Managing and Leading Change in a Health Organization
According to Hartley, C. P., Jones, E., & American Medical Association (2012), in order to build the teams required for collaboration in selecting a new EHR system, the team needs to size in between five to seven individuals who work in the company. If the clinic does not have an information technologist, someone with a background in information technology would need to be consulted. An attorney also needs to be used for consultation purposes but needs not to be on the team. From here, the roles within the department that match the team member need to be outlined. This needs to include clinical, pharmacy, administrative, IT, medical records, and coding a billing. Second, a contact list should be established for the team. Third, there needs to be a change model, such as Lean, Six Sigma, or Plan Do Study Act (PDSA) in order to effectively manage change, as this will happen. The last task for establishing the team is to have the team divide up all remaining tasks and get back together in order to continue planning (Hartley, C. P., Jones, E., & American Medical Association, 2012).
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Another approach to the team building process that can be utilized is a five-step process where Barner (2012) states that in step one, an overview of the team building process is to be outlined and explained. This also needs to include the benefits of a team building approach, as well as the roles each person involved. Second, there needs to be facilitation between the team leader and team in order to go over logistics and agree on a plan going forward with regard to the team building approach being used. Third, the team needs to understand they have support and their needs should be considered. Fourth, the team building session takes place with where ideas are fostered and any options for change are considered. Lastly, in step five, any ideas hashed out in the session should be translated into actionable plans and a follow up meeting should be considered in order to affirm a consensus (Berner, 2012).
A third approach to team building, according to LaTour, American Health Information Management Association, Eichenwald & Oachs (2013), is to use the approach of continuous quality improvement (CQI), as a way of incorporating all involved in a process. This a way of garnering a consensus within the team. By including all involved, a better understanding of what is expected from each individual employee is outlined, as well as how each employee can be an effective part of the overall team. Having team members from all aspects of the operation, from top to bottom, will allow different and new ideas to be expressed as part of the problem-solving aspect (LaTour, American Health Information Management Association, Eichenwald & Oachs (2013).
When transitioning to the new EHR system, there will be resistance to changing to a new system. In order to overcome this, the leadership should be distributed throughout the organization and not come from one individual (Hodges, 1016). This will allow improved buy-in from all individuals across the organization and promote more inclusiveness throughout the organization during a time of change (Hodges, 2016). According to Hodges (2016), there is also the need to consider how power and politics within the organization can affect the ability to implement change. There can be a “silent veto power” involved within the organization during a time of change. This mean individuals within the organization exercise their power simply by not participating in the change or doing nothing to support the change. In order to overcome such thinking and obstacles, the leader needs to build in stability and maintain relationships with the key stakeholders and those that exercise power over others within the organization (Hodges, 2016).
Another challenge from changing to the new EHR system is the resistance thought that this is a new trend and not needed in the overall improvement of the organization. According to LaTour, American Health Information Management Association, Eichenwald & Oachs (2013), the use of Bridges’ Stages of Transition can be utilized to help overcome this resistance to change. It is important to keep all involved abreast of the change, why it is needed, and what the next steps will be. Communication in this aspect is critical. Next, the organization needs to continue to support all involved throughout the changeover to the new system and support all involved each step of the way. Finally, as more acceptance is gained, all involved need to be re-trained and feedback should be given and taken from all involved for a smoother transition (LaTour, American Health Information Management Association, Eichenwald & Oachs, 2013).
In order to implement a departmental strategic plan, LaTour, American Health Information Management Association, Eichenwald & Oachs (2013), states that reviewing the current profile within the organization. In order to do this, the current mission, vision, and values need to be examined to make sure the plan used adheres to all of these, as they set the direction of the organization. Next would be looking at the internal and external environments in order to get a sense of where the organization currently is in relation to their strategic direction. This would include performing a SWOT analysis of the internal environment. This allows for a thorough examination of any risks or gaps within the organization and their current strategy. With the external assessment, comes an examination of anything outside of the organization, such as demographics, political, or technological factors, as well as trends within the industry that may influence the organizations strategy (LaTour, American Health Information Management Association, Eichenwald & Oachs, 2013). Harrison (2016) states that, along with these considerations comes a need to compare the organization against other organizations that are performing at the highest levels. This is a process known as benchmarking and it also includes improving upon one’s own organization to improve quality, value, and efficiency (Harrison, 2016).
