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Literature Review

Healthcare organizations functions with varied professionals from different background (Anderson, 2010). Leaders in healthcare have greater responsibilities to handle and manage such responsibilities such that they are able to manage and tackle complex responsibilities and overcome any pertinent issues facing the same. However, while handling professionals from a diversified background leaders needs to maintain effective communication skills to handle employees. While dealing with patients in healthcare a leader need to pay attention to each and every inputs received from a diversified range of professionals and then take decisions pertaining to a patient (Lee, 2008). Especially in palliative care in has been seen that as it is an end of life care greater amounts of inputs needs to be taken in order to render care and make the patient overcome his or her current conditions. The scope of this report analyses pertinent communication challenges that has led to problems within the scope of a healthcare organization by root cause analysis and then adopting change management practices to overcome the same. Toot cause analysis was incorporated in order to understand and develop deeper knowledge regarding the situation which then allowed to conceive a prominent understanding regarding the subject matter (Cronenwett, 2007). A literature review has been accommodated for incorporating the complex concept and then analysis of the situation pertinent has been developed to arrive at the key situation facing the healthcare organization.

Root cause analysis is a problem solving technique that is incorporated within organizations to understand the cause that leads to a certain problem. Root cause analysis is incorporated for identifying underlying faults or problems to particular situations, that prevents a particular situation from reoccurring (Wu, 2008). Root cause identification in any kind of problem can render its solution, whereas identification of casual factor might remove the problem for the time being. RCA is a methodological procedure that analyses root causes of events rather than arriving at symptomatic results. Identifying the center of any type of problem helps eliminate problem from its bases such that it does not reoccur again. It encompasses a reactive method for revealing any problem and its subsequent analysis post occurrence of a particular event (Berry, 2012). RCA encompasses various tools, philosophies as well as processes that has a system based origin. Hence, while analyzing for root cause in a particular problem factors as magnitude, timing, location and nature of the event has to be diagnosed along with its harmful outcomes. Generally team effort is required for identifying root cause to a particular problem and arriving at its solution will be determined by way of identifying various alternatives to the solution. A RCA systems and processes needs to be documented for future references (Taitz, 2010). In organizations often RCA is adopted for better productivity and attainment of organizational goals in a better way.         

The process of change management is a method of transiting individuals or teams such that resources can be redirected to meet organizational processes. An organizational change management process considers every aspect of the organization that requires change hence it is rather used as a tool that is stressed on changing individuals within organizations. The process is focused on the management to handle teams in such processes. Change management involves transition of practice from one to another for betterment of a condition or in overcoming an issue. The process of Change Management involves a step by step procedure that is initiated to arrive at a destined situation (Carter, 2008). In case of every change management generally a leader is handed responsibility to oversee conduct of the tasks, then final goals are ascertained. Post evaluation of situation or initial change processes, the deviation from the goals has to be identified such that proper steps can be followed for the same. In change management processes employees are prepared for handling the circumstances and then changing over to the process such as final goals can be met. Employees and other relevant stakeholders needs to be convinced during the process of change management such that they participate in the processes and helps attain goals as well as productivity for final procedures (Young, 2009). A steady transition into change processes requires that procedures are properly implemented and steps undertaken such that current situation can easily be overcome. A change management procedure is generally adopted for arriving at a desired destination by identifying relevant gaps that exists. Following step by step change management procedure helps arrive at processes that entails incorporating new steps and procedures within the purview of organizational culture for delivering advantages to the same (Klaus, 2014). There are various pertinent models of change that provides transition into a new arena. Such change management procedure is incorporated such that structured and smooth processes are deployed that can yield success and achieves long lasting benefits. There can be various pertinent reasons for incorporating the process of change as it is required to match productivity, outputs and various other objectives. The scope of the current change management is to cater to effective services in healthcare. Hence, it can be said that organizational change impacts all its departments along with its employees (Hayes, 2014). An entire organization is made to learn effective change management procedure, however such changed processes can be positive or negative in nature directly impact morale of the employee. John Kotter provided a change management model that incorporates a guided 8 step procedure for leading through change. The factors that determines whether a change is successful or not is stakeholders achievements, assessing risks and effective communications. Monitoring or implementing a successful change management procedure is also integral along with periodic review of the same (Mitchell, 2013).         

