Full Text: Managing Change in Healthcare

Managing Change in Healthcare
Rashid Khalfan Al-Abri

Quality Management Department,

Sultan Qaboos University Hospital,

P.O.Box 35, Al-Khod 123, Muscat, Sultanate of Oman.

Email: aalabri@hotmail.com

Submitted: 24 July 2007
Accepted: 24 September 2007

One of the key concerns in Health care management is management of change and health care professionals are obligated both to acquire and to maintain the expertise needed to undertake their professional tasks, and all are obligated to undertake only those tasks that are within their competence.1 Moreover, change occurs continuously around us. We may want to support it, be indifferent to it, and be passive or participate in it. The pace of change has increased dramatically.2


Managing change is about handling the complexity of the process. It is about evaluating, planning and implementing operations, tactics and strategies and making sure that the change is worthwhile and relevant.3 Managing change is a complex, dynamic and challenging process.4 It is never a choice between technological or people-oriented solutions but a combination of all.5


Effective change has been characterized as unfreezing old behaviours, introducing new ones, and re-freezing them.6, 7,8 Change may be continuous, sporadic, occasional, or rare. Predictable change allows time for preparation, whereas unpredictable change is more difficult to respond to effectively. Since changes in healthcare occur so rapidly, they are less likely to be predictable.9


The only sustainable competitive advantage today is the ability to change, adapt, and evolve - and to do it better than the competition.10


Failure rates are associated to a number of different factors such as lack of vision and commitment from senior management, limited integration with other systems and processes in the organization, and ill-conceived implementation plans. If organizations are to experience a greater level of success in their development efforts, managers and executives need to have a better framework for thinking about change and an understanding of the key issues which accompany change management.11


Even if change is endorsed, employees want to understand why change is happening and how they will be affected. Layoffs or other organizational changes can lead to paranoia, confusion, anger and insecurities under the auspices of change.12


Promoting change is both demanding and fatiguing. Bringing about change requires the manager to challenge the precedent, and requires perseverance against the habits and norms of established behaviours. Bringing about change takes time and requires the commitment of time on the part of the manager.13 The manager must know the values that matter and focus on changing those as opposed to reacting to every invitation for change. She/he must be clear about what is important and develop responses and proactive actions accordingly.14


Organisations that employ large numbers of professionals will not perform well if they become overly bureaucratic. Steiner stated that organisations that are known to be bureaucratised and hierarchical are less flexible, less amenable to change and less likely to empower staff.15 An organisation will not get full value from its professional employees if it insists that they do only what they are told. Therefore, leaders have to learn how to manage change, rather than change manages them in order to move forward with success.


Coram and Burnes argued that there is no "one best way" to manage change in an organization, and that public sector organisations need to introduce an approach to organisation change which matches their requirements and situation.16 It has to be admitted that change in management will keep happening. In addition, leaders need to understand the change process and issues that are involved with it in order to have the capability to lead and manage change and improve efforts effectively.5 They must learn to overcome obstacles and cope with the chaos that naturally exists during the complex process of change.17 Leaders should help employees and other stakeholders structure and build effective teams by developing new organizational structures and creating a shared vision that focuses on authentic employees’ output. Such inspired and informed leadership is critical and essential for organizations to be successful.


Establishing a clear vision about the direction of the change process is another key element for assuring successful change.18

Measuring and monitoring outcomes of the change process is essential for recognizing whether or not the change process has fulfilled its purposes.19 Since change is continuing to happen in organizations and associated modifications are taking place, it is important for those who are in charge of the change process to record and focus on the emerging problems due to change. This will help avoid them in the future so that the new administration system will help to manage the change in the proper and best manner.


To conclude, there are global changes happening, which drive individual organisations to change accordingly in order to proceed ahead. These changes have created problems within organisations concerned. Solutions are required to overcome any emerging problems due to the change that are continuing to happen. And in order to keep the organisation functioning according to plan, managers and employees’ knowledge and skills should be upgraded; necessary training on the changes in technology must be provided.  Individuals who are in charge of the change process should record all emerging problems and design an ultimate solution for better future of organisation. Changes in healthcare practice are welcome if they improve quality and safety, or save money. However, it is important to tailor health care delivery to the needs of the local population and create awareness programmes and clear communication between the public and organization is essential and highly required. In addition, the rate of change in healthcare is accelerating, not slowing and the powerful forces that are transforming healthcare can generate vast economic potential for those who are able to employ effective survival techniques in the short term and at the same time plan for success in the long term. To accomplish this, an organization must harness the forces driving transformation and use them to its advantage. Finally, the change in health services entails incremental improvement on existing organizational capabilities, more empowerment to the changing agents and continuous support to the changing leaders.




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