Healthcare Change Management Strategies

Introduction

The change management is referred to the process, techniques and tools used for managing transition within the organisation required in the situation through adoption and realisation of change. The effective change management is required in healthcare so that it can improve the current delivery of services and safety for the service users to save money as well as ensure better well-being of the individuals. The change management required to be implemented which is identified from the practice is that waiting times for the referral regarding physiotherapy of patients are to be lowered so that the patients can receive timely care to have quality health condition. This means actions are to be taken and change in the system regarding the way physiotherapy services are provided is to be made so that physiotherapist are able to deliver timely care for patients referred by general practitioners. In order to implement this change, the Lewin’s Change Management Model is to be used along with PDSA and 5 Why’s change management tool is to be implemented in the process for explaining the way change is to be made. Moreover, the leadership approach to be taken is to be discussed. In addition, the way change is to be evaluated and communicated is to be discussed.

Background

The physiotherapy is the nature of injury or disease management in which massage, exercise and heat treatment is used as physical methods compared to use of surgery and drugs to ensure the well-being and better health of the patients (Chukhraev et al. 2017). In the UK, the current scenario of physiotherapy services for patients informs that there is lack of proper management in delivering physiotherapy services due to which patients who are referred for the services have to wait for long time to avail the support. This is evident as people trying to avail physiotherapy services in the UK on referral have to wait as long as minimum of 132 days to interact with a physiotherapist in England. It is also found that patients have to wait on an average 45 days for routine check-ups and minimum 18 days for urgent appoints with physiotherapist in England. The waiting times for physiotherapy services on referral are seen to have increased in the past 2 years in the UK (covermagazine.co.uk, 2019). This informs change in physiotherapy services on referral for patient is required so that the waiting times can be reduced to ensure quality and timely care for the patients. The physiotherapy services are mainly availed by the patients to lower pain in the body to live a painless lifestyle. Thus, the longer waiting time for availing physiotherapy services on referral leads the patients faced deteriorated health condition as a result of suffering from pain. This is because unable to avail timely care leads the patients feel pain for longer time making them at times unable to endure it and eventually develop stress and anxiety regarding their health condition (Deslauriers et al. 2017). For instance, physiotherapy services in timely manner for the people suffering from arthritis are seen to help them retain mobility and empowered to take proper care (Bearne, 2018). However, the delay in physiotherapy services for the patients making them suffering from pain regarding arthritis as well as show reduced movement in turn making them become dependent for care on the family members and carer (Deslauriers et al. 2017). Therefore, effective change in reduction of waiting time of patients who are referred by general physicians is needed as it would ensure the effective mobility of the patients suffering from pain of arthritis and other diseases which reduces their mobility.

Implementing the Change

Change Management framework

The Change Management framework informs the structure that is to be followed for generating insights regarding the way change within the organisation is to be planned (Lawrence and Frater, 2017). The change management framework to be used is Lewin’s Three Stage Change Model in making change to avoid cost-cutting and splitting the cost of physiotherapy among the patients in the NHS. According to Lewin’s Change Model, the three stages are unfreeze, change and refreeze (Wojciechowski et al. 2016). In the unfreeze stage, the changes to be made are identified and need for change is created. Moreover, the understanding of doubts and concern of staffs to be involved with the change are managed to ensure strong support is accessed in making the change at unfreeze stage (Ellis and Abbott, 2018). Thus, at the unfreeze stage, identification of the intended change would be done by evaluating and assessing the management system related to provide physiotherapy services as well as the physiotherapist who are involved in providing services to patients on referral by general practitioners (GP). This is because the analysis would inform the hindrances faced in the management and by physiotherapist which are making them create delay in delivery of services to the service users (Harding et al. 2019). Thus, assessing data developed in the process would assist the leaders in making the change by determining in which aspect alteration is required for better health outcomes. In order to create need for the change, information has to be shared in such a way so that the emotions, as well as thoughts of the people to be required in making the change, are influenced (Lv and Zhang, 2017). Thus, in unfreeze stage, to create need for the change the leaders are to inform the individuals who are to be involved in the change regarding the way current nature of providing delayed physiotherapy care is negatively impacting the patients physically as well as emotionally. This is because it would influence the physiotherapists to understand and show dedication to make the change as they would be able to determine why the change is needed. The doubts and concern of the individuals making the change are to be resolved by leaders making the change so that no confusion is raised that may withdraw individuals in implementing the change (Cameron and Green, 2019). Therefore, effective communication is to be made by the leaders making the change with the physiotherapist and managers in the healthcare settings so that their confusion can be resolved to make them strongly support the intended change.