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Mitigating risk is during the EHR implementation is also a key factor as risk exposure with EHR and PHI can be somewhat complicated. According to Hartley, Jones, & American Medical Association (2012), one area of risk is that of access to PHI and in order to mitigate this risk, standards need to be established with any exceptions annotated with an explanation of why they need to happen. Another area of risk is reviewing access to the information on the system. The way to mitigate such a risk is to have an IT security team in place that can authorize access and supervise activity, with reviews taking place on a regular basis. These reviews can take place more frequently initially, in order to keep greater control on access and this will allow all users to understand there are boundaries and what those boundaries are (Hartley, Jones, & American Medical Association, 2012).
The process of procuring goods and services is needed order to keep a project moving forward. This can be complicated depending on how the policy is outlined within the company. According to Heldman (2011), the request for proposal (RFP) is used in order to gain information from vendors on the goods and services needed and provided. The project is outlined in order for vendors to examine whether or not they are able to fulfill the requests of the project (Heldman, 2011). The request for information (RFI) is used to find out information regarding goods and services in the sense of cost, location, and quality and the request for quotation (RFQ) is a call for bids on the goods or services (Lantz, 2019). Initially the RFP will be used in order to send out and look for information on the project. Followed by this the RFI will be used to find out specific information from the vendor, and lastly the RFQ will be used to determine actual bids from the vendor or vendors.
- Barner, R. (Robert W. . (2012). Building Better Teams: 70 tools and techniques for strengthening performance within and across teams. Retrieved from https://search-ebscohost-com.libauth.purdueglobal.edu/login.aspx?direct=true&db=edsssb&AN=edsssb.bkb00049562&site=eds-live
- Harrison, J. P. Essentials of Strategic Planning in Healthcare. [Purdue University Global Bookshelf]. Retrieved from https://purdueuniversityglobal.vitalsource.com/#/books/9781567937916/
- Hartley, C. P., Jones, E., & American Medical Association. (2012). EHR implementation : A step-by-step guide for the medical practice. [Chicago, Ill.]: American Medical Association. Retrieved from https://search-ebscohost-com.libauth.purdueglobal.edu/login.aspx?direct=true&db=nlebk&AN=544067&site=eds-live
- Heldman, K. (2011). Project Management JumpStart (Vol. Third edition). Hoboken, NJ: Sybex. Retrieved from https://search-ebscohost-com.libauth.purdueglobal.edu/login.aspx?direct=true&db=nlebk&AN=368343&site=eds-live
- Hodges, J. (2016). Managing and Leading People Through Organizational Change : The Theory and Practice of Sustaining Change Through People. London, United Kingdom: Kogan Page. Retrieved from https://search-ebscohost-com.libauth.purdueglobal.edu/login.aspx?direct=true&db=nlebk&AN=1162775&site=eds-live
- Lantz, K. (August 14, 2019). Seminar: HS450-01. [PowerPoint slides]. Retrieved from https://purdueglobal.brightspace.com/d2l/ext/rp/96821/lti/framedlaunch/2f38eb98-e817-4a98-bba7-54ea308d4017
- LaTour, K. M., American Health Information Management Association, Eichenwald, S., & Oachs, P. K. (2013). Health Information Management : Concepts, Principles, and Practice (Vol. 4th ed). Chicago, Ill: AHIMA Press. Retrieved from https://search-ebscohost-com.libauth.purdueglobal.edu/login.aspx?direct=true&db=e000xna&AN=667492&site=eds-live
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