Change Management in Hospital Settings: A Case Study Analysis

This report examines the implementation of change management within the orthopedic ward of Raffles Hospital, focusing on issues such as staff shortages, infection control, and hazardous substances. The author, a nursing student, observed these challenges and analyzed the need for change management. The report details the application of Lewin's change management theory, including the unfreeze, change, and freeze stages, and the role of a change agent. It discusses the implications of change management on professional practice, highlighting the importance of staff training, technology integration, and stakeholder engagement. The report emphasizes the significance of the Singapore Nursing Board (SNB) Code in ensuring patient safety and ethical conduct. The study concludes that change management is crucial for addressing challenges, improving existing systems, and maximizing patient care in a hospital setting. The report also reflects on the author's learning experience and how the implementation of modern technology and change management will help in their future career.

Running head: CHANGE MANAGEMENT
Change Management in Hospital Settings
Name of the Student:
Name of the University:
Author’s Note:

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Table of Contents
Introduction......................................................................................................................................3
Description of the clinical experience.............................................................................................3
Theoretical analysis.........................................................................................................................4
Implication of the professional practice and management..............................................................6
Conclusion.......................................................................................................................................7
References........................................................................................................................................8

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Introduction
Safety issue becomes a major issue in the hospital settings. However, in the orthopedic
ward infection occurs easily, which affects both patients and the nurse. In the hospitals, nasty
bags are present, which creates infection (Busse, Aboneh & Tefera, 2014). In the orthopedic
section, infection occurs during the intervention period. The nurses face challenges to correct
such problem effectively. This study deals with the implementation of change management to
deal with the problem in hospital settings.
Description of the clinical experience
As a nursing student, I am currently working in the orthopedic ward of Raffles Hospital.
However, I have observed the critical situation in this ward. It has been received by me that
infection and staff shortage is a very common problem of the orthopedic ward. After the surgery
often infection takes place in the body part of the patients due to lack of proper care and
medication. Therefore, the presence of hazardous substances is another big problem in the
orthopedic ward. Risk and bacterial infection occur from the hazards. This is due to the lack of
proper cleaning and care process. Another big problem is the shortage of staff in the orthopedic
ward in Raffles Hospital (Rrafflesmedicalgroup.com, 2018). Lack of safety and less number of
staffs create a problem, which leads the nursing student to take extra pressure during their work.
As a nursing student, I have to carry out long hour duty due to lack of staffs. Therefore,
inappropriate maintenance in the orthopedic ward creates a problem for the patients as well as
for the nurse. In order to deal with this problem, it is crucial to bring change in this ward. In
Raffles hospital, change management is required in their orthopedic ward to improve its quality
and care process.

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Theoretical analysis
From the above analysis it has been received that in Raffles Hospital, shortage of staffs
and inappropriate maintenance of hazardous substances create issues in this ward, which affect
the health of the patients, work of the staffs and image of the organization. In order to deal with
this situation, change management is crucial. The authority of Raffles hospital has decided to
increase the staff number and to implement the hazard control strategy to reduce this current
issue. In order to do this, they have recruited the part-time staffs and implemented the redesign
process and automation technology to deal with the challenges. However, recruitment of the
part-time staffs will be effective for an organization to provide 24 hours care to the patients
(Hayes, 2018). In the orthopedic department, continuous care is crucial during the intervention
period. However, the inefficiency of the previous system leads this organization to implement
change in this ward.
Change agent is involved in bringing change in an organization. In Raffles Hospital, the
new manager in the HRM department is involved in implementing this new change. The
competencies of this manager include good listening skill, analytical and skill and proactive
nature. In order to implement a change, it is crucial for an organization to develop a clear
concept of change management. According to Lewin's change management theory, unfreeze,
change and freeze are the major three steps of change management (Al-Balushi et al., 2014). In
unfreeze stage, the managers are able to create the importance of change among the employees
and make them ready for the change. In the second stage the transition occurs in the old system.
In freeze stage finally, the implemented change will be reached in stable condition. The staffs

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and the nursing students of Raffles Hospital will be able to manage the new changes in the
orthopedic ward by following this theory.
The nursing students have followed this theory and gave shape to the new system in this
organization. They have helped the part-time workers to learn the work procedure in the
orthopedic ward. All the nursing students and staffs are trained by the experts to understand how
to deal with the hazards in the orthopedic ward. Providing training is an effective way to improve
the knowledge of the staffs in an organization (Birnkrant et al., 2018). By using change
management concept the workers of this organization are able to identify the areas of
improvement. On the other hand, change management enables the staffs to use new technology
in the existing system. For example, automation, ventilation, redesigning and robotics enable the
staffs to eliminate the hazards from the orthopedic ward (Ginter, Duncan & Swayne, 2018).
Hence, incorporation of these new technologies in the orthopedic ward allows the nursing
students and staff to gather more knowledge and handle the crisis.
Response of the people is a crucial part of the change management. In Raffles Hospital
the change management process needs a positive response from both internal and external
stakeholders. This will bring success by implementing a change management process. However,
stakeholder resistance is a big barrier of the change management (Ginter, Duncan & Swayne).
Often the patients and the staffs show resistance towards the new changes in an existing system
as they think that new system may hamper their comfort zone. In the context of Raffles Hospital,
some staffs and patients were not happy with this new change. Hence, they need high motivation
from the management. Hence, the managers and the nursing staffs use effective communication
strategy to explain the importance of this change among the patients. Recruitment of the part-

