Change Management in Healthcare

This document discusses the importance of change management in healthcare, including theoretical approaches, internal and external drivers of change, the role of leadership and managers, and the relationship between organizational culture and the change management process.

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Table of Contents
Introduction......................................................................................................................................2
Theoretical approaches to change management and organization behavior in health care.............2
Internal and external drivers of change in healthcare......................................................................5
Evaluate the role of leadership and managers in the planning and initiation of change..................6
Relationship between organizational culture and change management process.............................8
Some examples of its implications in a hospital setting................................................................10
Conclusion.....................................................................................................................................11
References......................................................................................................................................12

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Introduction
The primary motives of this task are to discuss and outline the change management and
organization behavior in health care. Change management is essential in healthcare to promote
the services and to make happy the patients widely (De Bono, Heling and Borg, 2014). Change
management is a systematic process to deal with transition and conversion of an organization’s
goals, tools, techniques and processes. The paper also discusses that how internal and external
drivers may affect the progress and success of healthcare to a large extent. Along with that, role
of leadership and managers in the planning and implementation of change also have been drawn
in the report widely. The report also outlines that how organizational culture affects the change
management in healthcare. Some of the examples related to change management in a hospital
setting. More detail of the task has been shown below.
Theoretical approaches to change management and organization behavior in health care
Change management is an ongoing and effective process that takes time, dedication, experts and
endeavors to initiate and run. Some of the excellent change management approaches are
discussed below.
1.Lewin’s change management model: It is one of the significant and dynamic approaches that
make it possible for people to understand structured and organizational change. This model is
created by Kurt Lewin in the 1950s. The three stages of this change management approach
include the following:
Unfreeze: It is a first stage of the change management approach which involves the planning for
the change. At this stage, the health care sector shall be prepared for the change and also for the
evidence that change is needed and vital. This phase is unique because most of the workers
across the world try to resist change, and it is significant to break this status quo. This stage
further involves the healthcare to seek into its core and reexamining its status. Health
organisations at this stage needs to start from the basics such as challenging the values,
behaviour, attitude and belief of the organisation before actually making the changes. In health
settings since these are the core things that improve the services hence change management by
analysing these factors is very much crucial (Nielsen, et al. 2010).
Change: It is a stage where the real transition or organizational change takes place. At this stage,
dynamic leadership and reassurance is vital because these attributes not only lead to steer
forward in the right direction but also make the procedure easier for the workers who are

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involved in the process. Time and communication therefore are the keys for this stage to
implement change management effectively and successfully (Kaminski, 2011). Health care
settings must look for resolving their uncertainties such as to what is the position they must take
is and what is the objective they actually want to achieve. Since health care settings are at greater
risk of safety hence the changes must be done carefully. Understanding all the aspects of change
is crucial. Organisations must know the way in which they will have to respond to problems in
the change process.
Refreeze: In this stage, the change has been adopted, embraced and initiated by people; the firm
begins to become constant again. That is why the stage is referred to as refreeze. This stage
needs support of the people to make sure changes are optimized all the time and initiated even
after the aims and objectives have been attained (Sarayreh, Khudair and Barakat, 2013). Health
care settings must look for the stability while the changes are going on and new changes are
being planned. Creating belief in the staffs of the health organisations is very much essential as it
allows them to change itself in the future also while ensuring that the process is not so difficult
for the staffs and the patients.
2.Kotter’s change management theory: It is one of the well-known approaches to change
management. This approach is divided into eight stages where each one of them monitors on key
beliefs and values that are interconnected with the response of employees to change. The eight
steps of this change management model are shown below.
Increase urgency: This stage involves generating a sense of urgency among the employees so as
to inspire and encourage them to move forward towards the aims and targets. It is the role of the
manager of health care setting to build this sense of urgency (Cane, O’Connor and Michie,
2012).
Develop the team: This stage is interconnected with getting the right and talented employees on
the team by appointing a mix of skills, commitment, engagement and knowledge. Staffs such as
doctors, managers, nurses and other medical staffs need to create team so as the process of
change becomes easier (Brown and Osborne, 2012).
Get the vision accurate and correct: It is a stage that is related to creating the right and
dynamic vision by considering creativity, aims, objectives and emotional connectivity. For
example in Health care setting need to make sure that safety of patients must not be
compromised while making these changes (Dixon-Woods, McNicol and Martin, 2012).

