Facilitating Change In The Health And Social Care Sector - A Case Study Of Royal United Hospital Essay.

Change can be defined as the series of actions or steps that has the potential to alter the organizational practice in the field of health care. Change can come in health care as the means of organizational changes, transforming the nature and delivery of care (Watts et al. 2015). Health care is a people focussed industry and alike any other people focussed industry there is a lot of economic, societal and environmental factors that can drive changes in the entire system of health care (Munn-Giddings and Winter 2013).

The changes that affect the operation and practice of the health and social care organization can only be implemented through a number of interconnected steps (Watts et al. 2015). Measuring the impact of the changes also contributes to the improvement of the quality standards of the organization. Apart from that an organization cannot implement changes or improve their operational standards without a proper monitoring body in place (Wager, Lee and Glaser 2017). The monitoring also ensures that the interests of all the stakeholders associated with the operational changes are safeguarded. This report will explain in detail all factors associated with facilitating change in the health and social care sector as per the guidelines of the CQC report taking the example of a renowned UK based hospital, Royal United Hospital.

There can be a lot of factors that contribute to the upheaval of changes in the health and social care sectors. This section of the assignment will focus on the all the factors that can be instrumental in facilitating change in the health and social care sector taking the example of Royal United Hospital, United Kingdom.

One of the vital factors responsible for facilitating change in the field of health care is the economic factor. With the global financial crisis at the pinnacle, the cost to health and social care is rising continuously, and as the costs continue to reach sky high, there are more and more changes in the health and social care system to make it affordable for the mass (Drummond et al. 2015). The pressure of cost cutting is affecting the care quality and changing the standard of health care absolutely.

Another decisive factor in the health care field is the changes in the societal outlook, the changing and rising expectations of the consumers or the patients have mandated the health care to become flexible and easily accessible. That is the reason why there are multidisciplinary teams at the service of the patients so that they can avail the treatment they need at one step with any hassle (Zavras et al. 2012). This has surely been a revolutionary change in the health care system fuelled only by changing expectations of the patients.

Economic factors

A by-product of the current changes in the societal structure is the rapidly changing recruitment condition, along the years the female workforce have started to dominate the health and social care field. Internationalization of the work force is another monumental change in the health care sector, these two changes have made the existing working pattern modified and diversified to a large extent (Feldstein 2012).

Internet and the virtue of world-wide-web cannot be overlooked and it has made a substantial place for itself in the medical sector as well. The importance of knowledge on to the field of medicine is tremendous and the introduction of internet databases has made a significant change in the quality of health care in the RUH (Kondilis et al. 2013). Apart from that national and global health care policies and programs also deserve a place in the discussion in my opinion, as they have contributed their part as well in changing the face of health care (Watts et al. 2015).

For example the NHS workforce has expanded clinical knowledge to such an extent that it has become a prime contributor in the transformation of health and social care. It has brought clarity ad discretion in the roles and responsibilities of all the different sectors of health and social care workforce that has care delivery and standard for the better (Grol et al. 2013).

In accordance to the changing economy and societal structure the operational environment of the health and social care had also changed. As the government regulation increases over health care, the pressure for the regulatory authorities to improve the performance has changed their professional and operational environment. The new age of consumerism is focused on the patient satisfaction, and for that reason the care needs are affected drastically (Purnell 2012). However the national authorities have started new schemes to increase the knowledge and skill of the health and social care professionals who have undoubtedly heightened the care standards but the majority of organizations are abusing this golden opportunity to pool budgets and expenses. However the entry of charitable and nongovernment organizations like care trusts, women and child welfare trusts are also a significant a change in the old health care system (Flottorp et al. 2013). Apart from that the dehydration policy taken up by most of the hospitals are another important change, often the dehydration is either misdiagnosed or diagnosed late in the patients, specifically in the elderly. Health care facilities like the RUH, have taken interdisciplinary hydration assessment of all newly admitted patients mandatory and within 21 days. These changes are transforming the health care standards day by day (Best et al. 2012).

Societal factors

All these factors have contributed to some extent to the improvement or deterioration of the health care system, each of the factors have their own sets of benefits and challenges. In order to understand the implications and impact of these changes on the health and social care industry the help of a SWOT analysis taking the example of RUH can be taken.

It is clear from the SWOT analysis above that there are a lot of threats associated with the changing scenario of health care. Inevitably there are and will continue to be a lot of challenges in the way for the health and social care system to overcome in order to excel in this dynamic economy.