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time staffs, use of technology and training are effective for the nursing students to reduce hazards
and work pressure from the orthopedic ward.

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Implication of the professional practice and management
The above analysis shows that poor maintenance creates infection in the orthopaedic
ward after the surgery. On the other hand, shortage of the staffs is another big issue that hampers
the care process of the patients and the nursing students need to carry out long duty. Recruitment
of the part-time staffs, training and incorporation of the new technology facilitate the care
process and handle the current challenges. Implementation of the change management allows the
nursing student to improve their knowledge in care process (Kash et al., 2014). As a nursing
student of the orthopaedic ward I have learned that change management is crucial to deal with
any type of challenge in the hospital setting. Change management improves the existing system
and introduces new way to deal with the challenges. It has been received that a large number of
part-time workers are required to provide 24 hours care and reduce the work pressure. Therefore,
redesigning helps the staffs to improve the infrastructure of the hospital setting. By using
automation technology and ventilation system the bacterial infection can be removed (Birnkrant
et al., 2018).
This change management through the implementation of modern technology will help me
to access the new modern technology in my future work. As a nursing student, I will be able to
boost my career by reducing the hazards substances though utilizing the technology. SNB Code
for Nursing and Midwives 2018 includes various practices to set out the professional conduct.
This SNB Code provides a framework for the nurses and midwives to maintain the standard of
the care process (Healthprofessionals.gov.sg, 2018). It has been received that safety issue and
staff shortage are the major issues of the orthopedic department in a hospital setting. The fifth
principle of SNB practice shows that the nurse and midwives need to be responsible and carry

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out their work in an accountable manner. The nurses should ensure the safety in the workplace
and maintain the ethical principle. Therefore, the nurse needs to identify the risk and to promote
workplace safety. This principle supports the change management process in the context of
Raffles Hospital.
Conclusion
The entire study focuses on the issues in the orthopedic ward that are faced by the nurses.
It has been received that poor safety and staff shortage are then vital challenges in this ward. In
order to deal with these challenges implementation of change management concept is crucial. On
the other hand, change management improves the existing system by ensuring safety in a
hospital setting. Incorporation of new technology and recruitment of the part-time staffs are vital
changes that can maximize the care process.

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References
Al-Balushi, S., Sohal, A. S., Singh, P. J., Al Hajri, A., Al Farsi, Y. M., & Al Abri, R. (2014).
Readiness factors for lean implementation in healthcare settings–a literature review.
Journal of health organization and management, 28(2), 135-153.
Birnkrant, D. J., Bushby, K., Bann, C. M., Alman, B. A., Apkon, S. D., Blackwell, A., ... &
Sheehan, D. W. (2018). Diagnosis and management of Duchenne muscular dystrophy,
part 2: respiratory, cardiac, bone health, and orthopaedic management. The Lancet
Neurology, 17(4), 347-361.
Busse, H., Aboneh, E. A., & Tefera, G. (2014). Learning from developing countries in
strengthening health systems: an evaluation of personal and professional impact among
global health volunteers at Addis Ababa University’s Tikur Anbessa Specialized Hospital
(Ethiopia). Globalization and health, 10(1), 64.
Ginter, P. M., Duncan, W. J., & Swayne, L. E. (2018). The strategic management of health care
organizations. John Wiley & Sons.
Hayes, J. (2018). The theory and practice of change management.
Healthprofessionals.gov.sg (2018). Code for Nurses and Midwives. Retrieved on: 09 July 2018,
from: http://www.healthprofessionals.gov.sg/content/hprof/snb/en/topnav/
announcements/Code_for_Nurses_and_Midwives_2018.html

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Kash, B. A., Spaulding, A., Johnson, C. E., & Gamm, L. (2014). Success factors for strategic
change initiatives: A qualitative study of healthcare administrators' perspectives. Journal
of Healthcare Management, 59(1), 65-81.
Rrafflesmedicalgroup.com (2018). Raffles Orthopaedic Centre. Retrieved on: 09 July 2018,
from: https://www.rafflesmedicalgroup.com/specialist-centres/services-by-centre/
orthopaedic