In the change stage, the Lewin’s model informs that to empower change actions often communication is to be established, rumours are to be avoided and effective participation of people is to be made in making the change (Johnson et al. 2016). Thus, according to the stage, the leaders making the intended change of reducing physiotherapy service waiting time for the patients are to develop effective communication with the managers and physiotherapist to inform the way the change is to be made in a systematic process. Moreover, any rumours regarding the intended change to be avoided by the leaders by properly clarifying data to all individuals involved in the change. The action of the people making the change is to be empowered by the leaders by providing them effective availability of resources so that any issues which may be raised are removed ensuring smooth pathway to create the change. The plan for change which is to be communicated includes increase number of physiotherapy staffs, arrange service delivery based on priority, outsource services and arrange first-cum first-serve physiotherapy services. In the refreeze stage, the change is to be anchored in the culture and ways are to be developed so that the change is sustained (Thorpe, 2015). This informs that leaders making the intended change of reducing waiting time for physiotherapy services are to arrange ways in which the change is to be anchored in the culture. For instance, by increasing the number of physiotherapist through recruitment would help to allow reduction in waiting time as more professionals would be present to care for the increasing number of patients. Moreover, physiotherapists are to be encouraged to determine priorities regarding patients so that the individuals who require urgent care are delivered support without much delay. In addition, the physiotherapy services by the NHS are to be outsourced so that with additional assistance timely care can be provided to patients being referred. The policy and rules in the physiotherapy care centre are to be made in strict way so that any intentional delay to the patients care can be avoided from the part of the physiotherapist.

The advantage of using Lewin’s Change Model is that it allows fewer steps to be followed in making the change, in turn, making it a simple and easy model to be understood in making the change (Wu and Chu, 2015). Thus, it informs that using this framework to introduce the intended change is beneficial as the leaders do not require complex systems to be followed allowing them to easily and timely accomplish the change due to simple model framework. The limitation of Lewin’s Change Model to be used in change management is that people involved in the change always remain in change shock which degraded their way of working (Arab-Zozani et al. 2019). Thus, it informs that using the model may make the managers and physiotherapist at the healthcare settings remain in shock that another system change regarding physiotherapy services for the patients may be made due to which they have to follow new routines at work.

Change Management Tools

The change management tool and techniques to be used for supporting the intended change management are PDSA Cycle and 5 Whys. The PDSA cycle informs four stages to be followed in supporting the change which is Plan, Do, Study and Act. In the plan stage, the change to be implemented is tested and developed (Christoff, 2018). It informs that in plan stage the leaders making the change of reducing waiting from referral to treatment among the patients are to determine in to what extent the workforce is to be increased, how the priority list of patients is to be identified, way first-sum, first-serve basis of care is to be established and other changes to be made. This is done to develop effective planning so that the patients do not have to wait longer for the services and feel bothered regarding their health and think of facing deteriorated health condition. The Do stage informs the planned change is to be implemented (Reed and Card, 2016). Thus, at this stage, the planned change regarding ways to lower waiting time from referral to treatment in physiotherapy settings is to be implemented. At the study stage, on the basis of the measurable outcome which are agreed before initiating the change data is gathered regarding before and after effects of change to reflect and study its impact (Bollegala et al. 2016). This informs that at the study stage the leaders are to examine the impact of the change by analysing the data gathered before and after its implementation in the settings and for the patients. The Act stage informs the planning the next change cycle based on the information gathered in the study stage (Wiemann and Hergenroeder, 2018). This informs that in the Act stage the leader is to decide what further changes in the proposal for reducing waiting time from referral to treatment is to be made so that successful timely care services are made available for the service users. The advantage of using the PDSA cycle in supporting the intended change management is that it allows making continuous improvement so that proper physiotherapy services are received by service users without hindrance. However, the limitation of using the PDSA cycle in supporting the change is that it avoids taking proactive approach in making the change (Bollegala et al. 2016). This indicates that if any wrong act is executed in planning the change then it can only be resolved after its impact is seen.

