Implementing and Sustaining Transformational Change in Healthcare

This essay delves into the implementation and sustainability of transformational change within healthcare, specifically focusing on clinical process redesign. It examines the principles and strategies employed in redesigning clinical processes to improve the delivery of healthcare services, drawing on examples from the National Health Service in the UK and the Institute of Healthcare Improvement in the US. The essay highlights the importance of elements such as leadership, data access, and team-based problem-solving in driving successful change. It critiques the provided arguments, pointing out the lack of supporting evidence, such as primary data and quantitative analysis, which makes it challenging to fully assess the impact of clinical redesign. Despite these limitations, the essay acknowledges the potential of process redesigning as a tool for enhancing service quality, patient safety, and operational efficiency, emphasizing the significance of patient-centric approaches and continuous improvement. The essay also discusses key aspects of sustaining these changes, including the role of management in setting standards and motivating staff, and the importance of flexibility and persistence in the redesign process. Ultimately, it concludes that clinical process redesign is a crucial pathway for enhancing healthcare delivery, with a focus on the patient journey and the involvement of staff and patients in identifying and resolving issues.

Essay

Table of Contents
Topic - Implementing and sustaining transformational change in health care: lessons learnt
about clinical process redesign....................................................................................................1
REFERENCES................................................................................................................................3

