Health and Social Care Services

Facilitating Change in Health and Social Care

Project description
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FC Assessment criteria breakdown

LO 1.1 Explain the key factors that drive change in health and social care services
What is meant by any of these factors of change management
Give a detail account of how and why these factors occur.
In your explanation you should write clearly in such a way that the complex procedure and sequences of these principles can be understood at the same time relate it in the organization

To explain consider the following factors:
Discuss on the Factors that drive change using SWOT analysis, PEST or force Field analysis. This should include both internal and external factors.
Factors such as (choose 2-3 of them):
The Legislation: NHS and Community Care Act 1990, Health and Social Care Act 2001; changes of government; funding issues
Demographic Issues/Cultural: ageing population, minority ethnic community needs, lifestyle factors, public awareness (perceptions) and news media, human factors.
Technological issues such as electronic record keeping; electronic communication; assistive technology
Internal factors include the following: Skills, Staff, structure, systems and shared values
Relate the above factors to your chosen case study.

1.2 Assess the challenges that key factors of change brings to health and social care services.

The challenges that the above factor can bring to the organization, service user and professionals.
Identify the factors and relate them to your health and social care work place.
Include the positive and negative effects of these challenges
Weigh up to what extent the statements are true and point out any flaws and counter argument.
Then conclude by stating how far you are in agreement to challenges that these factors bring to Health and Social Care

2.1 Devise a strategy and criteria for measuring recent changes in health and social care.
Identify the factor which could be measured in the organization such as waiting time, service delivery, new technology, respect of dignity and privacy etc
Devise a principle or method either from your own idea or from existing principles to measure the recent changes. These can be performance measuring tools such as (use 2-3 of them)
Survey,
PDCA ( Plan DO Check Act),
360 degree cycle,
Cost benefit analysis,
focus groups, Structured interview.
Fish bone analysis
Questionnaire
Explain how the method (s) can be used to measure these change in the organization in terms of: (use one)
Its effectiveness and efficiency
Customer satisfaction
Staff satisfaction
Access/ environment
Cost and benefit of the change

2.2 Measure the impact of recent changes on health and social care services against set criteria
Identify the measuring tools that will be used to measure these changes and measure the impact against criteria such as
Impact of recent changes on organizations, service users and staff:
how services are organized
effect on front-line staff;
effect on service delivery
direct users
families of those who use services

2.3 Evaluate the overall impact of recent changes in health and social care

To evaluate is to give a verdict or decision or findings on the above mentioned impact of the change in the organization by giving an over view of its benefit and dis- benefit to the service user, government/organization and the workers.
Provide evidence from a wide range of resources that both agree with or contradict the above mentioned points
Conclude by coming to a final decision on what you think its the most important factors of change and how these can be improved on.

2.4 Propose appropriate service responses to recent changes in health and social care services

Suggest ways that you think that these organization can respond to these changes that what they can do in order to correct the identified failings by CQC such as
training,
change of management structure,
employment of new staff,
change in equipment
change in service delivery

3.1 Explain the key principles of change management

Explain
What is meant by any of these principles such as Kotter eight steps to change, Lewis Model of Change, Kulber Ross, ADKAR, Reducing Resistance, Creating Ownership etc-(use 2-3 of them)
Give a detail account of how and why these change management principles occur.
In your explanation you should write clearly in such a way that the complex procedure and sequences of these principles can be understood while explaining how you can use this model to facilitate change it to your chosen organization

3.2 Explain how changes in health and social care are planned

Explain how the methods and factors that can be considered when planning change in the organization.
What are activities that can be carried out, Consider the following-use 2-3 of them

Stakeholder analysis
consultation;
communication;
top-down or bottom-up;
management style;
use of informal social systems;
reconditioning;
managing anxiety;
staff development needs

3.3 Assess how to monitor recent changes in health and social care services.

Identify the measuring techniques and relate them to your health and social care work place these include: evaluative research surveys; customer/staff satisfaction; measures of efficiency (cost-benefit, referral rates, and case completion, waiting and response times)

Include the positive and negative effects of these techniques
Weigh up to what extent the statements are true and point out any flaws and counter argument.
Then conclude by stating how far you are in agreement to using these technique to monitor change in the organization.

