate decision for patient discharge. However, the major problem is that Trust never
benefited from the government’s option of pouring in additional resources to meet its targets as it
was even already cash-trap. The Trust’s option was to only work to meet its targets as best it was
possible with its own existing resources. This goal thereby gave rise to expedient measures
which generated hurdles downstream as they patient had to wait almost 12 hours leading
increased pressure being mounted on medical admission ward to assign the patients to a ward-to
evade violation of 12-hour ruling. This implied that the patient could be dispatched to wherever
there was a free bed. Characteristically, such wrong assignments surged the duration of stay
among patients since they would never be seen any relevant specialist, who undertook their
respective rounds on other wards. The target pressures also distorted clinical priorities as patient
were sent home early and had to be rushed back to the hospital for re-admissions. Aware of such
a risk, Tracey knew the Trust would have to increasingly monitor their re-admission patterns
very closely.

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There were various solutions implemented by the Trust in answer to the discharge
problems. Discuss the main solutions. (10 Marks)
A golden bullets performance objectives were introduced by the Chief Executive in 2003.
It entailed an energetic investment in the improvement as well as overhauling the discharge
performance of the Trust. Tracey secured a pledge that where nursing took responsibility for
discharge planning, matrons would be relieved of their onerous bed management duties that
would be then taken up by general management. Supported by her firm mandate from the top,
Tracey organized the workshop on the improvement of process of discharge inviting the whole
body of matrons each being in charge of a cohort of wards and 20 out of 22 attended. A reduced
duties became effective from July.
The Hospital engaged in effective discharge planning. They undertook this initiative and
it benefited the Hospital greatly. It was successful because the lead matron had in past been the
link between the hospital and matron for matters relating to discharge. Helen build on her
experience and within few weeks following her first matron’s workshop, she was already
producing a report that clearly highlighted the scope of the initiative for ward sisters as well as
nurses (Hayes 2014). Her report emphasized that it remained a key preference for Trust and that
discharge planning began from point a patient was admitted. Several preliminary measures that
had been undertaken already were documented in the report. The report further encouraged the
ward staff to make better use of discharge lounge, while matrons were given 30-day reports
about the utilization of lounge by various ward areas. Hellen further created a cartoon posters
marred with golden bullets that clearly showed how discharge planning fit into the overal
priorities of the Trust. Hellen shared such posters with all ward sisters that reported to Hellen and

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asked them to display posters to enable the staff to become familiar with their contents. Even the
sisters that never went to Hellen contacted her for them and under mere two weeks the posters
were displayed on each ward in Hospital. Hellen and newly appointed Discharge Manager were
acknowledging the first full-day workshop for the promotion of ownership of discharge planning
to make sure that all the staff sisters understood their respective pivotal roles in the process.
These initiatives were mostly focused on working smarter than harder. The workshops were also
opened to medics, therapist and social thereby raising their awareness of salient issues as a joint
problem.
Using one of the models of change discussed in class, explain in detail the change process
that took place at the hospital led by the Director of Nursing and her team.
(20 Marks)
The Lewin’s change management model will be used in explaining the change process
which occurred at the hospital led by Director of Nursing (Tracey Burns). This model views a
change a familiar thread which runs via all businesses irrespective of size, age or industry. The
world is changing rapidly and firms must change even more rapid as well. Organizations which
handle change well thrive, whereas those which do not struggle to survive. This model views
change as a process with separate stages and hence helps prepare one for what is coming and
making a plan to manage a transition as Burns did in this case (Doppelt 2017). This model begins
a successful change process by understanding why the change has to take place as Burns took her
time to understand this. As put by Lewin assert it “motivation for change has to be generated
before change can take place” One has to be assisted to re-examine various cherished
assumptions regarding oneself as well as one’s relations to other people. This is referred to as

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unfreezing phase from where the change starts. According to Lewin’s Unfreeze is the first phase
of change that entails organization being prepared to accept that the change is essential as we
saw Burns doing by explaining the purpose of the change and why it was needed in her various
meetings with matrons and we saw the matrons accepting when she explained the cuts on roles.
Burns used this phase as required by Lewin and developed a compelling message that indicated
why the prevailing way of doing things were bad and could not continue (Goetsch and Davis
2014). The second phase is to change itself. Once the uncertainty has been created in the
unfreeze stage, change stage is the point at which individuals start to resolve their uncertainty as
well as look for novel ways of doing thigs. We saw Burns relieving the matrons their duties and
making the nurse-led discharge as the change in the organization. The matron even started to
believe her and accepted to act in ways that supported her new direction as we saw the matrons
accepting to take part in the initiatives. Burns also allowed people enough time to transition as
required by this model and this is why she was ready to wait and bring everyone on board. She
even explained to them the benefits they will have thus accepting the change. The last stage is
the refreeze where change is already taking shape and people have embraced the new ways of
working, Burns was ready to refreeze.
What lessons and pitfalls are highlighted by the approach to change management at King
Edgar Hospital NHS Trust? How would you do things differently? Discuss. (10 Marks)
The lessons learned from this approach is that change is possible so long as there as a good will
and a person who willingly agrees to take the lead. As we saw here, Burns was ready and had a
willing heart and put herself into the position of patients to help them solve the problems they
were facing. Also we see that even despite have no external resources Burns was able to bring
people together and worked as team to realized great achievement (Cummings, Bridgman and

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Brown 2016). We saw starting very well by first telling people why there was a need for the
change and explained in details her plans and got immense support from almost everyone despite
few resistance. Thus we learn from that one needs to be objective and have self-efficacy that
something can at least be done to change the situations as Burns did in this case. Delegation of
duty and giving full authority is also a lesson learned as we saw both Green and Burns working
very well after they had assumed their duties. The pitfalls that I have acknowledged is that a
leader should not be annoyed as we sometimes saw Burns when some people were opposed to
her initiatives. There is always a need to understand everyone and bring them on board
(Cameron. and Green 2015). If I were in Burns position, I would always appreciate my critiques
and take their negative views as opportunities and use them to even make the change look more
appealing.
References
Cameron, E. and Green, M., 2015. Making sense of change management: A complete guide to
the models, tools and techniques of organizational change. Kogan Page Publishers.
Cummings, S., Bridgman, T. and Brown, K.G., 2016. Unfreezing change as three steps:
Rethinking Kurt Lewin’s legacy for change management. human relations, 69(1), pp.33-60.
Doppelt, B., 2017. Leading change toward sustainability: A change-management guide for
business, government and civil society. Routledge.
Goetsch, D.L. and Davis, S.B., 2014. Quality management for organizational excellence. Upper
Saddle River, NJ: pearson.
Hayes, J., 2014. The theory and practice of change management. Palgrave Macmillan.

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Hornstein, H.A., 2015. The integration of project management and organizational change
management is now a necessity. International Journal of Project Management, 33(2), pp.291-
298.