Introduction
In an increasingly innovative and technologically advanced world, healthcare providers are compelled to adapt to change. Additionally, change is beneficial for meeting the evolving needs of patients. Healthcare executives require a well-structured change management strategy and personnel to achieve the desired outcomes.
Change in a healthcare organization can be transformational or adaptive, depending on the situation. Transformative change impacts how healthcare processes, people, and critical functions are conducted to provide better services. Adaptive change refers to minor adjustments that streamline workflow and clinical processes. Therefore, leading change is crucial in the healthcare system because it significantly impacts the quality of services and workflow processes within a healthcare setting. This study will research leading changes in healthcare organizations.
The Main Forces for Change in a Healthcare Organization
External
Political
Change in a healthcare organization can be due to internal and external forces. The external forces are those that affect the organization’s external environment. These include political shifts, demographic changes, technological advancements, and the economy (Nahavandi, 2009). An example of political shifts was the policies adopted in the US during the COVID—19 pandemic by political executives to protect citizens. Therefore, healthcare organizations had to adjust their working shifts and hours and prioritize services for COVID-19 patients.
Demographic
An example of demographic forces is related to the number of people and their behaviors. For instance, if a vaccine is being given to children between the ages of 10 and 12 years, in the past, it would have been administered at home, door to door. However, with the increasing level of school-going children, administering vaccines at school has become more effective. This demographic shift has impacted how healthcare services deliver mass services to an entire population (Nilsen et al., 2020).
Technological
Technological shifts are driven by technological advancements, which lead to the development of new models for providing care. For instance, the introduction of lasers has made surgeries easier and safer, leading to a change in traditional methods.
Internal
Low Satisfaction
Internal factors that lead to a change in healthcare organizations may include low satisfaction, low-quality services, a new mission, conflict, and new leadership. Low satisfaction may result from some of the implemented strategies not providing enough motivation for employees, hence resulting in low satisfaction rates (Nahavandi, 2009).
Low Quality
Concerning low-quality services, when healthcare organizations receive complaints about subpar services, they are likely to implement changes to improve the situation. For instance, a healthcare facility discovered that medication errors were one of the leading causes of extended hospital stays. They adopted a technology to help the nurses record and administer the correct medication to the correct patient at the correct dose.
New Mission and Leadership
When a healthcare organization has a new mission to pursue, it must adjust its strategy to ensure that its actions align with it (Nilsen et al., 2020). Change is needed in conflict to ensure that all parties are satisfied. Finally, in times of new leadership, change is suitable for implementing new strategies in the new administration.
How to Lead Successful Change in a Health Organization
Leading successful change in a health organization requires three essential factors: having the opportunity to influence the change, preparing the stakeholders for change, and recognizing the value of the change. For instance, initiating a slower change process can provide time for preparation and increase influence and engagement. This indicates that the three factors, in most cases, work interdependently to ensure that they positively influence change.
A study conducted by Nilsen et al. (2020) showed that showing the value of change, for instance, through patient benefits, increases the motivation of the healthcare staff. Additionally, preparing staff and involving them in the change process is positively associated with decisional latitude (Nilsen et al., 2020). This shows that to lead change, various values and processes must be employed by a leader to ensure its success.
Opportunity to Change
Having the opportunity to influence change is one of the essential factors that a leader should have. The study revealed a significant positive attitude towards change that is well-integrated among healthcare professionals (Errida & Lotfi, 2021). This comes especially due to power differences, whereby most people in charge of making changes are in the senior management, while the changes affect those at the bottom. Therefore, one effective way to implement change in healthcare organizations is to use a bottom-up approach to eliminate power differences between them. Swedish physicians have, in several instances, complained that top management makes healthcare policies without consulting medical professionals (Rogers et al., 2021). According to organizational research, increasing participation in change increases the acceptability. Harrison et al. (2021)stated that widespread participation in implementing change reduces the resistance rate. Leaders must build internal support by engaging staff in the change process to lead change effectively.