Topic - Implementing and sustaining transformational change in health care: lessons learnt about
clinical process redesign
A research was conducted in which the main objective was to analyse how sustainable
change can be brought in health care through processes. Also, it has been investigated about
redesigning of clinical process in bringing improvements delivering of health care services.
Besides this, it has been discussed about principles that can be applied in changing process. The
principles applied by author have been undertaken through overseas programs that are National
Health Service in UK and institute of health care improvement in US. For this secondary data
was gathered and analysed from database (Willis, Cameron David, et a1 2016). The principles
are clearly stated through which services can be delivered in effective way. In this it was found
that NSW health and Flinders medical centre have undertaken clinical redesign process. Hence,
secondary data is been collected from there and analysed.
There are several examples given related to redesigning of clinical process. In Sydney
web technology is used to provide real time information to managers. Through this, major
improvements are observed in quality of services.
The study concludes that process redesigning is powerful tool for improving delivery of
care services (McGrath, 2008). Through this, it has provided benefits in many areas such as
safety, flow of information, etc. thus; it has helped in generating effective results and improving
quality of services. It is stated that with support of experience in redesign of clinical process,
sustainability can be brought in delivery care services. Besides this, there are other key elements
as well through which process can be improved. They are leadership, access to data, team based
problems solving, etc. In study it has been clearly defined about each principle with an example
that how will help in changing process.
As critiqued by Silver, Samuel et.al., 2016, clinical redesign process is not entirely about
changing care practices, but focusing on changing system of delivery services. It enables in
developing a smooth flow of process by eliminating repetitive steps. The solutions are applied
initially at first stage and then in entire practice. It has been evaluated that in this the main focus
is on patient’s journey. They are categorised on basis of similar needs. This makes it easy in
finding out particular procedure to deliver care practice.
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As said by Parston, Greg, et.al., 2015, it is essential to understand patient needs so that
journey is simplified. It is done by communicating with them. For this a lean thinking concepts is
applicable. It is easily understood by staff that how care services has to be delivered.
No, the arguments are not supported by evidence. This is because no facts or figures are
been provided. Also, there is no target population defined and primary data gathered. Therefore,
no analysis is done that to evaluate redesign of process and its impact on service delivery.
Therefore, it is difficult to agree with author concept. But at some point evidence is provided
from data of UK and US. So, it has been useful in highlighting significance of redesigning in
clinical process.
By interpreting article it is clearly observed that there is a lot of information which is lacking
in it. There is no gathering of primary data on basis of which analysis is done. Besides this, no
statistical and facts and figures related to redesigning of process is included in it. Furthermore,
the author has only analysed theoretical information related to topic. Also, no quantitative
analysis is been done to evaluate benefits of changing process and its impact on quality of
services. Therefore, it is difficult to identify whether clinical redesigning has been helpful or not.
Alongside it, there is no exact information about different elements mentioned that how it has
benefited in improving process. Due to lack of numeric data it is difficult to understand what
change has occurred in delivery process (Willis, Cameron David, et a1 2016). Also, the author
have not given any valid justification that why leadership and management plays an important
role in clinical process. Moreover, there is no sample size or method selected on basis of which
data has been gathered. However, there is no model or theory described that can be applied in
redesigning of care service. Alongside this, it is only explained about different ways through
which sustainable process can be created. Furthermore, if article included any statistical data it
would be easy to justify arguments given. However, by gathering statistical data and information
from secondary sources could have been easy in concluding that implementation is successful in
delivery care services. Moreover, each element of success can be compared with each other and
from that the most effective one is selected.
It can be concluded from article that clinical process redesign is an important way through
which delivery of care services can be improved. Also, it has saved time and resources required
in it as well as improved its quality. The redesigning has improved overall mechanism. Through
this, changes are been made in ongoing process. Apart from it, this concept is been promoted to
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create or develop new processes. At last an example is been given where process design was
done in Flinders medical centre. There performance of staff was evaluated and weak areas were
identified. Then, accordingly on regular basis issues were resolved. In this redesigning was
implemented by proper management. A standard process was developed by writing summary. It
gave direction to redesign process. The summary was displayed on computer screen and a
handbook was provided to each division.
The study also summarise about how leadership and management are useful in delivery
clinical process. With the involvement of staff and patients problems can be identified. The main
information that is required in it is data or evidence. So, on basis of this targeted outcomes of
patients are determined and goals are developed. The major changes can be observed in cases
where intensive and emergency care has to be provided. But the main outcome of redesigning
depends on customer journey. This is because in some cases journey is complex so many
projects are developed. Moreover, redesign process is different at local and unit level. It also
differs for hospitals as well. It was implemented in NSW health in UK. It is also been concluded
that patient and carers has to be involved in solving issues. This is because sometime patient with
no experience also helps in giving useful advice. Furthermore, in order to redesign effective
process patient experiences must be included.
As critiqued by Ryan, Rosemary et.al 2015, it is also analysed that rather than designing it
is important to have persistence and flexibility in process. This is because flexibility helps in
removing iterative process. For this plan, do and study model is ideal. Here, it is easy to do
improvement on basis of reflective learning. Another thing in process redesign is to maintain
sustainability. In many projects it is most difficult task to do. Thus, a dynamic process comprises
of three basic elements that are standard work, maintenance and continuous improvement. It
represents cycle of sustainability.
As elucidated by Benzer, Justin et.al., 2017, management helps in setting of standards to
drive change. By engaging with staff goals and objectives are set. This has been easy in setting
parameters and developing strategies. It has been highlighted in FMC that senior people
supported in developing a clinical process through redesigning. They successfully analysed
customer journey. Alongside it, management also motivates by taking feedback and appreciating
them. For instance, in NSW director general visited hospitals to evaluate clinical redesign
process. So, it highly motivated the staff and management.
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It is necessary to maintain quality and standards of redesign process. This is because if
process is not designed properly then through standards its efficiency can be maintained. In
addition to it, standards assist in providing direction through which process quality is maintained.
Along with this, setting of some criteria makes it easy to determine what resources are to be
used. Hence, resources can be changes if process is not effective.
It has been discussed that the best way to start process of redesigning is identification of
issue and fixing it. The best way to do this is conducting short meetings with staff and managers.
By this solutions are designed by gathering and analysing data and information from them. Then,
at last implementation is done. The staffs play a vital role in this as overall success and failure of
process depends on them. It was found that staff excitement motivates them to implement
process with current resources. The achievements inspire them to innovate further and obtain
results.
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REFERENCES
Books and Journals
Benzer, Justin K., et.al., "The role of organizational structure in readiness for change: A
conceptual integration." Health services management research 30, no. 1 (2017): 34-46.
McGrath, Katherine M., Denise M. et.al.,. "Implementing and sustaining transformational
change in health care: lessons learnt about clinical process redesign." Medical Journal of
Australia 188, no. 6 (2008): S32.
Parston, Greg, et.al., "The science and art of delivery: accelerating the diffusion of health care
innovation." Health Affairs 34, no. 12 (2015): 2160-2166.
Ryan, Rosemary W. et.al., "Nursing leader collaboration to drive quality improvement and
implementation science." Nursing administration quarterly 39, no. 3 (2015): 229-238.
Silver, Samuel A.. et.al., "How to sustain change and support continuous quality
improvement." Clinical Journal of the American Society of Nephrology 11, no. 5 (2016):
916-924.
Willis, Cameron David, et al. "Sustaining organizational culture change in health
systems." Journal of health organization and management 30, no. 1 (2016): 2-30.
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