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Communication: It is also a significant part of change management because communication
plays a major role in change management (Small et al, 2016). Health care setting must take use
of communication model that helps in ensuring the flow of information is smooth.
Get things moving: To get things moving, the health care sector needs to eliminate road backs
and obstacles effectively.
Focus on short term goals: Monitoring on short term objectives, goals and categorizing the goal
into small and attainable parts is an excellent way to attain progress and success without too
much pressure.
Do not give up: This is an important attribute that not to give up while the procedure of change
management is up-to-date. For this the role of feedbacks becomes important.
Incorporate change: To manage or handle change effectively and efficiently, it is fundamental
to reinforce it (Appelbaum et al, 2012).
Organizational behavior in health care shows a clear and depth understanding of individual and
group behavior in healthcare. Organizational behavior in health care is affected by diversity,
communication, collaboration, conflict management, managing change and leadership (Paton
&McCalman, 2008). Thus, all these factors should be positive to achieve long term goals and
targets in a hassle free manner. The managers play a key role in maintaining positive
organization behavior at the workplace because they can directly influence an employee’s
motivation and satisfaction (McCalman, Paton & Siebert, 2016).
Internal and external drivers of change in healthcare
The internal change management drivers in health care are presented below.
Organizational culture: It is noted that organizational behavior may be defined as a systematic
study of the attitude and performance of individual and group in the health care sector. In
healthcare, the top management listens to workers, and analyzes their needs and requirements to
serve the people effectively and adequately. In this context, organizational culture plays a major
role in attracting and retaining skilled and potential people to implement the changes in
healthcare. Without maintaining a strong and dynamic culture, the organization cannot attain
long term targets and goals (Kotter, 2011).
Employee morale: It has been studied that strength of an individual and level of confidence is
crucial for a firm. To increase and enhance the morale of the workers, the company needs to

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provide motivation and recognition to potential and skilled workers. It will help in boosting
morale, loyalty and trust among the workers at healthcare (Mutlu, 2015).
Financial management: It is worth examined that finance is a major driver of change
management. Finance is a major and primary element of a business. Without finance, no
business can run. In the health care, the finance manager takes decisions about fund allocation
like purchase of raw materials, adequate fund distribution and introduces new assets (Gabbay
and Le May, 2010). In these reasons financial management plays an empirical role in
implementing change management.
Competition: It is another internal change management driver that may affect the progress and
success of healthcare sector. To face the competition, the health care sector suffers several things
like external issues, expense and organizational issues. All these things need to be considered to
initiate change management effectively (Patel, Asch and Volpp, 2015).
The external change management drivers in health care include the following:
Economy: It is examined that there is a close relationship between the economic environment
and business firm. The growth and performance of the business depends on the economic
environment and development. At any type of financial fluctuations such as deflation and
inflation badly affect the business activities and operations (Kirsch, Chelliahand Parry, 2011).
Political: The political forces like government policies, political stability, ideology of parties and
tax policy etc. are positively and negatively affect the business activities and initiatives largely.
The political forces are directly and effectively bearing on the functioning of the business. It is a
primary external driver of change management that needs to be kept in mind (Lee, 2015).
Socio-cultural: The socio-cultural factors include values, custom, religion and education may
affect the profitability and revenue of healthcare sector largely. The health care sector needs to
focus on the socio-cultural factors to serve life of people widely (Ivers, et al. 2012).
Technological capacity: It is investigated that new discoveries and advanced technology make
the old one obstacle. The healthcare has to keep itself up-to-date with the technological changes.
Furthermore, it is a significant and unique attribute as it shapes the business activities and
operations in the long run. Healthcare cannot run without advanced and innovative technology
(Gu and Subramanian, 2014).