Preparing Stakeholders
Another critical factor in leading change is the ability to predict the outcomes. In general, people can adapt to new behaviors when they are well-prepared. In leading change, healthcare managers should communicate the message to employees to prepare them for the change (Nahavandi, 2009). This is because when the information is not communicated in time, the staff may have difficulties aligning their feeling, thoughts, and behavior to the expectations of the change. According to the Organizational Readiness to Change Theory, the readiness of an organization’s staff to change depends on their belief and capability to implement change. It is essential to ensure that resources and culture are in place to facilitate the smooth implementation of change.
Communicating Change
Other studies in the same field stressed the issue of communicating health organizational change. For instance, a study by Harrison et al. (2021) states that leading change has a high probability of success if the change is well thought out and the managers responsible are highly respected. However, if the staff considers the change has little or no value for them and is poorly communicated, they will likely resist it.
Another study by Errida & Lotfi (2021) found that if a change is casually thought out and the staff do not understand its primary purpose, they will be reluctant to implement it. Thus, for change to be effectively implemented in the healthcare sector, it must also have value for the patients and healthcare providers. This is because the role of professional healthcare is primarily centered on the patient’s needs, which implies that any change that benefits the patients will also benefit the healthcare providers.
Collective Participation
Unlike the common assumption that healthcare leadership should help achieve organizational goals, it has been noted that there is a need for collective involvement. The staff is more loyal to leaders, and changes aim to reward their emotions or patients. Autonomy is not an option for leaders to effectively lead change in a healthcare organization because they must involve all other stakeholders (Errida & Lotfi, 2021). Just like lawyers, physicians treat every patient case independently because they are highly trained. Therefore, unlike nurses, it is tough for the management to conduct successful change if it is not patient-oriented. That is why physicians are likely to resist changes that are only management-oriented.
Essential Values in Leading Change
Creativity
One of the critical values for leaders in organizational change is creativity. Leaders and their staff must be creative to effectively implement change. Innovative employees are likely to be more confident in change and will come up with new solutions for problems that may emerge during the change(Nahavandi, 2009). Creativity enables people to find new ways to solve problems, even borrowing from other groups. However, for this to be possible, leaders must be able to see things from a different perspective to efficiently tackle the problems that will arise during the change process.
There are various models that healthcare leaders can use to ensure their staff is creative, such as the leadership style (Nahavandi, 2009). When the leader chooses autocratic leadership, it impedes the creative process, preventing the exchange of creative ideas. In addition, having a flexible structure, tolerating mistakes, having an open organizational culture, and having a questioning attitude increase creativity in a healthcare organization (Nahavandi, 2009). Leaders need to foster creativity in an organization when leading change.
Improvisation
Another value for leading change, which is close to creativity, is improvisation. Improvisation is an essential leadership skill because it enables emotional connection with staff and energizes them (Nahavandi, 2009). Just like in a dance, a leader should be conversant with the rhythm of a healthcare organization.
Improvisation helps leaders create solutions instantly without prior preparation (Errida & Lotfi, 2021). It can be done without a script, leaders being prepared, and without having perfect information. However, the leader should have knowledge, expertise, and perspective on the situations that will come to provide effective solutions.
The ability to improvise gives the leader the advantage of confidently trying changes. When any problems occur, they can easily improvise solutions (Nahavandi, 2009). For leaders to call for change in a health organization, they must be ready for change; therefore, with improvisation, it is easier to take risks.
Vision
The other values that leaders must exhibit to facilitate change are vision and inspiration. A leader must share a vision with the entire team to ensure they are moving in the same direction. A vision gives the healthcare staff a reason for the change (Errida & Lotfi, 2021). For a leader to successfully lead a change, they must show their followers the importance of the vision.
Confidence
The other step is being confident, empowering their followers, and allowing them to work independently toward the change. Due to the fast-changing environment, leaders should encourage their teams to be flexible in handling change. This helps them easily adapt to new procedures, policies, and processes.
Challenges of Leading Change
Limited Understanding
Leading change has several barriers, including the staff’s limited understanding of change and its impact. When the staff has a limited understanding of what a change may entail, they are less motivated (Tappen et al., 2017). This makes it difficult for them to implement the change successfully in an organization. Understanding change is vital because it affects many parts of an organization. Therefore, if the staff has a limited understanding of change, they will not know how to implement it and its results.
