Introduction
The effective work of the health care sector is one of the basic features of contemporary society. The health of the nation is the primary concern of the government, which means that the constant improvement of the work of facilities belonging to this sphere acquires the top priority. The increasing number of challenges and diversification of clients’ needs peculiar to the existing environment means that there is a need for radical change to replace outdated practices and establish a new framework that will be able to promote the better work of care providers and cultivate better outcomes. Under these conditions, management within health care organizations acquires the top priority as one of the ways to critically evaluate the functioning of various units and implement desired improvements by facilitating radical change. However, such programs might produce challenges for all clinicians engaged in the work of the sector, which means that there is a need for sufficient resolution.
Background
Today, management is viewed as an approach to achieve better outcomes for a particular organization by introducing positive change. It can be determined as a process of planning, organizing, leading, forecasting, coordinating, and controlling all available resources of a unit in a way that helps to achieve the existing goals (Buchbinder and Shanks, 2016). It means that the application of the basic assumptions of management is vital for the elimination of ineffective or inappropriate patterns and their replacement with new ones (Buchbinder and Shanks, 2016). For the healthcare sector, the theory becomes more specified as it is focused on the means of organizing human and material resources within the healthcare setting to provide clients with the appropriate care and guarantee their recovery (Burns, Bradley, and Weiner, 2011). The given purpose can be achieved by initiating a change process aimed at the continuous improvement of all components, which is vital for the healthcare sector.
Functions of Management within the Healthcare Setting
Healthcare management includes a set of functions that emerge because of the need to ensure the appropriate delivery of care to patients and their recovery. For any unit within the given sector, it is critical to be ready to operate and treat clients, which might demand additional effort or use of specific resources. That is why the major functions of management in this setting include planning, organizing, leading, and coordinating (Buchbinder and Shanks, 2016). The correct scheduling is a key to high effectiveness as it preconditions the determination of the number of supplies, beds, workers, and equipment required to remain prepared and provide clients with the desired treatment.
Organizing is another aspect of management that is needed to align the work of the whole unit and avoid critical flaws caused by the poor understanding of the current patterns or rules (Dunn, 2015). Leading means managing the staff in practical ways for them to be able to perform their functions with the best possible outcomes. Finally, coordinating presupposes the establishment of a beneficial framework for collaboration between workers and units to guarantee the continuity of care and the ability to meet the needs of all patients (Dunn, 2015). The existence of these basic functions contributes to the effective management of health units and their improved performance.
Radical Change
Radical change programs can be considered a method that is used to introduce significant reconsideration of the work of a health unit and attain better outcomes. The need for this change might be preconditioned by multiple factors such as poor performance, inability to meet current clients’ demands, or poor communication between specialists (Dunn, 2015). Managing change means handling the complexity of all processes peculiar to the healthcare sector, which also means that it is a complex, dynamic, and challenging aspect of the practice (Ginter, Duncan, and Swayne, 2018). Any effective change includes unfreezing old behaviors, creating new ones, and re-freezing them to establish a new framework (Dunn, 2015). For radical change projects characterized by the significant scope of planned interventions and alterations, the complexity increases as there are some major challenges and issues that should be considered at external and internal levels to achieve the desired goal and accept new patterns.
Major Challenges
The central challenges peculiar to radical change programs are mainly associated with their scope and the need to consider all elements of a healthcare unit to create an effective paradigm. Moreover, predicable change presupposes time for preparation and planning; however, in healthcare changes occur rapidly, and in the majority of cases, they cannot be predicted (Ginter, Duncan, and Swayne, 2018). It introduces another challenge as there is a need for emergent actions under complex circumstances. At the same time, the radical change affects all components of the health unit and presupposes serious reconsideration of the specialists’ work, their cooperation, and tasks. It might trigger the appearance of resistance to change, decreased motivation, and reduced performance. That is why the main challenges that are usually linked to radical change are related to human resources, leadership, and the effectiveness of managerial decisions.
Resistance to Change
Resistance to change is one of the most common issues that are associated with this process. It appears when specialists consider a planned alteration as a threat to them and their status (Spath, 2017). It is characterized by reduced performance, motivation, and actions that might undermine the change process. The given challenges emerge because of clinicians’ unpreparedness to work under new conditions and meet new demands to the quality that are usually associated with the process (Spath, 2017). For this reason, the establishment of a clear vision about plans, directions, and the whole process is a key element for a successful radical transformation. Health workers should be able to understand the benefits that will be achieved due to the proposed actions and engage in the process to attain outlined goals and cultivate a new environment.
Motivation
Motivation is another issue that is linked to any transformation process. Since any change is confusing for workers, it is associated with a high level of uncertainty about the future position, the ability to meet new requirements, and other factors that would affect them in the end (McLaughlin, 2017). For this reason, the decrease in motivation levels is a common problem for the radical change process in the healthcare setting. One of the possible ways to manage this challenge is to provide security guarantees to all individuals affected by the change and explain to them the need for this alteration and the benefits that might be associated with it (Spath, 2018). The correct understanding of future demands and required skills can eliminate confusion and uncertainty, which is vital for the preservation of high motivation levels. Moreover, as far as there is a positive correlation between motivation and performance, monitoring of this aspect is critical for improved outcomes.