• It has to be considered that health care is a public service, not a commodity to purchase that is heavily influences by the socio-economic factors. And the recent changes in the health and social care are centred around the socio economic factors to a large extent (Riekert, Ockene and Pbert 2013).
• The nosedive in the quality standard of the hospital due to the rising competition is a major concern in the health and social care industry, the competition is a huge contributor to it as it is mentioned in the SWOT analysis (Cameron, and Green 2015).
• To elaborate it further, the competition to the health care sector is escalating the pressure on the health care professionals to satisfy the patients. Furthermore pressure of the regulatory authorities like the kind of NHS constantly invigilating the operation and practice of the health and social care system has become a burden for the health care authorities top manage the standard of care while keeping up with the regulations and patient demands (Halfon et al. 2014).
• Another threat to the hospitals like RUH due to the changing scenario can be the rising popularity of multidisciplinary teams. While, it undoubtedly ensures that the patients will be receiving high end care for all aspects related their health concerns, however it narrows down the scope of practice for the health care professionals with no opportunity to acquire new skills (Riekert, Ockene and Pbert 2013).

It has to be considered that to overcome any challenge it is important to devise a strategy to combat the key areas of threat that the change poses, and it is important to measure the change and the extent of it. There are a number of methods and techniques that can be incorporated to measure the changes. This task will attempt to shed some light on the different measures that can be incorporated to successfully and optically measure the changes in the health and social care system. Along with that this portion of the assignment will also discuss the impact of the changes that has been discussed in the previous section and evaluate the consequences of the impacts (Baker and Eccles 2013).

The first step of devising any strategy to measure the changes that has been brought forward in the health care industry is the inclusion of the association with the change and the strategies with the key stakeholders of this industry and correctly identifying those stakeholders. The key stakeholders of the health care industry are all the different individuals or group of individuals who are affected or will be potentially affected by any change in the health care industry (Kondilis et al. 2013). The internal stakeholders of the hospital are consumers, care providers, targets and goals, drug market, technicians, and the management and the administration associated with a hospital, and the external stakeholders are the regulatory authorities, invigilator and supervisors and the media.

According to my understanding, planning the measurement needs should be the next step in the course and in order to do so, the professional might need to look for existing medical data, patient feedback, staff feedback, staff performance reports, management performance reports, audit reports and patient retention reports (Flottorp et al. 2013).

Recruitment structure

Another decisive factor to constructing change measurement strategy is to identify the right tools to choose for. In my opinion, the choice of tools can have a great impact on what information will be evaluated and how viable and genuine it is going to be (Kash et al. 2014).

For example, analysis of all the available data will be dependent on the electronic and paper record checking, where as collecting feedback will involve approaching different individual and engaging them in persuasive conversation to gauge their reaction and perception (Drummond et al. 2015).

Hence it is paramount that the professionals rely upon collecting the information, and are properly trained for the collected data to be viable and genuine.

The next step must be selection of the criteria for the measurement, establishing some benchmarks, national service framework targets, customer and staff rating, indicators of quality of life, measuring acquired skills, lifestyle improvement of the patients, dependence levels, efficacy of the staff and lastly the cost and the profit (Baker and Eccles 2013).

The ultimate step is devising tools for the feedback analysis like constructing questionnaires, surveys and group discussion And identification of the data analysis method to be used, qualitative and quantitative, based on the type of data collected.

Considering the previous CQC report, the quality improvement is at the heart of the recent changes put forth in the health and social care sector, focusing on the standardization, improvement governance, and establishment of new authorities to monitor the changes and its impact (Care Quality Commission Inspection Report 2013). We have to consider that the impact of organizational changes can be both positive raising opportunities and negative creating issues and challenges to overcome; hence measurement of the impact of the changes is vital for the survival and growth of any organization (Riekert, Ockene and Pbert 2013).

In any organization the impact of changes can influence the efficiency, cost, environment, consumer retention, and lastly staff satisfaction. And the recent changes targeted at the patient satisfaction and retention demands restructuring of the operational structure of any health care organization. The major impact of the changes in the health care sectors has been resulted in the delivery of high quality care (Appelbaum et al. 2012). The changed care standards include patient privacy, patient involvement in the treatment, compliance with the updated regulatory standards and quality benchmarks. In this assignment we have evaluated that the majority of the target market, patients in case of health and social care are, accustomed to heightened care standard and the change management should be directed at achieving this goal (Kuipers et al. 2014).

Introduction to databases

If we take into consideration the CQC visits of 2013, the changes brought forward in health and social care in general have been focussed on the changes that will bring customer retention, with well trained staff and optimal display of skills (Care Quality Commission Inspection Report 2013). It has to be considered that in the field of health and social care patient satisfaction is the ultimate decisive factor in the growth curve of any health and social care organization. Overall, the positive impacts of the recent changes are in accordance to raise the patient care provider ratio, with more and more qualified human resource personnel at the service for all the patients. Another positive impact of the recent changes can be the inclusion of digital or electronic data storage and usage of different databases. All these changes have improved the reputation of health and social care organizations and increased the care standards substantially however there still are some grey areas where more attention is needed (Hayes 2014).

Change comes only with appropriate effort, and without appropriate service respond from all the health and social care professionals, it will be impossible to implement successful changes within the healthcare sector (Kuipers et al. 2014). If we take the example of United Kingdom, the mass is already accustomed with high standards of care facility. Hence to heighten their satisfaction levels the health and social care sector has to elevate their operational standards much higher (Smets, Morris and Greenwood 2012).