The 5 Whys model informs that at first, the problem is to be identified based on which the change is to be made. After identification of the problem, it is to be defines and then five consecutive why is to be asked to understand the importance and need of the change (Schonberger, 2018). This informs that at first the problem which is leading the change to be needed to be implemented is to be identified. After the problem is identified, it is to be defined and then 5 consecutive why is to be asked regarding the problem. The root causes that lead to the health issues in the settings is to be determined so that effective actions can be taken.

Leadership Approach

The leadership approach to be used in making the intended change is Visionary leadership which one of the six leadership style mentioned by Goleman. The Visionary Leadership is referred to the style in which a leader has the potential to perceive the future and motivate people towards a certain vision to be achieved (Chiarini and Vagnoni, 2017). The visionary leadership is to be used for change management as it integrated people and task orientation which results to make people involved in the change to satisfactory participate on their own to execute task to the vision for change is achieved (Rich et al. 2018). Thus, using the leadership would make the leaders be able to inspire the managers and physiotherapist at the local level to participate effectively in making the change successful. As mentioned by Golafshani et al. (2018), visionary leaders are able to bring the best out of the people to make them perform beyond their limitations. This informs that using the visionary leadership approach is effective for making the intended change as the leaders by following the style can bring in the best skills and effective participation of large number of physiotherapist to act effectively in reducing waiting times. The limitation of visionary leadership approach is that it allows the leaders to make change by the considered current situation and avoid the way the decisions to be taken are going to impact in future (Joshi, 2019). Thus, using this leadership approach may manage waiting times issues in the settings at the present but the way it is to be managed in a long-term situation cannot be determined.

Impact of Change on the healthcare system

The proposed change regarding healthcare system mentioned is going to impact on improving access of physiotherapy care to the patients in the UK. This is because patients who are unable to access timely care due to previous delay seen would now be able to access the services as required. It would impact to improve their health condition making the NHS avoid facing more complicated health condition, chronic health problems, more disability work hours and others among the patients. The change would avoid the patients with arthritis to face mobility issues that are previously experiences as a result of delayed care. Moreover, the change is going to impact on lowering the emotional trauma faced as a result of enduring increased pain over time by the patients as timely care by lowering waiting time referral to treatment would make patients have early intervention for health condition.

Evaluating the Change

The evaluation of change management is important as it offers means through which consistent as well as standardised changed performance can be established (Allen, 2016). The feedback from patients is to be accessed for evaluating the proposed change through the help of closed-questionnaires. This is because feedback allows information regarding reactions and emotions of service or product provided to the individuals to be gathered to assess its impact on them (Lenander et al. 2015). Thus, this tool is to be used for accessing opinion of the patients to what extent their waiting time for physiotherapy services from referral to treatment has improved. The observation is another evaluation technique to be used for determining the impact of the proposed change. This is because the observation evaluation technique allows monitoring or examining the process or situation (Provost et al. 2015). Thus, this tool is to be used where observation will be made regarding what extent the proposed change is allowing patients requiring physiotherapy services to access them in timely manner. The less the waiting time faced by patients from referral to treatment it would that the proposed change has impacted positively and vice versa.

Evaluating the way change proposal would enhance the care quality

The proposed change is going to improve the care quality for the muscle-wasting condition of patients and others who required physiotherapy services by allowing to have reduced pain. This is because each of the patients irrespective can avail the services through minimum waiting time to ensure their well-being. In addition, the proposed change is going to improve mobility as well as independence of many disabled patients who were previously unable to avail timely physiotherapy services due to increased waiting time.

Ways to communicate the proposed change

The proposed change can be communicated to all the patients and healthcare workers through different modes such as written, visual, audio and others. The written communication is referred to the process in which a formal document is developed for definition of the nature of settlement to be made by individuals (Vermeir et al. 2015). Thus, the written document is to be developed to communicate the change to healthcare workers to inform them regarding the way they are to arrange providing physiotherapy to the service users so that waiting time is reduced. The visual communication is to be used for arranging informative campaigns where healthcare leaders are going to inform in details the way waiting time from referral to treatment in physiotherapy settings are to be reduced to offer the needy people timely care.

Conclusion

The above discussion informs that change in healthcare in the physiotherapy settings is to be made so that waiting time from referral to treatment is reduced. The Lewin’s Change Model mentions that through unfreeze, change and refreeze stage the proposed change is to be made. The PDSA cycle along with 5 Whys Model mentioned that by increasing number of physiotherapist and proper scheduling of patient’s care the change can be effectively made. The feedback and observation tools are to be used for examining the impact of proposed change.

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