Leadership and Management

This document discusses the concepts of leadership and management in organizations, with a focus on the stages of change program and strategies to overcome barriers. It explores the implementation of an Electronic Patient Record (EPR) system in Homerton University Hospital and the challenges faced. The document also provides strategies to overcome barriers such as cultural issues, fear of unfamiliarity, ineffective leadership, poor communication, and lack of planning. It concludes with the importance of effective change management and the need for employee cooperation.

LEADERSHIP AND MANAGEMENT
Leadership and Management

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Table of Contents
1. Introduction:...........................................................................................................................2
2. Homerton University Hospital:..............................................................................................2
3.a Stage of Change Programme and barriers to Change:.........................................................3
3.b Strategies to overcome the identified barriers:.....................................................................7
Remove obstacles:..................................................................................................................8
Build a Guiding Coalition:.....................................................................................................8
Create a Vision for the Change:.............................................................................................8
Communicate the Vision:.......................................................................................................9
Creating sense of Urgency:....................................................................................................9
Create Short Term Wins:.......................................................................................................9
Consolidate Improvements:.................................................................................................10
Anchor the Changes:............................................................................................................10
Conclusion:..............................................................................................................................11
References:...............................................................................................................................13

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1. Introduction:
Organizational change is the process of changing the structure of operational methods,
strategies, culture and the technologies used by the organization which are implemented for
improving the performance of the organization (Jones 2013). The organizational change for
the organizations can occur after a certain period of time or it can be continuous in nature.
Organizational change is important for developing adaptability of the organization in several
situations. Organizational change means modification in the roles of people and structural
relationship of the organization. These changes when implemented can disrupt normal
function of the organization but after proper adoption this can provide long term benefit to
the organization.
In this report an individual health care organization has been selected which is
“Homerton University Hospital.” This healthcare organization has initiated an organizational
change last year, an EPR system was implemented and this organizational change also
focused on information exchange regarding health among the hospitals and GPs. In this
report, the change adopted will be identified and its present stage will also be analysed.
Theories like the Kotter’s 8 steps change management will be used to fully analyse the
change management and its barriers in this organisation.
2. Homerton University Hospital:
Homerton University Hospital is a teaching hospital in East London and having a
capacity of 500 beds. Though this is marked as a general hospital, the availability of 500 beds
makes it relatively a small general hospital. This hospital delivers a community service to
patients. Although this hospital is a small sized hospital, it is looking to implement EPR
system or the Electronic Patient Record which can record periodic health care report of an
individual according to (Maillet, Mathieu and Sicotte, 2015). With an EPR system, Homerton

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University Hospital is also implementing a voice recognition system alongside implementing
health information data exchange by accessing the GP records and the community records.
Here, mainly the data related with physical, physiological and social aspects of patients are
accessed. Homerton University Hospital is implementing this organizational change for
improved care of the hospital. Integrating EPR system in Homerton University Hospital can
be considered as a part of East London sustainability and transformation partnership. This
discovery project of the Homerton University Hospital aims to deliver an infrastructure that
will help in accurate information exchange over the whole setting. In the current
infrastructure of the Homerton University Hospital datasets are stored in the proprietary
systems. The initiated planning also includes a service which is capable of extracting and
linking datasets among several of organizations related with the healthcare services
(Elhoseny et al. 2018). In this model the linked data can be used for developing the
population model that can be used for planning better services and predicting the needs of
individual’s health. Thus this type of change becomes a digital change in the Homerton
University Hospital.
3.a Stage of Change Programme and barriers to Change:
Currently, implementation of the EPR system is in the planning stage and the
Homerton University Hospital is currently starting to execute this plan. Thus all the stages of
the change management are in initiation or implementation stage. This change is a
technological change within the organization which aims to implement the EPR system
within the hospital. Here this change will be adopted by using the Kotter’s 8 step model.
While a technological change is executed, the overall change needs to follow various steps
and these steps are described in the Kotter’s 8 step model. For this reason in this case the
Kotter’s 8 step model is used for the initiated change. By using this system health record of
the patients can be easily maintained. As mentioned above the organizational change is yet to

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begin as the whole system is in the planning stage. The main problem which the Homerton
University Hospital is facing is the problem regarding implementation of this EPR system.
Many of the current employees might not be able to understand the new system which has
become the main problem.
These changes can be considered as the transformational change within the
organization. This is a large scale digital change and one of the main barriers in this case is
the culture of the organization. Different types of organization have different types of
cultural issues (Ferraro and Briody 2013). In the implementation process of EPR system,
another organization might need to work closely with the Homerton University Hospital and
this can create a cultural issue in the organization.
Fear of unfamiliarity is another issue in the implementation of EPR system in
Homerton University Hospital (Sillince and Shipton, 2013). While this system is
implemented, there is always an uncertainty about familiarity of the new system with the
existing activity of the hospital. This barrier of fear needs to be overcome in other to
successfully implement the EPR system at the Homerton University Hospital.
Ineffective leadership is another barrier in the implementation of EPR system. While
a change is initiated in the organization, existing employees of the organization can create
problem in the implementation process. This is because, while a change is initiated within
organization dynamic support is needed from the employees, without proper support of the
employees change implementation can take a long time (Aboyassin and Abood 2013). Also,
in many cases it has been seen that employees has protested against this type of
organizational change as a fear of job loss. In such cases effective leadership is very much
important for managing the employees. Thus an ineffective leadership can be a barrier in
Homerton University Hospital.