Financial Aspect
An effective manager should correctly realize the fact that and radical change demands significant financing as it will affect all aspects of the health unit’s functioning. For this reason, costs often become one of the serious challenges that are associated with the transformation process. The establishment of the correct price of the planned change is one of the complex issues as it might change during the next period because of emergencies or other unplanned accidents (Nowicki, 2017). Additionally, both internal and external stakeholders, along with the regulating agencies, might be unsatisfied with the proposed budget (Nowicki, 2017). Under these conditions, the most effective way to resolve this problem is the establishment of a certain cost of change that is negotiated with all actors involved in the process (Nowicki, 2017). It will help to reduce financial risks and increase the transparency of the process.
Training
The problem of costs mentioned above can be linked to the need for additional training that often comes with radical change projects. In numerous cases, the attempt to unfreeze old patterns and create new ones is followed by the need for additional education for clinicians to be able to work under new conditions and perform their basic functions providing care by new demands (McLaughlin, 2017). The creation of an appropriate schedule for training and explanation of its necessity are the main ways to overcome challenges that might be triggered by this component. The acquisition of innovative knowledge is an integral part of the healthcare sector and workers’ self-development. Under these conditions, specialists can benefit from the radical change as they will acquire new skills and experiences needed to attain better outcomes and build a successful career.
Monitoring
The successful transformation also presupposes the use of effective monitoring practices to be able to respond to any emergencies or unsatisfactory results and introduce demanded response. However, regarding radical change incentives, the major challenge comes from the scope of the project and the need to control a significant number of aspects peculiar to the functioning of a particular health unit. Under these conditions, the probability of mistakes or biased data increases significantly. It means that there is a need for practical monitoring practices that will help to avoid such problems. One of the possible solutions is the distribution of tasks presupposing the appointment of specialists responsible for the collection and provision of data about the change process. It will help to avoid the use of irrelevant data and problems with planning during the final stages of the transformation.
Leadership
Leadership plays the central role in any change process as it might have a positive effect on works and inspire them to move forward, or, on the contrary, precondition the failure of the incentive. For the healthcare setting, leadership presupposes the ability to organize and lead all workers to achieve the desired goal and attain the recovery or improvement of clients’ state (Weberg et al., 2018). For this reason, it presupposes organizational, motivational, and other activities that help to improve collaboration between all members of the staff. During the transformation projects, leaders also become responsible for decision-making and consideration of possible options to achieve the best possible outcomes. Selection of the appropriate leadership style and ways to cooperate with employees significantly affects the results of the transformation. For this reason, leaders’ competence, experience, and skills play a vital role in the radical change process.
Decision-Making
The Decision-making process is one of the central elements of radical change. Several approaches are used by managers and leaders to make decisions within the healthcare setting. One of the possible ways to avoid mistakes is the use of relevant data about the current state of the facility, problems that affect it, and the competencies of clinicians (Dye, 2017). The given information can be collected during the evaluation procedure that should precede the initiation of the radical transformation incentive (Dye, 2017). In general, an effective decision-making process considers several stages, which include problem definition, identification of limits, consideration of alternatives to choose the best one, implementation of the decision, and monitoring phase to evaluate outcomes (Weberg et al., 2018). The given approach to decision-making guarantees the absence of critical flaws; however, there is still a comparatively high risk of failure if the data is biased, or there is a structured approach to planning.
It means that leaders responsible for decision-making face a serious challenge associated with radical change. They have to accept and implement a solution that will promote the positive transformation of a unit to introduce new patterns vital for the continuous improvement and achievement of new levels of excellence. For this reason, there is also a need for constant leaders’ training for them to be able to make correct choices and organize the functioning of units insufficient way (Dye, 2017). Provision of additional knowledge regarding decision-making and planning will also help to prepare active participants of any change process as they will be able not only to follow the existing course but take part in its discussion and introduction of some changes vital for positive outcomes.
Impact of Stakeholders
Planning radical change in a health organization, it is also critical to consider the response of internal and external stakeholders as they play a vital role in its functioning. The first group consists of specialists who operate within a selected unit, or, in the majority of cases, the hospital staff (Karuppan, Dunlap, and Waldrum, 2016). They will be the first affected by the transformation as their work will be realigned by new recommendations and regulations (Karuppan, Dunlap, and Waldrum, 2016). For this reason, their support is vital for the final success of the planned intervention and its ability to bring positive change. Internal stakeholders possess the ability to facilitate or limit change by their actions and behaviors.
