Leadership Ethics and Planned Change: A Healthcare Perspective

This report examines the implementation of electronic health information management in an oncology hospital, focusing on leadership ethics and planned change. The study details the hospital's transition from manual to electronic information systems to address increasing patient demand and impr...Read More

Running head: LEADERSHIP ETHICS AND PLANNED CHANGE 1
Leadership Ethics and Planned Change
Student’s Name
University Affiliation

LEADERSHIP ETHICS AND PLANNED CHANGE 2
Abstract
Planned change is going against the status quo. Although they will be met by equal resistance,
what needs to be recognized is the diversity of human reaction to a new phenomenon particularly
when cost will be incurred. Some will take a longer time to adjust; others will take the slightest
of the available opportunity to adopt the new technology. Both will singly and collectively lead
to the realization of innovations in not only health information management but will extrapolate
to other sectors. Ample time, therefore, needs to be given to enable the majority to embrace the
technological advancement to simplify work
Introduction
Planned change is going against the status quo (Caldwell et al., 2012). Some will be
willing to adjust while others will be reluctant to change. An effective organization change, for
that matter, requires a combination of strong ethical leadership skills to balance conflict of
interest from employees, the board of directors, the patient populations and the planned change
to realize success. My experience as a health practitioner will assess the adoption of electronic
health information management in a hospital I worked at to discuss effective change
management paying attention to resistance to change and the ethical leadership applied.
Hospital overview
I worked at an oncology hospital in our country as a health practitioner for two years.
However, the hospital has never witnessed any challenge with regards to managing information

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of their patients since the hospital was just introduced into the market. It started as exclusively
inpatient with an intention to attract more health seekers as well as increase their revenue.
Planned change
One of the planned changes created in the hospital during my practice as a health
practitioner was the abolishment of the use of manual information acquisition and retrieval to
their low population patients and developing electronic information system. This system
primarily involved maintenance of information in files that were coded and arranged in sequence
depending on the admission date. This information could be kept for a long time and could also
be acquired any time of need. There was a planned need to change form the manual storage to
electronic storage of information. As the organization progressed with its services meeting the
cancer patients’ needs, the hospital witnessed overwhelming demand. All the resources of the
organization were stretched and everybody had to contend with working overtime to ensure all
are served. A lot of changes followed that involved adoption of an electronic information system
to help in controlling long consultation and admission queues. However, with the beginning of
the increase in the population of the patients, the use of the electronic system was introduced.
This allowed for the safe storage of information as planned by the hospital management.
The effectiveness of the strategies witnessed resistance and how it was solved.
The adoption of the electronic health information involved multiple approaches that were
not limited to; formulation of an implementation team drawn from across the hospital
departments. The typical team included nurses, physicians, medical assistants, administrative
staff and compliance office staff with each playing a distinctive role. The lead physician guided

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the organization throughout the adoption process linking the frontline users to the administrative
staff and technical users. The project leader, on the other hand, works in conjunction with the
vendor and all the staffs to ensure the stakeholders remain focused on their timelines, monitor
project progress as well as maintain routine practices. This ensured continuity of hospital
operations at the same time a new system was being installed contrary to an earlier speculation of
hospital closure. However, there was a low turnout of the caregivers particularly those who lack
technical expertise for fear of being underrated. What followed is a duplication of machines to
facilitate sharing of knowledge in the interim period until a time when everybody has been taken
through formal training. A stand by personnel recorded patients’ particulars as the physician
undertook the examinations. The final result was then keyed in as he watched. The hospital,
therefore, made insignificant lose as opposed to when it could have closed. Some of the junior
staff also preempted being laid off, and new staffs who are technologically updated will take
their places. The initial discussions in private and public forums created fear that adversely
demoralized their work performance (ShokriZadeArani & Karami, 2010). A formal
communication and involvement during meetings reaffirmed a commitment to ensure that
everybody is as per the required technical know-how (Cummings, Bridgman & Brown, 2016).
The next was to configure the software so that each healthcare giver would access the
database from their working locations. This involved the consultation of the health IT vendor to
secure the electronic system to render it tamper proofs from internal and external threats.
Hardware needs identification followed suite where there was a need to seek for professional
guidance to effectively identify the most cost efficient hardware (Feo & Kitson, 2016). After
hardware needs have been determined, data transfer from the files would follow. The hospital
outsourced individuals and combined with its data management team to migrate data from the