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Poor communication is also a big issue in the organizational change. During an
organizational change, it is very much important to communicate effectively throughout the
organization (Wehmeier and Winkler, 2013). It has been assessed that for a successful
organizational change everyone involved with the project must be informed about the change
in a clear and decisive way. An unclear communication about the change can create
confusion among employees of the organization thus the change might not be an effective
one. Thus poor communication is one of the major barriers while implementing EPR in
Homerton University Hospital.
Organizational change also faces internal barriers. If the process of organizational
change is very much complex then it becomes very much hard to implement in the
organizational environment. Generally, in multinational companies performing an
organizational change is very much complex and due to that multinational companies faces
many failure cases during the organizational change. Thus it is very much important to keep
the organizational change as simple as possible. Thus it is very much important to keep the
organizational change for Homerton University Hospital very much simple.
Another type of issue in the change management process is lack of planning. Whenever a
Change management plan has been initiated it should follow the planning for change
management process. This planning should be followed in a step by step manner. If this
planning is not followed in proper sequence then the change management process is going to
fail (Tahernejad, et al, 2013). It must be understood what kind of changes will take place and
how this changes will be achieved. Without a proper planning by Homerton University
Hospital, executing a Change management plan can create several disruptions in the overall
process. There might be some limitations as the change process can become very much slow.

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Low employee morale is another type of problem which is faced by organizations
regarding the process of change management. Organizational employees might not happy
with the change which is occurring within the organization due to various reasons. For
example, the staff of Homerton University Hospital might think that the change is not
required by the organization or the changes can take so long, by so doing employees can
misplace their patience and their morale towards the project. In such type of scenarios low
morale of the employees becomes a serious issue in the change management process as the
employees are going to resist the changes (Arunchand and Ramanathan, 2013). This
resistance can bring difficulty in smooth transition of change management. So therefore, the
hospital employees including the management level of staffs should all co-operate with the
changes if they want a better and smooth change management process.
Adopting new technology is also a real issue in the change management process.
Technologies are advancing day by day and some of them are becoming very much critical to
understand. There can be two types of challenges while implementing a new technology
using the change management process. The first challenge is the integrating the new
technology with the existing old Technology (Langley et al. 2013). This challenge can be
minimised by taking the help of IT department. The second challenge is using the new
system. The existing employees of Homerton hospital might not be able to use the new
system due to lack of knowledge and the IT department does not have any solution for that.
So this becomes a real challenge for the organisation.
One real issue in the Change management process a lot of organisation face is the
ineffective change in the organisation. Which means implementing change in the
organisation is not working properly. According to Mosadeghrad and Ansarian, this issue can
be seen after proper planning and implementation of the change management process is due
to some internal barriers within the organisation (2014). After the whole change management

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process this type of issues can become a real problem for such organisation as Homerton
university Hospital, as vast amount of time and money is invested in this change management
process.
3.b Strategies to overcome the identified barriers:
Kotter’s 8 steps:
A discussion is done here to identify the application of the Kotter’s 8 step process to
overcome the issue regarding organizational changes.
(Figure 1: Kotter’s 8 Step Model)

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(Source: toolshero.com)
Now these processes are discussed in details in this context:
Remove obstacles:
Due to fear for changes many people in the organizations do not accept change at the
organizational level. The main reason behind this is the inability to overcome the personal
barrier. Hence according to the Kotter’s 8 steps process, in order to implement change in the
organization, the important step is to identify the barriers both at the organizational and the
personal level. Involving all of the employees in the change process is not only required but
essential step as well for successful change implementation at the organizational level (Small
et al. 2016). Thus for the Homerton University Hospital it is important to identify the barriers
which are creating problem for EPR implementation phase. Also, the Homerton University
Hospital must identify individual barriers that are protesting against the EPR implementation
or creating problem in EPR implementation.
Build a Guiding Coalition:
In previous step of Kotter’s 8 step model individual barriers and the organizational
barrier has been identified. Thus for proper implementation of the EPR system guiding
collation can be built as per Kotter’s 8 step model. This step of Kotter implies that, a project
team need to be established for the Homerton University Hospital that can occupy itself with
the projected changes. Also, this project team will manage all the efforts and will encourage
the employees of Homerton University Hospital to corporate with the change (Auguste,
2013). Thus the EPR system can simply be implemented in the Homerton University
Hospital.