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Evaluate the role of leadership and managers in the planning and initiation of change
Leadership plays a primary role in the strategy making and implementing process. It is a
responsibility of leaders to develop a strategic vision and mission, establishes objectives and
goals, craft the approaches and strategies and implement it and then analyze the performance.
Initiating corporate strategy needs a team effort managed and headed by organization’s
leadership team. Thus, it is a responsibility of each and every person to participate in change
management. It is further significant for the entire company to understand and evaluate the role
of leadership in strategic initiation to make assigning responsibility and roles more effective.
Leadership plays a major role in health care to implement the change management successfully
(Salmela&Fagerström, 2008). By using leadership, the leaders can keep an eye on the
performance, productivity and efficiency of the employees. It will help to improve and enhance
the effectiveness and efficiency of the workers at the workplace. The roles and responsibilities
can be assigned easily by using leadership within the organization. Thus, leadership plays an
integral role in delegating tasks and duties among the workers in a constructive manner. The top
management develops interest among the employees to adopt the changes easily (Helms Mills,
Dye & Mills, 2009). It is a responsibility of leadership to create urgency by describing that why
change management is essential in the organization. Leadership also helps the workers
understand and evaluate how the firm benefits from the new initiation, but it also needs to get the
company to get the setbacks of not making a change. Apart from this, it is the responsibility of
leadership to put an effective and dynamic monitoring system in place. Another duty is to
analyze and measure the data and facts that are generated during the implementation of change
(Root, 2019). In this way, leadership plays a essential role in planning and implementing the
change effectively.
On the other hand, managers also play an essential role in planning and initiation of change
management. The role of manager involves supporting and directing workers through the process
of change. They are wholly accountable to use ADKAR and Lewinchage management models to
initiate the change management process. The managers are further liable to formulate the
strategy and they also create a set of plans and policies tailored to direct people towards change.
These plans include communication plan and training plan. Managers are also responsible to
apply a structured change management methodology to initiate the changes. The managers and
leaders further accountable to maintain a strong communication with employees and to listen

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their issues and problems that are being faced by the workers while adopting the changes.
Managers and leaders are liable to conduct training programs and sessions for improving
effectiveness and efficiency of the subordinates. It also will help in boosting loyalty, trust and
faith among the customers. In this way, various roles and responsibilities are played by managers
and leaders in planning and implementation of change (Carney, 2000).
Relationship between organizational culture and change management process
Organizational culture may be defined as a pattern of values, attitudes, rules, norms and
assumptions that may not have been expressed but shape the way in which people behave and
things get done. In a simple way, it can be said that culture of a company is the typical way of
conducting business in the company. On the other hand, change management process is one of
the basic and innovative skills in that most leaders and managers need to be capable in there
management process (Buchanan &Badham, 2008). Change management is not possible without
maintaining a strong and dynamic culture at the workplace. To handle organizational change,
managers concentrate their endeavors on analyzing and identifying the culture of their
organization, abide by values, norms, beliefs of the culture. Set organizational culture is
predicted to induce inertia, encourage Unitarianism and maintain social structures. Culture in
healthcare is thus attributed by collective path dependency meaning they show an accepted, a
standardization and conventional behavior which generates a dominant and collectively adopted
opinion and views. In this way, culture can affect the change management in several ways. It is
studied that a cooperative and strong culture combined with a consensus building leadership led
to dynamic and efficient adoption decisions. It is outlined that three different perspectives of
culture promoting and enhancing change management. Firstly, the assimilation perspective
corresponds to the traditional review of culture supporting solid and conventional consensus and
maintaining social structures. The two other types, destruction and differentiation perspectives
explain the culture as a collection of subcultures of vagueness and contradiction. Such type of
diverse and innovative culture contributes to conflict and plays a key role in change process.
Strong and effective culture helps in improving and enhancing collaboration, communication and
coordination of initiatives (Fagerstrom&Salmela, 2010). The culture of the healthcare sector is
the most dynamic strategic variable that promotes leaders and managers need to handle
effectively and efficiently. The organizational culture and change management process in