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earlier manual systems prior to a patient’s next visit. The outsourced personnel were on a
temporary basis to save on time that would have been undertaken by the few administrative staff.
Nonetheless, the boards of directors were hesitant to provide good will as they perceived such
moves to require unnecessary spending yet they can be achieved in phases ignorant of the fact
that they were postponing a risk where they would incur more cost regarding consistent system
upgrades to accommodate emerging system needs. It would have also burdened the care givers
and the health administrators to migrate the information at the same time serve the waiting
patients that would have consumed a lot of time. Demonstrating the cost benefits by the
management softened the affirmative of the directors. It also acted as a proof of highest level of
trust the Board of Directors bestowed on the management staff that will go a long way in
delivering services to the satisfaction of all the stakeholders (Cummings et al., 2016).
There was also need to identify and ideally lay out a room that would provide favorable
operations of the electronic system. There was an urgency to redesign the front office to create
more space to accommodate the health records staff as well as system administrators. However,
the established format ensured that the physicians could see the patients while using a computer
that compromises the need for patient privacy and engagement medical codes of conducts
(ShokriZadeArani & Karami, 2010). There is a need for adoption of a ‘triangle of trust’ design
which allows for strategic location of patient, physician, and computer to enhance
communications. The best way to design a ‘triangular’ configuration is through the adoption of a
semicircular desk which provides for direct face to face connection between the physician and
the patient. Alternatively, place the computer on a cart that can be adjusted into position at the
physician’s convenience in the examination room to enhance physician-patient communication.
The only challenge is the board of directors’ perception of investing in such a system who finally

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fail with no opportunity to recover the incurred cost. The other portion voted unanimously for the
adjustment of the examination rooms to incorporate the new health information management
system (ShokriZadeArani & Karami, 2010).
The final face would involve a training plan to equip the current employees on how to
operate the new system. The training took the form of administration of bulletins and operation
manuals that the care givers can go through in their free time with regards to system functionality
(Shirey, 2013). There is, however, a great need to provide continuous improvement to keep the
employees updated on any new system functionality demands. The training required an extra
time at the work place which faced mixed reactions. Most of the care givers demanded an
overtime pay that will increase the overall cost of hospital operations. The hospital boards of
directors were reluctant to adopt such a recommendation for fear of operating above budget.
Nonetheless, the management requested the healthcare practitioners to volunteer part of their
lunch and tea breaks to at least grasp a concept of the upgraded system. The management, in
turn, used the tea breaks and weekly strategic meetings to undertake the training that limited time
and cost that would have been incurred. Volunteering time is a pointer to the good working
relationship and a non-coercive urge to acquire new technological skills (Shirey, 2013).
What is in doubt about the implementation of the new system is the provision of a course
of action in case of system failure. Care givers would revert to the manual system that would
appear cumbersome as they are used to the electronic thus the patient particulars could suffer
from human errors. The errors could find their way when the new system will be put up that will
translate into performance or administration of substandard care; a recipe for intensified legal
jeopardy diminishing the established positive rapport with the target population. The backup

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generator only serves the surgical room but should be extended to the examination room (Lussier
& Achua, 2015).
Summary and Conclusion
After a successful formulation and implementation of a new electronic health record
system, there was easy access to the patient’s medical history. The care givers were able to
identify previous treatment regimens provided and thus evaluate their effectiveness and whether
there is a need to adjust to a new treatment with ease in contrast to the manual records where
tracing an individual patient’s file would take a lot of time. In addition, the system ensured a
better coordination of care as care givers can easily locate an individual patient from other
referral clinics (Menachemi & Collum, 2011).
The overall organization performance increased as staff and patients have less to no
physical form to fill making the clinicians devote more time to the care of the patients. The
overall effect is a patient satisfaction that will translate into more revenue. There was a remarked
reduction in the billing errors occasioned by miscalculations to serve long queues (Menachemi &
Collum, 2011).What is realized from my experience as a health practitioner is that the future of
health information management depends on the actions taken today. Although they will be met
by equal resistance, what needs to be recognized is the diversity of human reaction to a new
phenomenon particularly when cost will be incurred. Some will take a longer time to adjust;
others will take the slightest of the available opportunity to adopt the new technology. Both will
singly and collectively lead to the realization of innovations in not only health information
management but will extrapolate to other sectors. Ample time, therefore, needs to be given to
enable the majority to embrace the technological advancement to simplify work.

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REFERENCES
Caldwell, C., Dixon, R. D., Floyd, L. A., Chaudoin, J., Post, J., & Cheokas, G. (2012).
Transformative leadership: Achieving unparalleled excellence. Journal of Business
Ethics, 109(2), 175-187.
Cummings, S., Bridgman, T., & Brown, K. G. (2016). Unfreezing change as three steps:
Rethinking Kurt Lewin’s legacy for change management. human relations, 69(1), 33-60.
Feo, R., & Kitson, A. (2016). Promoting patient-centred fundamental care in acute healthcare
systems. International journal of nursing studies, 57, 1-11.
Lussier, R. N., & Achua, C. F. (2015). Leadership: Theory, application, & skill development.
Nelson Education.
Menachemi, N., & Collum, T. H. (2011). Benefits and drawbacks of electronic health record
systems. Risk management and healthcare policy, 4, 47.
Shirey, M. R. (2013). Lewin’s theory of planned change as a strategic resource. Journal of
Nursing Administration, 43(2), 69-72.
ShokriZadeArani, L., & Karami, M (2010). The impact of information technology in improving
the health care system from the perspective of Shahid Beheshti hospital staff. J Health
Info Manag, 8(6), 835-41.