LDR 615 Contemporary Organization Change
The dynamism of the healthcare environment implies that healthcare organizations always have to the competence necessary to handle the complexity of the process. The process entails evaluating, planning, and executing operations, tactics, and strategies so as to make the change worthwhile. The complexity of the healthcare system alongside the need to constantly produce quality and safe healthcare services means that healthcare organizations always face change events. The advent of evidence-based practice calling for the adoption of technology in various facets of healthcare has ensured that technology has disrupted the way facilities undertake matters. The present paper will thus examine the manner in which the University of Texas Medical has responded to technological disruption caused by EHR and its response to the change dynamics therein.
Organization and Change
The University of Texas Medical Branch consists of a healthcare system encompassing both research as well as emergency services on four of its campuses. The organization offers a network of specialty and primary care clinics, walk-in services and emergency care, as well as interprofessional collaboration entailing physicians and nurses among other healthcare professionals. The University of Texas Medical Branch has facilities that support both long-term and short-term care needs of numerous conditions from maternal issues to trauma cases (“Health care at UTMB”, n.d). The vast nature of the facilities comprising the UTMB demanded for the existence of a centralized way of addressing patient issues in terms of data leveraging.
UTMB provides itself in using advances in medicine to properly serve the Texas communities. In alignment with the above assertion, the facility currently responds to the healthcare disruptions caused by technology by adopting the use of electronic healthcare records to centralize patient data (Adler-Milstein et al., 2017). The UTMB purposes to ensure that it has a comprehensive EHR unit in all its facilities and clinical units. The desire to improve patient services and lead in evidence-based practice adoption by the UTMB has pushed it to embrace the technological disruption caused by EHR. By leveraging EHR and its innumerable benefits, the UMTB expects to improve the quality and safety of services that it offers to the Texas community.
Effects of Change
The adoption of electronic health records by UMTB led to certain disruptions of the healthcare system at the facility. The
disruptions witnessed align with the assertion made by Jacobs et al. (2019) that the formative stages of comprehensive EHR implementation form the most disruptive period. The UMTB experienced physician dissatisfaction following the implementation of comprehensive EHR system due to the absence of concomitant skills. Moreover, the execution of the comprehensive HER system led to the presence of reduced quality due to the disruption that it caused to the workflow (Busch, Bates, & Rauch, 2018). The waiting time of patients reduced in a statistically significant manner since the healthcare providers grappled with the complexity of the system. In other words, the adoption of the EHR system by the UMTB led to the presence of disruptions that affected the quality of care offered by the hospital to its patients.
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In order to address the above disruptions, the UMTB turned to evidence-based practices related to adoption of a change process. The first step entailed the organization ensuring stakeholder involvement after reviewing the project after the first month (Jacobs et al., 2017). UMTB formulated a project organization comprising of physicians, nurse managers, nurses and essentially broad participation of every hospital department. During this period, the project team appointed key users who discussed a transparent list of issues weekly so as to solve them and ensure project ownership.
Moreover, UMTB chose to increase the competence of its workforce as relates to the operations of the comprehensive EHR system that it adopted. They achieved this through strategies such as group trainings to allow for optimum training of personnel through determining the optimum hours required for the same. Further, UMTB also introduced the provision of real-time support to personnel to leverage the optimum learning potential for the personnel at the facility. Moreover, the UMBT addressed the workflow disruption by having the vendor to re-assess their models and align them to the organizational requirements (Jacobs et al., 2019). The UMBT conducted successive review days entailing the assessment of the progress by a workgroup.
In lieu of the above strategies, UMBT started seeing numerous changes related to the adoption of the EHR. The workforce bought into the idea of change and participated in trainings to improve its competence level (Busch, Bates, & Rauch, 2018). The above enthusiasm allowed the organization to register improved physician and patient satisfaction. Moreover, the stratagems led to the improvement of workflow, which ensured the presence of improved quality of services. Further, the waiting times improved and overall quality parameters of the hospital enhanced.
The adoption of the EHR, similar to any change, faced certain resistance from various stakeholders. The nurses and other medical personnel felt left out of the matter and hence they did not feel like they owned the project. This resulted in a go slow during the first month of the project. Moreover, the EHR did not have a competent clinician champion, who resisted in due to lack of participation in the initial stages. The initial assigned project manager did not have the necessary skills and knowledge and hence resisted the adoption of certain aspects of the EHR. The rejected aspects of the project fell under the complex category.
The UMTB responded to the stakeholder change through various evidence-based practice. To address the issue of resistance by clinician champions, the hospital appointed a more knowledgeable clinician champion who solidified provider support through clearly identifying the way that the EHR would become useful in improving quality. The UMBT also adopted the “train the trainer” approach to train clinicians concerning various aspects of the EHR. Using the model, the vendor identified super-users within the organization and trained them, who in turn trained their colleagues. Moreover, the UMBT allowed clinicians to design and redesign the workflow process, hence making them support the EHR change and also address the workflow challenges.
Effects of Change on Interdepartmental Collaboration
Since the introduction of the EHR, interdepartmental collaboration has improved within the UMBT departments. The change as produced by the EHR has led to improved collaboration between the nursing department and other departments at the hospitals in terms of medication management and other patient aspects. The EHR has improved patient management across the continuum of care from admission to discharge with wait times reducing dramatically. Moreover, the EHR has introduced the usage of clinical decision support at the facility, which has made easier decisions made by clinicians concerning patient welfare by referring them to necessary units (Busch, Bates, & Rauch, 2018). Therefore, the EHR system had created a seamless interdepartmental association between various units at the UMBT.
Evaluation of the Responses of the Leaders
The leadership of the organization initially did not adequately prepare for the change. They thought that the personnel had sufficient goodwill to support the change. However, upon the realization that resistance to change existed, the strategies implemented by the leadership worked. For instance, the usage of train the trainer strategy made certain that all the personnel possessed requisite skills, which greatly influenced their embracing of the project (Reyes-Portillo et al., 2018). Moreover, allowing the personnel the latitude to design and redesign the model ensured that the final product had consistency with the desired product hence improved workflow at the facility. The resolution to change the project manager to a knowledgeable person similarly produced the desired results. Therefore, the leadership adopted effective responses in relation to resistance to the proposed change that the facility witnessed at the beginning.
The adoption of the EHR by the facility due to the HITACH Act occurred in a manner characterized by challenges. However, the leadership of the UMBT can undertake certain steps to address the resistance to change at the facility. The leadership may have to identify a couple of clinician champions and then define their roles (Adler-Milstein et al., 2017). Moreover, the leadership ought to include clinical champions in tactical decision making so as to avoid errors as well as complex judgment calls that affect the personnel. Lastly, the leadership should formulate a framework that would enable clear and rapid communication concerning the health IT within the organization
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Busch, A. B., Bates, D. W., & Rauch, S. L. (2018). Improving Electronic Health Record Adoption in Psychiatric Care: A Cornerstone for Healthcare Transformation. The New England journal of medicine, 378(18), 1665.
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