External stakeholders are defined as groups who are impacted by the functioning of the unit but do not work in it. These are suppliers, interest groups, patients, and competitors. Associations responsible for the effective work of the hospital also belong to the group. During the radical change process, they might act as observers who monitor transformation and offer their recommendations (Spath, 2018). The ability to guarantee support of both internal and external stakeholders is vital for positive outcomes, which means that any plan should emphasize the need for cooperation to attain improved outcomes and accomplish the existing goals.
Risk of Errors in Decision Making
The scope of changes that are presupposed by the radical transformation introduces the need for specific competence among managers responsible for decision-making and strategic planning. The outcomes of the project and its duration depend on the experience of a specialist, his/her ability to consider all existing factors, and offer sufficient solutions (Spath, 2018). Under these conditions, the risk of errors and their impact on results acquire the top priority as one of the aspects that might precondition the failure of the change. The structured and comprehensive approach to change and quality management includes the creation of specific backup plans or alternative strategies that can be implemented if the error emerges (Spath, 2018). It helps to minimize losses and guarantee that the planned results will be achieved.
The probability of a mistake is also closely related to the human factor and professionalism of individuals involved in the process. Thus, the performance of clinicians and their ability to promote positive outcomes depend on a set of aspects that impact them at the moment and affect their motivation, decision-making process, and overall understanding of current tasks. For this reason, the human factor becomes one of the major challenges that emerge about radical change. Stressful situations and the lack of understanding might stipulate the appearance of mistakes or serious reduction in professionalism levels, which is critical for the transformation.
Effective change management in a healthcare setting presupposes the creation of a positive environment that is deprived of the negative impact of the human factor and boosts professionalism in specialists. It can be achieved by introducing continuous training for specialists responsible for change management and the provision of additional information about the ways to minimize errors in decision-making (Spath, 2018). At the same time, professionalism and high performance levels can be achieved by sharing experiences with other employees who have the desired skills and competencies (Karuppan, Dunlap, and Waldrum, 2016). The given strategy is essential for managing the risk of errors during the process of radical change.
System Failures
Finally, there is also a high risk of system failures peculiar to healthcare organizations and resulting in their inability to perform their major functions during a crisis or a period of radical change. They can emerge because of the disregard of some systemic problems or problematic approaches to organizing the functioning of the unit (Karuppan, Dunlap, and Waldrum, 2016). They are usually categorized as active and latent failures to demonstrate the casual paths and manage them (Karuppan, Dunlap, and Waldrum, 2016). One of the most effective approaches to handling this sort of issue is the in-depth investigation of the unit before any radical change and evaluation of its functioning regarding the existing milestones or standards. It will help to outline the problematic issue and solve it before the emergence of a potentially dangerous situation.
Inter-organizational cooperation can also be considered one of the possible methods to avoid system failures and acquire information needed for the improved work of the unit. It presupposes sharing experiences and the creation of specific relations with other organizations within the healthcare sector to deal with complex cases and offer unusual and effective solutions to some problems (Dunn, 2015). Managing change or improvement processes, it is critical to take into account opportunities for inter-organizational cooperation as it will contribute to the achievement of better results.
Conclusion
Altogether, managing radical change within the healthcare sector is a complex process as it presupposes consideration of multiple factors that influence of work of a certain healthcare unit. The majority of challenges come from the unique nature of the selected sphere and the need to preserve the high quality of care delivery even during the transformation process. For this reason, it is essential to introduce additional training and education to prepare the staff for the planned alteration and minimize the risk of errors in decision making. Successful outcomes can be attained only by considering the most important aspects of change and providing appropriate responses to emerging issues.
Reference List
Buchbinder, S. and Shanks, N. (2016). Introduction to health care management. 3rd edn. New York, NY: Jones & Bartlett Learning.
Burns, L., Bradley, E. and Weiner, B. (2011). Shortell and Kaluzny’s healthcare management: organization design and behavior. 6th ed. Thousand Oaks, CA: Cengage Learning.
Dunn, R. (2015). Healthcare management. 10th edn. Chicago, IL: Health Administration Press.
Dye, C. (2017). Leadership in healthcare: essential values and skills. 3rd edn. Chicago, IL: Health Administration Press.
Ginter, P., Duncan, J. and Swayne, L. (2018). The strategic management of health care organizations. 8th edn. New York, NY: Wiley.
Karuppan, C., Dunlap, N. and Waldrum, M. (2016). Operations management in healthcare: strategy and practice. New York, NY: Springer Publishing Company.
McLaughlin, D. (2017). Healthcare operations management. 3rd edn. Chicago, IL: Health Administration Press.
Nowicki, M. (2017). Introduction to the financial management of healthcare organization. Chicago, IL: Health Administration Press.
Spath, P. (2017). Applying quality management in healthcare: a systems approach. 4th edn. Chicago, IL: Health Administration Press.
Spath, P. (2018). Introduction to healthcare quality management. 3rd edn. Chicago, IL: Health Administration Press.
Weberg, D. et al. (2018). Leadership in nursing practice: changing the landscape of health care. 3rd edn. New York, NY: Jones & Bartlett Learning.