LO1 Understand the factors that drive change in health and social care services
1.1. Explain the key factors that drive change in health and social care services
1.2. Assess the challenges that key factors of change brings to health and social care services

LO2 Be able to evaluate recent
changes in health and social care services
2.1. Devise a strategy and criteria for measuring recent changes in health and social care
2.2. Measure the impact of recent changes on health and social care services against set criteria
2.3. Evaluate the overall impact of recent changes in health and social care
2.4. Propose appropriate service responses to recent changes in health and social care services

LO3 Understand the principles of change management
3.1. Explain the key principles of change management
3.2. Explain how changes in health and social care are planned
3.3. Assess how to monitor recent changes in health and social care services
-Make effective judgments made and complex problems with more than one variable have been explored when you Measure the impact of recent changes in the organisation against set criteria and explain the key principles of change management in your chosen organization LO 2.2 and 3.2

-Use Relevant theories, methods and techniques have been applied when you explain the key factors that drive change in the health and social care organisation and explain the key principles of change management that can be applied when managing change in the organisation-1.1 and 3.1

-appropriate structure approach and range of sources of information has been used when applying your chosen case study to your answers in each of the Assessment Criteria in Section A, B and C.

-conclusions have been arrived at through synthesis of ideas and justified when you evaluate the overall impact of recent changes in health and social care – 2.3.

-demonstrated your own autonomy / independence of thought and Substantial activities, projects or investigations have been planned, managed and organised whe
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Solution

Facilitating Change in Health and Social Care

LO1 understand the factors that drive change in health and social care services

1.1 explain the key factors that drive change in health and social care services

Health and social care services are constantly undergoing through change. Emerging ideas concerning the superlative methods of providing care to people have a significant influence on organizations. Technological changes, partnership formation, public spending and changes in the organization are just but some of the factors that have had significant influence on health and social care services. It is paramount for organizations and the staff to manage change positively as change poorly managed has adverse effects on the organization creating tension and resistance. This can result to failure in delivering effective service by the staff that can consequently lead to collapse of the organization. Understanding the factors driving change in health and social care services is an effective way of ensuring that transformation reflects positively in such services.  This essay will evaluate the changes that have occurred in health and social care services taking into account the factors contributing to these changes. It will also examine principles of change management and how monitoring and organizing such change can be beneficial to an organization.

            In health and social care services, people are a vital element in service delivery to those receiving the service and those offering them. Transformation affects people to a great degree, as people are sensitive to change thus essential to take care on the changes in service delivery. One aspect contributing to change is the presence of numerous potential stimuli to change. These stimuli produce forces that drive force in an unstoppable mode. The factors contributing to change may generate from internal stimuli but it is prevalent for external stimuli to trigger changes in organizations.

One feature that has a consequential influence on health and social care is legislation. Government legislations are constantly emerging as the government search for ways to advance the health and social care services. One way the government observes this is through initiating systems that direct health standards and control service provision. An example of such legislation is the Health and Safety at Work Act in 1974 that was initiated to cub the rising number of accidents in service provision. The Act aimed at protecting the people receiving health and social care services from harm. It requires the service providers to be more diligent in the quest of providing services through ensuring observation of the safety and health measures. Legislation sets the standards through which employment, public funding and all health and safety services provide quality care to everybody. Some key legislative changes that influenced health and social care include formulation of the NHS Commissioning Board and Clinical Commissioning Groups (CCGs).

            Technology is another pace setter in the transformation of health and social care services. An excellent example is the advancement of the internet. Internet has enabled sharing of information among the multi-disciplinary sectors in the health care. This has simplified conveying of relevant information and still maintains confidentiality and privacy of the information. The staffs working in the health-care services enjoy a wide range of information flowing through the internet. Due to advancements in technology, the health-care service experts require the staff to use internet and other technologies in decision-making. Training of staff has become efficient and convenient through technological advancements. With internet, distance is not a barrier to conducting health-care services for the staff and the users.

Developments in technology have also brought about advancements in technology. An example is the state-of art organ transporters that store and maintain body organs healthy and suitable. Before this equipment, preservation of body organs was done through the use of which reduced the lifespan of the organ. This has given new hope to patients awaiting transplants.