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Create a Vision for the Change:
As the project team has been formed now it is the time for Homerton University
Hospital to execute the changes. It is very much essential for the hospital to execute the
changes in a proper way for apt implementation of EPR in Homerton University Hospital.
Now, the third step of Kotter’s 8 models can be used to formulate a clear vision that can help
to understand what changes the Homerton University Hospital is trying to achieve.
Communicate the Vision:
Creating vision for the change will have no implication if it is not communicated
properly throughout the organization. Thus once the vision for the change is developed, it
needs to be communicated throughout the organization. If the communication is not proper, it
creates confusion for the change among the employees of Homerton University Hospital.
Thus proper communication about determined vision is required for the Homerton University
Hospital for creating support and acceptance among the employees (Allen and Shanock
2013). By proper communication concerns, opinions and anxiety of the employees can be
understood and proper actions can be taken if required. Also, by communicating the vision
changes can be fully adopted in Homerton University Hospital.
Creating sense of Urgency:
Creating urgency of Kotter's 8 step model can be useful to mitigate the challenges of
lack of proper planning. By developing a sense of urgency proper communication can be
done among the various department of organisation. Shirey stated that creating urgency will
ignite the initial motivation for the change management process (2013). Through creating this
urgency environment for the change management process, a perfect plan can be created and
that can be used for executing the change management process in a step-by-step manner.
Thus the change management process will be a hassle free one for hospital.

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Create Short Term Wins:
Creating short term wins can be very much effective for dealing with the low
employee morale. The Change management processes can be so lengthy that employees
might lose their patience during the Change management process and can be demotivated
towards it. In this type of situation creating short term wins can help to motivate employees
again. By creating short term wins early victory taste can be provided to the employees,
which can motivate the employees towards the Change management process (Ortiz‐de‐
Mandojana and Bansal, 2016). This will also boost the overall process of Change
management for the hospital.
Consolidate Improvements:
Build on the change is also an important step of Kotter's 8 step model. This step of
Kotter's 8 step model can be very much useful for adopting new technologies in the
organisation. As per Kotter, many of The Change management process fail because victory is
declared too early. Real changes require a strong base. Quick wins are only the beginning of
long term goals. Thus improvements are always required to make the system more stable.
Now the main challenge in the change management process that many employees will not
understand is the new system implementation. Thus in this case, build on the change step can
help by providing proper training to the existing employees so that they become familiar with
the new implemented system (Elnaga and Imran, 2013). In this way this step of Kotter's 8
step model can be very much useful adopting new technologies in the hospital.
Anchor the Changes:
Ineffective changes are a real issue which can be found due to the change
management within the organisation. Ineffective changes means, the changes which have
been implemented and not working properly though proper process and planning has been

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followed during the change management process implementation. This issue can be fixed by
anchoring the changes in corporate culture which is one of the steps of Kotter's 8 step model.
The implemented changes are needed to be strict within the organisation and it should
become a part of the core of the organisation. In many cases the implemented change might
not work at the initial stages. In such of the cases continuous efforts are required to ensure
that the change is working properly respective of organisational change (Georgalis et al.
2015). This will also help to ensure a place of the change within the culture of organisation.
Support of the leaders and the staff members at the hospital are required for successful
implementation of these changes has stated earlier in this report. Thus by this step the issue of
ineffective change can be solved easily.
Conclusion:
From the above discussion, it can be concluded that the process of organizational
change is very much important for achieving some particular objective of the organization. In
this case by implementing the change the Homerton University Hospital is trying to get more
improved service for the patients and an efficient patient management system. Here the main
barriers regarding the change are the fear of unfamiliarity with the projected change,
ineffective leadership, broken or poor communication and the complexity of the
organizational change process. With that the other barriers regarding the Change management
are the lack of proper planning, low employee morale, adopting new technologies and
effective changes. To mitigate these barriers Kotter’s 8 step has been utilised in this case. All
of these 8 steps are able to mitigate the change related issues which the Homerton University
Hospital is currently facing. Fear of unknown or unfamiliar is tackled by various steps of
Kotter's 8 step process of Change management. Following that ineffective leadership issue is
handled by building a guiding coalition. In this context, the broken communication is fixed
by creating a vision for change. Following that misunderstanding organisational change issue

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is fixed by communicating the vision of the change. Ineffective change issue is fixed by
anchor the changes in corporate culture. Low employee morale is also a huge problem for the
organisation which is tackled by creating short term wins which is also a step of Kotter's 8
step process of Change. Adopting the new technologies can also become a problem in many
cases and for this case it is handled by build on the change. Thus the Homerton University
Hospital, can successfully implement the changes regarding the EPR system by following the
Kotter’s 8 step model. This will allow the change management process to be completed
smoothly without any type of problems.

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