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interconnected with each other. There are several culture impacts for dynamic and effective
change management process (Kotter, 2011).
Healthcare sector has unique culture, so management system further accepted that culture
effectively. If they initiate any change process, they have to acclimate that change process with
their culture; otherwise they have to change company’s culture. Healthcare motivation process is
frequently to improve and enhance the efficiency of this worker to boost and improve the
financial image of the firm (Ginter, Duncan and Swayne, 2018). It is stated that organizational
culture is making issues and barriers to initiate changes, so they have to face and handle those
resistant against to change. Most of the leaders and managers are not willing to make changes,
because they have some distress to do changes about it failure and success. Cultural changes and
changes implementation to culture are needed to growth and progress of changes, because these
two cannot be differentiated. Dynamic relationship between change management process and
organization culture always bring progress of change. If the healthcare maintains a positive and
favorable culture at the workplace then it will help in creating a sense of urgency among the
employees. Thus, they can easily accept the changes at the workplace. Besides this, culture
shapes the way workers interact and communicate at their workplace; hence it will help in
collaborating and cooperating with workers in healthcare. In this way, organizational culture
plays a primary role in implementing the change management process at the workplace (Brady,
2010).
Some examples of its implications in a hospital setting
For example, Voluntary service overseas organization is focusing on the advanced technology to
provide services to the customers across the globe. This organization has adopted digital
technology to survive the business successfully and to protect the rights of clients effectively. To
implement new and advanced technology, the organization has provided training and
development coaching to the workers at the workplace. Another example is BMI healthcare
which is an independent provider of private healthcare, rendering treatment to private patients
widely (Kotter& Cohen, 2012). The company has also made the changes in technology to satisfy
the customers across the globe. Online personal medical records and healthcare apps are used by
this healthcare to attract and retain wide range of patients and to make a strong image in the
minds of clients. The chief digital officer is a unique and strong believer in technology’s role to a
digital enabled hospital. Optimizing intelligent technology in the form of data, smart

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infrastructure, mobile and wearable devices would no doubt support to render a safer more
effective and dynamic healthcare system and eventually better care for patients. Monitoring on
technology to enhance and improve preventative care and minimize readmissions would enlarge
society’s wellbeing while further saving the public health service money. To initiate this change
management, the hospital provides lucrative incentives and bonus to the workers in order to
improve and augment their efficiency and potential. Apart from this, the top management at BMI
health care is maintaining a solid relationship with workers to motivate them for accepting the
changes at the workplace (Hamel and Zanini, 2014). By using digital technology, the
organization can see that patients speaking to their consultants via a video app from their mobile
and tablet, having their innovative evaluation derived remotely, being able to track and analyze
all their patient records from their smartphone. The future of digital healthcare is innovative and
objective is to be at the forefront of the technological innovations, supporting to improve and
enhance the experience of consultants and patients as well (Grol, et al. 2013). Additionally, NHS
also uses change management process to stay in the competitive market. It uses change
management process to identify and reflect on the gaps between what is presently being rendered
and what is likely to be needed in the next few years. Various models and approaches can help
the workers to expand either directly or indirectly the coherent for the change. The organization
has changed its TQM and business process reengineering (BPR) technique to provide more
services to the clients. To redesign TQM and BPR, the National Health Service organization uses
dynamic and innovative change management models and tools at the workplace. All these are
significant examples of change management in healthcare setting (Health Service Executive,
2010).
Change initiative taken by the health care sector
In the current era, many initiatives has been taken by the heath care organization to sustain their
position and improve the quality of the services as compared to their competitors named as new
payment models, electronic medical records, and team-based and coordinated patient care
models. In the current era, the organization has used the electronic payment tool by which
organization could offer an opportunity to the consumer to make payment by online services
rather than manual as it supports to make a positive image of the firm among the consumer
caused of saving the time of both firms well as consumers. Another change that has considered
by the organization is imply the electronic medical records that facilitate to firm for recording

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organizational data as it saves the patients data and helps to easily found the record of patients in
the least time. Preventing care is also another imperative initiate that is used by the firm by
which organization could aware to the patients about the healthy lifestyle for declining the
number of patients from the hospital and gain the healthy people (Grol, et al. 2013).
Conclusion
It is concluded from the above limelight event that change management process is necessary for
the healthcare sector to expand the business activities globally. The quality of nursing can be
improved and enhanced with the help of the change management process. It is analyzed from the
above analysis that changes in healthcare practice are welcome if they enhance and enlarge
quality and safety or save money. Change management understands and assesses the
requirements and the effect of change. It has been found that the change management process
helps in increasing revenue and maximizing efficiency of the workers in healthcare. It is stated
that Kotter’s model and Lewin’s change management models are implemented in healthcare to
adopt the various changes within the organization. Along with that, external and internal drivers
are used to initiate the managerial changes in healthcare. Moreover, leadership and managers
play an empirical role in the planning and execution of change management at the workplace.
Additionally, there is a strong and effective relationship between change management and
organizational culture in healthcare to amplify the profitability and to reduce the
cost(Bmihealthcare, 2019). It is recommended that the healthcare sector should focus on the
capabilities and efficiency of the workers while implementing the managerial changes.

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