Negative Experience
Another barrier to change is the negative attitude of the employees. Sometimes, this may be caused by previous failed changes or dissatisfaction with the change management process (Tappen et al., 2017). Thus, the leader must consult staff about a change and its impact. Employees represented in a change that works for their best interests gain a positive attitude.
Poor Communication
Implementing change failure can be caused by a lack of good communication with the healthcare staff. This problem is commonly visible if the change directly impacts the healthcare staff, yet they feel unconsulted. When there is no clear communication about a change, the staff will not know the value and impact of the change (Rogers et al., 2021).
In addition, lack of communication leads to rumors across the healthcare organization, creating trust issues bout the change; hence, the staff will not embrace it. Therefore, they will likely resist because they will not see the benefits to themselves or the patients (Rogers et al., 2021). Therefore, the leader should ensure good communication across the health organization, so everyone knows about the change.
Lack of Resources
Sometimes, inadequate resources can be a barrier to change in an organization. Change is expensive because it may include additional staff, expensive equipment, and other costly products (Rogers et al., 2021). For instance, an innovative change that includes the introduction of laser scanning into surgery is costly because the hospital has to hire the laser scanner. The leader must ensure a sufficient budget; otherwise, the change will be incomplete. In addition, it is essential to utilize resources effectively and ensure that the change does not lead to the mismanagement of funds.
Employee Resistance
Resistance is the other challenge that a leader will face in implementing change. People are naturally likely to resist change because they are accustomed to the protection of the current status quo. When people get too comfortable in their current situations, they leave no room for growth (Rogers et al., 2021). That is why a change leader should address problems from the psychological level and eliminate behavioral barriers that may hinder the evolution of the people.
In addition, the leader needs to support the staff with reassurance and offer them new training to give them the required skills to adapt to the healthcare change. For instance, in the case of the new surgery beam, it was essential to ensure that the physicians who use it have fresh training in operating the machine to avoid resistance. Organizational support is essential as it eases the transition process and ensures the reassurance of the staff.
Conclusion
Change is inevitable in the current healthcare system due to internal and external factors. For a successful change, there are various factors that the change leader should embrace, which include: having the opportunity to influence the change, preparing the stakeholders, and recognizing the value of the change. In addition, the leader should have values such as being creative, having the ability to improvise, and being visionary. Nevertheless, the leader may face challenges, such as employees’ limited comprehension of change, negative attitudes, poor communication, resource constraints, and resistance.
References
Errida, A., & Lotfi, B. (2021). The determinants of organizational change management success: Literature review and case study. International Journal of Engineering Business Management, 13(1). Sagepub.
Harrison, R., Fischer, S., Walpola, R. L., Chauhan, A., Babalola, T., Mears, S., & Le-Dao, H. (2021). Where do models for change management, improvement and implementation meet? A systematic review of the applications of change management models in healthcare. Journal of Healthcare Leadership, Volume 13(13), 85–108. NCBI.
Nahavandi, A. (2009). The Art and Science of Leadership (7th ed.). Pearson.
Nilsen, P., Seing, I., Ericsson, C., Birken, S. A., & Schildmeijer, K. (2020). Characteristics of successful changes in health care organizations: an interview study with physicians, registered nurses and assistant nurses. BMC Health Services Research, 20(1).
Rogers, H., Pablo Hernando, S., Nunez Fernandez, S., Sanchez, A., Martos, C., Moreno, M., & Grandes, G. (2021). Healthcare organization and management barriers and facilitators for health promotion in primary care. European Journal of Public Health, 31Â (Supplement_3).
Tappen, R. M., Wolf, D. G., Rahemi, Z., Engstrom, G., Rojido, C., Shutes, J. M., & Ouslander, J. G. (2017). Barriers and facilitators to implementing a change initiative in long-term care using the INTERACT® quality improvement program. The Health Care Manager, 36(3), 219–230.