1.2 assess the challenges that key factors of change brings to health and social care services

            There is a requirement to take into account challenges that result from change in an organization. According to Manchester, et.al, 2015, 82, people do not always welcome change. There is a high possibility of resistance to change in the normal routine by the employees. Resistance occurs because of fear of the unknown. The feeling of being unsure of what entails the change and disruption of the employees’ normal schedule creates a sense of fear in the staff who reciprocates by resisting change.

            Technological improvements have brought about both positive and negative effects in health and social care organizations. It is likely that in an event of change, technology could bring about unexpected outcomes as technology is complex and requires a great level of integration within an organization. Technology influences largely the level of care and a sequence of health and social activities. One potential challenge posed by technology is the use of different health systems by different health and social facilities. This results to differences in compatibility of the health systems posing a challenge to these facilities especially in the event of collaboration with other facilities and organizations and in instances of referrals.

            Stakeholders and decision makers may have a wrong perception that technology is wholly beneficial and thus embraced. This result in less concentration on the negative consequences of technology has on the organization. New technology requires the staffs to be trained on its use. This entails training sessions that require resource in order to run. In some instances, the resources are not always available and may constrain the organization’s budget if it was not initially planned. There are materials needed in the installation process of the technologies that also require resources.

            One major challenge with legislation is that it is time consuming. The process of passing bills into legislation is complex and can take a long period before it is operational. Legislation faces the risk of being opposed or even facing gridlock. Sometimes, important legislations that could change the health and social care services positively face opposition on party basis. Legislations are prune to political treatments and are not guaranteed no matter how good they are. Another challenge is facing legislation is the lack of involvement of the major personnel in the health and social organizations. The people making legislation sometimes do not enquire from the people on the ground to develop policies affecting them. This results to legislations that reflect the interests of the people making them rather than the interests of the people in these facilities.

            Legislations have had significant influence on changing health and social care facilities. It is however important to review these legislations from time to time and identify areas that need improvements or change. Once the legislation is made, the process of changing it is as complex as the process of formulating it. The government needs to develop mechanisms that facilitate effective legislations.

LO3 understand the principles of change management

3.1 explain the key principles of change management

            It is paramount to recognize the ethics of change management to facilitate change in organizations effectively. One principle of management useful to organizations is the John Kotter is who expresses managing of change in his eight-step model of change. According to Kotter, change comprises two components; emotional and situational components and in order to facilitate change, an organization needs to be able to manage these components successfully. This model emphasizes on the understanding of the causes of employee suppression and their emotions. At every step that change occurs, an organization should identify, understand and wisely deal with emotions related to change among the staff such as anxiety, exhaustion and panic. The human feelings largely undermine the efforts set for promoting change. It is thus vital for an organization to improvise ways that encourage the staff towards changing the negative feelings into positive feelings that lead to proactive emotions that encourage change.

            The first phase of the model accentuates the importance of constructing a viable climate of change. The organization needs to create a sense of urgency to its staff especially when there is an anticipated challenge when change occurs. One way of creating this sense is through trainings and meetings where the organization educates the staff on change. When there is growing urgency among the staff, it is necessary for the organization to initiate a team that will guide change through the all stages. The members of the guiding team need to have appropriate knowledge concerning change that affects the organization. The members should have the ability to establish trust among their colleges. In such cases, leadership and managerial skills are necessary for the guiding team to lead the rest of the organization towards positive change. Expressing the vision of the organization in precise way will give an appropriate direction the change should lead the organization.

            The next phase of Kotter’s model is engaging the organization in the management of change. It is likely that emotions of anxiety and panic emerge in an instance of change as the fear of the unknown creeps-in. It is vital for the organization to communicate effectively to all staff the changes that affect them as they occur. There is need to address all the emotions arising and help the staff to develop feelings that enable them behave in a manner in line with change. Resistance can sometimes occur at a given point in time during the change. Identifying the cause of resistance is vital in solving it. Encouraging dialogue between the organization and the staff will give the staff a session of expressing their feelings and create a sense of importance, as the needs of the staff are listened-to. An effective way to fighting resistance during change process is communicating the advantages and rewards that arise from the process of change. The staffs appreciate change better when they realize they gain something from the change.

