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Analysis

Analysis Performance Improvement Plan Dynamic?

The healthcare industry is a very dynamic and interesting industry. There are lot of stakeholders in this industry and an active participation of different stakeholders is required to have effective health care management system in place. One of the key objectives of health care management system is support the healthy community (Janamian & Upham, 2016). A healthy community is one in which all members are able to live their lives freely and without extenuating health issues that interfere with quality of life. Healthy communities are clean, the members are respectful towards each other, and community members all take part in keeping the community nice. Part of keeping a community nice is not leaving certain groups out of the community and not aiding those in need. In recent times, the stakeholders have realized the benefits of using technology and Information System to manage health care needs. Health Management Information Systems (HMIS) are one of the six building blocks essential for health system strengthening. HMIS is a data collection system specifically designed to support planning, management, and decision-making in health facilities and organizations (Janamian & Upham, 2016).

Building upon a sound understanding of contributing factors that lead to health degradation, Healthy People 2020 strive to create environments that combat and reverse health problems such as tobacco use, obesity and physical inactivity. As these are the major contributors to morbidity and mortality in Australia, a concerted effort needs to be made to reverse them. This paper would discuss the role of leadership in developing a performance improvement plan in the area of HMIS. The specific health related practice that would be discussed in this paper would be the use of Information Technology or Health Care Management System by health care organizations to increase the educational and awareness level of health care community (Maddern & Courtney, 2006). The paper would focus on large hospitals and health care institutions in Australia, as the use of HMIS is high for large organizations as compared to small hospitals.

Authors argued that many challenges need to be overcome in order to address the ground level problems and the effective use of technology. Local, state and federal government need to agree in the laws that regulate the use of Information System in health care. There are various areas in healthcare that requires or that demands the support of effective leadership at top. The initial research suggests that servant leadership is the style that is most effectively connected with the effective leadership in health care industry (Siriwardena, 2006). The role of leadership, change management plan, and various other part of this report can be discussed as:

Role of leadership in HMIS

To attain the complete benefits of healthcare management system, all the stakeholders in the organization should have a common understanding of the drivers and benefits of HMIS. It is critical that different stakeholders should not have their own perception about HMIS. The key role of leaders is to understand the expectations of different stakeholders and to ensure that all the stakeholders are on same page. It is critical that the leaders and public health professionals should focus on providing education to people about the risk of unhealthy habits (Sullivan, 2013). Also, it is imperative to provide guidance and support to programs such as free smoking environments and cessation programs. Leaders should model and set regulations that encourage healthy habits. For example, talk to the manager of a company to create a free smoking area, build a gym onsite for all the employees, and conduct free healthy cooking classes. Education leaders should incorporate a stronger focus on health education and childhood obesity. Issues of health disparity and factors that contribute to them are immense and oftentimes hard to overcome. A solid and growing understanding of how these disparities become present is the beginning of abating them. Through a strong focus on how these issues occur there then can be action which allows for effort to overcome them (Son & Chuck, 2011).

It is evident that the implementation or optimization of any HMIS needs big change in the organization. Therefore, it is crucial that the health organization has god the strong leadership that can steer the change in the organization (Sullivan, 2013). The types of leadership that can bring the change successfully for the performance improvement plan for HMIS implementation can be discussed as:

There are various leadership types and styles that leaders can follow. Authors argued that transformational leadership style and servant leadership style are the best leadership styles that would be best to manage the change of this sort (Sullivan, 2013). These two leadership styles and their impact on change of HMIS implementation and optimization can be discussed as:

The transformational leadership style would be one of the most suited style in this scenario as the focus of the leaders is to transform the business from current state to desired state. The effective and efficient implementation of HMIS would need transforming the current way of operations (Marquis & Huston, 2015). With the transformational leadership style, leaders follow on the end state and end objective. To implement the performance improvement plan, the leaders must have a vision in place.

Leadership types to bring the change

The advocate of servant leadership style believes that the leaders should lead from front and they should first follow. The servant leadership style focuses on doing the things rather than getting the things (Son & Chuck, 2011). It is important that leaders should be committed to take the organization forward by bringing the changes in the healthcare information management system. It is crucial that leaders must be willing to serve others.

It is suggested that the organization should use the Kotter change management model to bring the change in the organization. The logical diagram of Kotter change

management model can be shown as:

As shown in the above diagram, the leaders must first create an urgency to implement the change. These phases of Kotter change management model to implement the change of HMIS can be discussed as:

Phase 1: Create Urgency – This is the first phase of change management plan. In this phase, the leaders must communicate the drivers of change to different stakeholders. In this phase, the leaders must understand the vision associated with the change and the same should be explained to the internal and external stakeholders (Sullivan, 2013).

Phase 2: Form a powerful coalition – The implementation of any big change may have the resistance from internal or external stakeholders. This is the phase in which leaders must form strong partnership or coalition with different stakeholders group. This partnership could be fruitful only when the stakeholders are convinced about the drivers of change.

Phase 3: Create a vision – In this phase, the leaders must create the vision of the change to different stakeholders. It is important that an end-state should be associated with the change and it is the role of leaders to create this end state to different stakeholders.