Taking the example of RUH as the health and social care organization based in UK, to implement the change the organization will need a strong leadership and management program to ensure that the changes are implemented in accordance to the guidelines (Care Quality Commission 2012). The first step in the right direction should be the cooperation and collaboration among the entire staff, it is vital that the staff operate in harmony so that the care delivery is optimal. Another important factor in facilitating change and improvement is the effective communication to coordinate all the changes and ensure that they are being practiced diligently (Wager, Lee and Glaser 2017). Overall, the management of the RUH must focus on inclusion and involvement of all the employees in the improvement program and will also involve the consumers and their preferences in the program so that the changes lead to more patient-centred improvisations (Swayne, Duncan and Ginter 2012).

Operational environment

Change is always welcome in any organization if it does not threaten the structure and welfare of the organization, and in order for preventing implementation of change from being detrimental to the growth curve of the organization, it is important to employ proper change management. There are a few key principles that can guide the organization through successful change management (Mockford et al. 2012). For example in John Kotter’s model there 8 interconnected steps, that address inspiring the employees, team building, effective communication, empowerment, recognition, and most importantly determination, practicing all these steps can ensure change management in an strategic manner. It can be instrumental in reducing resistance to the change and creating a sense of rightful ownership.

In my opinion, the evaluative model by Elizabeth Kubler-Ross can also be implemented in this scenario, this model has five steps emphasizing the grief cycle in change management (Halfon et al. 2014). This model of change management is much more focussed on the reactions of the individuals and undoubtedly is the best choice for health and social care sector (Best et al. 2012). The five stages of this model are the denial, anger, bargain, depression and acceptance and encompass the reaction of individuals to implementation of any change. Measuring and addressing the response to change can serve as the best method to manage the change and its outcome, be it desired or not.

Change in health and social care must be implemented carefully, as the implementation of change does not only impact the staff and management but also the safety and welfare of the patients. In case of the Royal united hospital as well, the change planning should be precise, sustainable and with patient safety in mind (Best et al. 2012).

The first step in the planning should be detection of the issues, conflicts both external and internal that can drag down the progress of the implementation process. The next step should be involvement of the staff to share views and concerns regarding the dilemmas (Mockford et al. 2012). It has to be considered that involving all possible stakeholders in the evaluation process of any issue can only increase the possibility of these change being implemented successfully and elevating the care standards (Frieden 2014).

In my opinion, followed by the discussion process, the selection of a few strategic evaluative steps is important, as that can address the issue under consideration and will also be in accordance with the suggestion and recommendation of all stakeholders (Groves et al. 2016).

Implications of these factors

In order to elaborate further, monitoring the implementation of change is a crucial process to the success of facilitating changes. The responsibility of the management lead is to ensure that all the possible hindrances are effectively removed and the staffs contribute to bringing change in harmony and satisfaction. Evaluating the change management requirements overall, in my opinion, the very last step in line must be to supervise and monitor diligently over the practices going on in the hospital so that there is no potential harm to the growth and reputation to the hospital and changes are being made in accordance to the CQC guidelines (Care Quality Commission 2012).

Feedback is the best method to monitor the progress of the change in health and social care industry. The feedback can be acquired formal or informal, surveys, interviews or any other method of data collection. Taking the example of the evaluation of change management of RUH, the best evaluated manner to collect feedback is to interview the staff of the hospital; however focus groups and audit reports can also help in the monitoring (Chandra and Skinner 2012).

For instance, in order for there to be quality vigilance in the hospital, there is need for a audit or feedback committee to observe the practicality of the situations during implementation of change. This will ensure that the entire staff will be under pressure to comply with the requirements of the changes outlined by the CQC report (Care Quality Commission 2012). Furthermore, another evaluative technique that the management of the RUH can use is the spot checking system, where the authority will employ invigilators that will conduct sudden or surprise check of responsibilities and practice of different employees (Cameron, and Green 2015).

Therefore it can be said that there are meticulous steps to the management and monitoring of the changes but implementation of this steps will ensure that the change management is executed without disrupting the daily operational structure of the hospital and will also ensure that these steps will safeguard the benefits of the patients and the staff at the same time (Schoen et al. 2012).

Conclusion:

Health and social care is changing, and it is changing fast, there is no denying the transformations that have occurred in the health care sector in the last few years. It also is just the tip of the iceberg, with the rapidly deteriorating lifestyle of the society and the escalating demands of the same, satisfying the demands of the public while complying with the guidelines of the of the regulatory authority is going to be tough. However, it also has to be considered that changes are brought forward to facilitate improvements, not just for the patients but also for the care providers. Hence, facilitating change in the health care sector might be difficult and complicated even, but in the end it is going to be beneficial for both parties. Furthermore, from the discussion of the entire assignment it can be clearly concluded that with the right strategies and steps successful implementation of change is possible.

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