Analysis of Issue

Leaders within organizations need to adopt changed procedure and processes with basic assumptions as costs, returns on investments, cultural issues and so on. Leaders within organizations also needs to overcome employee resistance during the process incorporating or overcoming change. The aim of change management is to realign strategic objectives to newly formed and designed goals to overcome a challenge (Turner Parish, 2008). Thus, the process of change management can require counseling of employees such that they attain fine tuning to deliver the changed processes. However, there might be pertinent factors that dampen the process of change management with difficulties in integrating and final aligning of objectives. Employees’ inertia or unwillingness to change can greatly hamper and dampen all efforts made to overcome a change management process (Paton, 2008). Employees are often apprehensive for any types of change and hence lacks necessary motivation to include in it. A large number of people as well as teams are impacted by the process of change management within organizations hence it becomes relevant to establish and obtain steady guidelines from upper management necessitating the process of change (Tomey A. N., 2009). 

In the current origination there are multiple types of conflicts regarding roles and responsibilities. It is integral in palliative care that roles and responsibilities are defined uniquely such that patient can receive maximum care and support (Lambton, 2010). However, conflicts regarding such roles can lead to suffering of patient as well as loss of life. Conflicts is however is the outcome that is faced by the organization regularly that has led to disruptions in work procedures leading to psychological impact on employees, staffs and nurses. Root cause analysis of the relevant issue provides that such conflicts are regarding roles and leader has greater responsibilities regarding the same (Akerjordet, 2008). The leader within the healthcare organization has not been able to create distinctive responsibilities for each person within the purview of the organization. In order to render palliative care doctors, nurses, staffs and employees works hand in hands taking regular feedbacks and ensuring that necessary care is provided to patients such that maximum amounts of relief can be provide to them (Sherwood, 2007). A leader in such organization takes input from every participant within the framework of the organization who is responsible for handling the patient and then makes decisions as to what medications and course of therapy has to be provided to particular patient. As nurses are closest to patients and deliver them care it becomes pertinent that inputs from all necessary stakeholders be provided. In case of discrepancy the leader is responsible for holding meetings and in deciding the course of action that needs to be taken (Nicolini, 2011).     

Diagnosis of the root cause to the problem indicates that the leader is self-centered and considers his opinion to be the final in case of delivering judgments regarding patients. The attitude of the leader has led to incompetency in handling of patient parties and also in conflicts amongst various internal stakeholders as doctors, staffs and so on. The attitude of a leader is critical in its role played such that he can deliver according to particular situations (Tomey A. N., 2009). A leader in healthcare organization has become one after staying in the nursing role since long periods of time. Thus, it was expected that the leader had necessary understanding the various roles delivered by members of the organization while taking care of their patient and handling patient parties. A leader is a key communicator between the upper management as well as lower strata of employees to deliver responsibilities. A leader makes use of his personal charisma, attitudes and other factors in determining the effectiveness and efficiency of his team members (Roberts, 2007). An enhanced communication system and processes allows a leader translate goals and objectives into deliverable courses of action. As in this case the leader due to his personal attitude failed to communicate relevantly to the teams regarding the deliverables resulting in conflicts and clash of interests. Thus, communication has been identified as the key aspect that can deliver effectiveness to a leader in handling complex roles and responsibilities. In case a communication is not maintained it can lead to arising of conflicts and other possible challenges (Sandström, 2011). Communication enables translating of objectives from one party to the other and in maintaining relationships. IT is through steady communication that a person within an organization understands delegation of responsibility and undertakes challenges. Through steady and transparent communication a leader can easily win trust of various employees and gain followers for carrying gout necessary actions. Conflicts arise when there is absence of communication and leader is unable to handle the complex demands and cater to needs of individuals (Wong, 2007). In such a situation pertinent changes needs to brought about within the scope of the organization such that the prevailing situation can be overcome and new processes can be adopted. Leadership issues are extremely pertinent within organizations and needs to be overcome such that the organization can attain its future goals.      

