Changing how we Change
Change is necessary and important for any organization because without change, businesses would lose their competitive edge and fail to meet the needs of loyal customers. With advances in technology, cultural alterations, policy modifications and the price of care, hospitals have changed to more patient-centered approach organizations that address inconsistencies in quality and efficiency. To succeed in healthcare today, hospitals have to change their organizations to ones that operate more like businesses than traditional hospitals. Leaders and managers must deal with internal and external environments which in turn promote organizational change. To compound the matter of changing an organization, these external and internal factors affect organizations but more importantly affect people differently.
Organization Description
In Florida there are over 300 hospitals in the state (Florida Hospital Association, 2014) with many of these hospitals being associated with large healthcare systems located within the state. Broward County is located in Southeast Florida, and is the second most populous county in Florida; it is 1200 square miles with 16 acute care hospitals that offer similar services (United States Census Bureau, 2014). The county’s smallest acute care hospital is associated with a world renowned healthcare system from Ohio which is both advantageous and unfavorable in the realm of managing organizational change. The Ohio health system was established in 1921 by three WWI surgeons and has proven itself as one of the primary cardiac care hospitals in the world. The system from Ohio has been responsible for many firsts in health care and continues to do so in the 21st century. To have a niche that separates the 155-bed hospital from the other 15 hospitals in Broward County, the medical and senior administrations from Ohio strategically planned that the Florida hospital would implement three-organ transplantation programs within 15 months as well as maintain its reputation as a tertiary surgical hospital, and start a surgical residency program. ‘Patients First’ is the memorable vision statement for the health system and is the framework for all initiatives, but the statement loses its meaning when initiatives are not planned well and hidden personal agendas are drivers for change.
Current Situation
Intensive care units (ICUs) were first introduced in the mid twentieth century and with the aging population, advances in technology and demands of healthcare the acuity of hospitalized patients has increased exponentially over the years (West et al., 2014). A large healthcare system such as the Ohio system features innovative processes that will pose organizational pressures for change in the Florida hospital due to internal factors like the Ohio health system’s reputation and external factors such as the demand of specialized care (Paris, Devaux, & Wei, 2010). To standardize practices, use evidence based research and have a better financial positioning the health system shares talent, policies, procedures and other resources. This sharing of resources is not always positively received due to the physician model and local resistance to the presumption that the main campus in Ohio knows best.
The 23-bed critical care unit in Florida is separated into two geographic locations consisting of a 9-bed unit and a 14-bed unit. Prior to August 2014, the intensive care unit was considered one critical care unit with nine pulmonologists being the primary attending physicians who developed a successful pulmonary care fellowship program and had achieved many national accolades in critical care. The strategic business plan developed by the newly formed local administrative and medical leaders indicated that the surgical intensive care unit should consist of 9 beds but the location had to be in the 14-bed unit due to proximity to the surgical suites. Nursing knew that the number of beds designated in the strategic plan was not accurate but with the medical model of care and new leadership style, nursing was excluded in the strategic planning by the new administrative leadership. The new administration voiced that any future strategic plans for the institution were revised based on the data that they analyzed.
Desired Change
The desired change in this change management initiative is to have separation in the leadership and change the culture of the surgical critical care to one where only physicians are key decision-makers and the only outcomes important are ones associated with physicians. The national recognition for the Florida critical care was the foundation used as a platform for future enterprise strategic objectives such as the organ transplant initiative. Since the health system had the reputation of being a teaching hospital, the local surgeons got the approval to develop and implement a surgical residency program in Florida. As a part of large health system the 155-bed Florida hospital is in a unique position and the desired change is believed to cement the World Class Care reputation of the health system
The recently employed Florida transplant physicians verbalized their specific objectives and objections to senior Ohio leadership and strategized against the pulmonologists as well other members of the healthcare team resulting in a team divide that was never present before. The local senior leadership changed in the past two years, to one that is more directive and the image of change management is now controlling, which is completely different from the previous shaping style which compounds the disunion more. Leaders cannot successfully change organizational culture without knowing where the organization plans to move to or the foundations of the current organizational culture that need to change.