Phase 4: Communicate the vision – In this phase, the leaders must communicate the vision of the change to different stakeholders. It is important that an end-state should be associated with the change and it is the role of leaders to communicate this end state to different stakeholders. The leaders would be able to gather the support of stakeholders only when this vision is communicated to different stakeholders (Kotter & Schlesinger, 2008).

Phase 5: Empower Action – This is the phase in which the leaders would decide the change agents and the empowerment should be given to the change agents. The empowerment of change agents or the employee empowerment is necessary to have effective implementation of change in place.

Transformational leadership style

Phase 6: Create quick wins – To take maximum benefits of the change, leaders must first focus on low hanging fruits. It is the responsibility of leaders to create the avenues of quick wins. The possibility of quick wins not only generates the confidence in the team but it also keeps the momentum going.

Phase 7: Build on the change – This is the phase in which the change is matured in the organization. In this phase, the focus is to derive the benefits from the change. In this phase the leaders must work together with employees to understand various intricacies and risks involved in the change management process.

Phase 8: Make it stick – Once the change is implemented, it is important that the organization can get the continuous value from the change. It can happen only when the leaders could keep the things moving with the change (Kotter & Schlesinger, 2008).

It would be correct to say that the change management would work best only when the organization that wish to implement HMIS has got the supporting culture. This is one of the reasons that leaders must communicate the reasons or the drivers of change to all the employees of the organization. For any sort of change in the area of technology, it is important that the organization should have an agile culture in place (Grol & Bosch, 2007). The people in the organization should be willing to change and they must not apprehend the change. It is the responsibility of leaders to ensure that people support the change. The culture of the organizations should be supportive where the employees can reach out to leaders to clarify any doubts. It is recommended that the leaders should be available to interact with the people and employees at different levels. It would create a feeling of self-belongingness among the employees and would ensure that the change could be implemented in a successful manner.

It is so challenging to get a more multi-faceted, multi-disciplinary approach to addressing public health outcomes because there are so many barriers making it so hard. First of all, multi-disciplinary approach needs a policy change and it is difficult in a first place to know which policy will be more effective. Then, more data are needed in order to achieve a multi-disciplinary approach when wanting policy change. Finally, people need to understand more the importance of social determinants in order to successfully have everyone involved in this. It is the role of public health professionals to achieve more public awareness so that people understand the importance of social determinants (Hindle & Braithwaite, 2006). The specific challenges and facilitators in the change process can be discussed as:

Servant leadership style

As discussed above, one of the key challenges in this performance improvement plan would be change management. In order to implement this performance improvement plan, leaders would have to manage a big change in the organization. There is always a possibility that the existing employees in the organization may not want to switch to technology and Information Systems. Resistance to change is one of the biggest problems in healthcare.  Many people who are use to doing things the same way that they've done for many years are typically the one's that resist the most (Baars & Evers, 2010). That makes it difficult for everyone as a whole, because if there is division among the group, then there is a potential for a compromise in patient safety.  Resistance can cause harm, because the reason why change takes place is to improve the overall system.

Another key challenge would be cultural challenges and the failure to understand the ground level issues. Within nursing many experienced nursing leaders understand nursing in general but may not appreciate the subtleties of perioperative nursing or some other sub specialty. So what seems like a simple solution to the leader may seem simplistic to the nurses. Challenges certainly change circumstantially (Westphal, 2005). A strategy that is proceeding well this week may suddenly falter next week because of a change in the circumstance. Again, the change may not be readily apparent to the leaders but may be palpable at the line level.

The four functions of management (planning, organizing, leading and controlling) can be leveraged to assist organizations in implementing successful innovations and change management by:

  1. Demonstrate value creation: This step can be related to the planning function of management which is the key function because it involves the process of determining ahead of time what needs to be accomplished, when, by whom, how, and at what cost. Planning can contribute greatly to success as well as productivity. Planning also is about determining any organization’s goals and objectives
  2. Generate business model options- This step can be related it to the organizing function of management because it involves establishing structures and systems through which the organization objectives will be defined and coordinated. This is where management can strive to create that unique product or creating a culture that’s unique only to the organization, which stands out and sets that organization apart in its uniqueness.
  3. Prioritize the risks: This step can be looked at as the leading function of management. Leadership can identify variables that are likely to have the most success, which leads in cultural alignment, and best-practice management processes, which can effectively transform the organization (Scott & Mannion, 2003).
  4. Reduce risk through business experiments: This step provides a window of validation so it can be related to the controlling function of management where the leadership teams or management can leverage to create a meaningful, manageable, and sustainable strategy for fulfilling an innovative vision.

 It would be correct to say that benchmarking is a powerful tool for organizations to keep themselves updated. In Australia and in other parts of the world, there are various examples of successful implementation of HMIS (Healthcare Management Information Systems). The organization that wishes to bring the performance improvement plan and change in the field of HMIS can use benchmarking to learn from the successful implementation of other players in the health care industry. Isouard & Messum (2006) lays out how important it is to actually manage transitions rather than to just dream them up and tell people to change. One way to deal with resistance is to show people that the change is truly necessary and to allow them to help get themselves through the loss of the old and on to the acceptance of the new normal. With the use of benchmarking, the organization would be able to learn the industry best standards.