 Recommendation and Conclusion 

From the above analysis of the root cause problem it can be understood that change management processes can help overcome the problem. The state of the current situation requires that a change in leadership practices be brought about such that the organization can reduce its conflicts substantially and emerge as a good organization to work for. As the change management procedure initiates with the vision incorporating the changed state, in this case the vision is to free the organization of conflict or to direct them towards positive conflicts. The healthcare organization needs to cater to its patients in a better way such that employees also experience high levels of satisfaction in their working. Employees need to have a psychologically stable and conducive environment where they receive steady communications from their leaders such that they feel motivated to deliver productivity. As in case of current organization there is a conflict in roles and responsibilities leading to conflicts, the leader need to consult all stakeholders regarding their problems. Then a procedure such as regular weekly meeting or any form of regular communication needs to be initiated. Further each individuals roles and responsibilities needs to be delegated in the organization display board such that there prevails no confusion regarding the same. Each patient needs and demands has to be assessed and evaluated and a proper worksheet that is used for recording activities needs to be added to the same. The leader needs to preview such charts periodically such that goals can be aptly met, further delegation of responsibilities will also ensure that there are no clashes in roles.

While incorporating this procedure a step by step and a periodic assessment needs to be made. Further all internal stakeholders of the organization needs to be consulted prior to incorporating in the change, their agreeableness regarding each and every procedure is essential to yield benefit to the changed processes and deliver results. No change management processes can be successful without it being accommodated by the employees. The change management within the scope of the current organization is necessary as well as integral as it is hampering organizational proceedings and lowering morale of employees. Employees and staffs are the key stakeholders within organizations who render effectiveness and deliver productivity. They are the immediate face for the organization hence need to face issues pertaining to patients first. Thus, if they are not well equipped and handle complex challenges as well as responsibilities then there might be greater issues and challenges. Patients and patient parties interact on a regular basis with such staffs and employees. They receive every input and feedback necessary regarding each patient, which they need to communicate to their leader such that appropriate treatment can be rendered to them. But without the scopes for such communications there will be high levels of conflicts as well as greater challenges that might hamper the entire working within organizations.                      

 Reference Lists

Akerjordet, K. &. (2008). Emotionally intelligent nurse leadership: a literature review study. Journal of Nursing Management, 565-577.

Anderson, D. a. (2010). Beyond change management: How to achieve breakthrough results through conscious change leadership. John Wiley & Sons.

Berry, P. A. (2012). Novice nurse productivity following workplace bullying. . Journal of Nursing Scholarship, 80-87.

Carter, E. (2008). Successful change requires more than change management. The Journal for Quality and participation, 31(1), 20.

Cronenwett, L. S. (2007). Quality and safety education for nurses. Nursing outlook, 122-131.

Hayes, J. (2014). The theory and practice of change management. Palgrave Macmillan.

Klaus, C. (2014). Change Management. . Grundlagen und Erfolgsfaktoren.

Lambton, J. &. (2010). Conducting root cause analysis with nursing students: best practice in nursing education. Journal of Nursing Education, 444-448.

Lee, H. O. (2008). Factors influencing job satisfaction of front line nurse managers: a systematic review. Journal of nursing management, 768-783.

Mitchell, G. (2013). Selecting the best theory to implement planned change: Improving the workplace requires staff to be involved and innovations to be maintained. Gary Mitchell discusses the theories that can help achieve this. . Nursing Management, 32-37.

Nicolini, D. W. (2011). Policy and practice in the use of root cause analysis to investigate clinical adverse events: Mind the gap. . Social science & medicine, 217-225.

Paton, R. a. (2008). Change management: A guide to effective implementation. . Sage.

Roberts, A. B. (2007). Community pharmacy: strategic change management. McGraw Hill.

Sandström, B. B. (2011). Promoting the implementation of evidence?based practice: A literature review focusing on the role of nursing leadership. . Worldviews on Evidence?Based Nursing, 212-223.

Sherwood, G. &. (2007). Quality and safety curricula in nursing education: Matching practice realities. Nursing Outlook, 151-155.

Taitz, J. G. (2010). System-wide learning from root cause analysis: a report from the New South Wales Root Cause Analysis Review Committee. Quality and Safety in Health Care, qshc-2008.

Tomey, A. M. (2009). Nursing management and leadership. Elsevier, Missouri. 

Tomey, A. N. (2009). Nursing leadership and management effects work environments. Journal of nursing management, 15-25.

Turner Parish, J. C. (2008). Want to, need to, ought to: employee commitment to organizational change. Journal of Organizational Change Management, 32-52.

Wong, C. A. (2007). The relationship between nursing leadership and patient outcomes: a systematic review. . Journal of nursing management, 508-521.

Wu, A. W. (2008). Effectiveness and efficiency of root cause analysis in medicine. . Jama, 685-687.

Young, M. (2009). A meta model of change. . Journal of Organizational Change Management, 524-548.

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