Steps required or implementation plan

It would be correct to say that nurses would be a key stakeholders and it is never easy to keep nurses motivated. Nursing is primarily concerned with throughput and resource management while the doctors and PAs are concerned with quality and not missing any problems which might lead to patient harm and legal issues (Jones & Redman, 2000). Meanwhile ancillary services such as Lab and Housekeeping have smaller windows of concern over the piece of the puzzle that they deal with. All of the concerns are legitimate and must be given some weight. If rooms are dirty and lab tests are not reported in a timely way then the concerns of both the nurses and doctors are not going to be met. This challenge is solved by Information Systems and relationships, understanding, conversation, and standard work processes (Isouard & Messum, 2006). Relationships help because they break down the ‘us-versus-them’ walls that people tend to have. It is easy to see one’s own priorities but often difficult to understand competing priorities of others. As people relate they begin to understand and appreciate the considerations that others use when looking at problems. Conversations enhance this understanding and open vistas to collaboration and consensus. It is suggested that leaders should use Maslow need hierarchy model to keep nurses motivated. The Maslow model can be shown as:

The leaders should start with the basic need of employees and then should move forward to address the higher level needs (Mickan & Boyce, 2006). It is also important to mention that different set of employees in the organization can have different motivation level. The efforts should be made by leaders to manage the motivation need of different set of employees differently.

Conclusion

The above paper discusses the performance improvement plan in the area of implementation of healthcare management information system for large organizations or hospitals in health care system in Australia. With the above discussion it can be said that the implementation of HMIS would certainly bring large changes in the organization and it is important that the organizations and leaders should be willing to drive the changes in the organization. The paper discusses the Kotter change management model that should be used to bring the change in the organization. It is important that the leaders must understand the motivation level of different stakeholders before making any decision

References

Baars, I.J., Evers, S.M., Arntz, A. &  van Merode, G.G. (2010). Performance measurement in mental health care: present situation and future possibilities. International Journal of Health Planning Management, 25, (3), 198-214

Grol, R., Bosch, M.C., Hulscher, M.E., Eccles. M.P. & Wensing, M. (2007). Planning and studying improvement in patient care: The use of theoretical perspectives. The Milbank Quarterly, 85, (1), 93–138

Hindle, D., Braithwaite, J., Travaglia, J. & Iedema, R. (2006). Patient safety: a comparative analysis of eight inquiries in six countries. Sydney: University of New South Wales.

Isouard, G., Messum, D., Briggs, D., McAlpin, S. & Hanson, S. Improving Organisational Performance.  In Harris M.G. & Associates. (2006). Managing Health Services: Concepts and Practices. Sydney: Mosby Elsevier. pp. 349 – 380.

Janamian, T., Upham, S.J., Crossland, L. & Jackson, C.L. (2016). Quality tools and resources to support organisational improvementintegral to high quality primary care: a systematic review of published and grey literature. Medical Journal of Australia. 204(7) 22-28  Retrieved on 27/01/17 from https://www.mja.com.au/sites/default/files/issues/204_07/10.5694mja16.00113_Appendix%204.pdf

Jones, K.R. & Redman, R.W. (2000). Organizational culture and work redesign: Experiences in three organizations. Journal of Nursing Administration, 30, (12), 604-610

Kotter, J.P. & Schlesinger, L.A. (2008). Choosing strategies for change. Harvard Business Review, July-Aug 2008, 130-139

Maddern, J., Courtney, M., Montgomery, J., & Nash, R. Strategy and organisational design in health care. In  M.G.Harris & Associates (2006). Managing health services: Concepts and practices. Sydney: Mosby Elsevier. pp. 270-280.

Marquis, B.L. & Huston, C.J. (2015). Organizational structure. In Leadership roles and management functions in nursing: Theory and application (8th ed.pp.260-283).

Mickan S.M. & Boyce, R. Organisational change and adaption in health care. In M.G. Harris & Associates (2006). Managing health services: Concepts and practices. Sydney: Mosby Elsevier. pp 67-78

Scott, T., Mannion, R., Davis, H. & Marshall, M. (2003). Implementing culture change in health care: theory and practice. International Journal for Quality in Health Care, 15, (2), 111-118

Son, C., Chuck, T., Childers, T., Usiak, S. Dowling, M., Andiel, C., Backer, R., Eagan, J. & Sepkowitz, K. (2011). Practically speaking: Rethinking hand hygiene improvement programs in health care settings. American Journal of Infection Control, 39:716-724.

Siriwardena, A. N. (2006). Releasing the potential of health services: translating clinical leadership into healthcare quality improvement. Quality in Primary Care, 14(3), 125-128.

Sullivan, E.J (2013). Effective leadership and management in nursing (8 th ed.) Upper Saddle River, New Jersey: Prentice-Hall.

Westphal, J.A. ( 2005).  Resilient organizations. Matrix model and service line management. Journal of Nursing Administration 35(9), 414-419

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