            Prosci’s ADAKAR Model is an excellent model for evaluating change in an organization. It entails individual change and the organization needs to identify the five building blocks to control change in individuals successfully. Based on the ADKAR model, the organization needs to carry out Awareness conveying need for change, Desire of the staff to support change, Knowledge on how change affects the organization, Ability to apply the necessary skills and Reinforcement necessary to uphold change. In the ADKAR model, six applications enhance the organizations ability to go through change.

            Making sense of change is one application vital to the change process in any organization. Making sense of change in individuals entails focusing on the challenges the staff face in the event of change. Three stages help the organization manage change in the current state, transition and the future. Current state is how things are done such as the current treatment procedures, transition are the things brought about by changes in the current state towards the future. Guiding change in the management plans such as communication plans and training programs where the staff become aware of the change and trained on how to handle the change.

            A critical step advocated by the ADKAR model is measuring the progress of change in the organization. This is done through identifying the number of the percentage of staff keeping up with the change through activities such as meetings and training conducted on the staff. Diagnostic gaps assist an organization to identify the reasons why a certain change is not taking place or the factors hindering intended change in an organization. Diagnosing gaps helps an organization to identify those areas that are failing for instance in case there is failure in the awareness stage. In diagnosing gaps, the barrier point is identified. The barrier point identifies the building block that is not functioning well concerning change. The barrier point recognizes the root causes for the gaps.

            Once the root causes of the diagnosing gaps are indentified, the next steps involves developing corrective measures to curb the gaps. Corrective measures should focus on the right ADKAR building block that has a hitch. If the diagnosing gap was lack of awareness, then more training sessions need be put in place. Corrective measures assist in helping individuals move forward in the change process without hindrances. The last application involves enabling supervisors and managers who are a crucial component in the change process. Supervisors and managers are a source of information and direct the organizations activities. The other staffs look up to them as the change initiators thus influence the wave of change in the organization. The organization can enable the managers and supervisors through training especially by external experts at change. ADKAR is an important stage in managing individual in an organization. This helps the staff to accept change positively.

3.2 explain how changes in health and social care are planned

            It is vital to plan change in an organization to reduce the negative effects associated with unplanned change. One method that is effective in planning change is the stakeholder analysis. Stakeholder analysis helps an organization to identify the staffs that are willing to be involved in an event of change. A list of their names is organized and the people in charge categorize it in groups or individuals based on the level of involvement. The categorization helps in allocating resources and time with more resources being committed to the people who are more devoted to the organization. This will help maintain the commitment that the staffs have thus enhancing their involvement.

            Stakeholder analysis requires active involvement of a large number of people in this case clinicians, patients and other administrative staff. All departments in the organization are considering avoiding conflict or delays that can arise from lack of involvement. There are a number of steps carried out in stakeholder analysis;

• Identifying stakeholders is the first step that requires critical analysis. One great way of carrying out this exercise is assembling experts who brainstorm through a list of all staff identifying those most likely to be affected by the proposed change. The list is then presented to the group of experts.
• Prioritizing the staff through analyzing the list is the second step. The analysis is made based on the level of influence by change on the individual, power and influence. A table with each name having four sections is then made. To avoid eliminating any stakeholder, the 9Cs method is essential in the analysis. The 9Cs include the commissioners, customers, collaborators, contributors, channels who may be other hospitals, commentators, consumers that is the patients, champions and competitors in this case other hospitals.
• The third step involves preparing a readiness for change matrix that will help the organization identify any activities influencing the change.

Understanding the key stakeholders in this analysis is very important. Understanding their reactions to different situations and how best to have them involved in the process of change will enable the organization to bring out the best in them, and utilize their capabilities to the fullest. Some of the key questions that help the organization to understand the stakeholders include among other; what is the stakeholders expected outcome out of change? What motivates the stakeholders? The stakeholders are the best people to answer the questions regarding them.

            Managing the stakeholders is the next step that is vital in sustaining their enthusiasm. A model examining the degree of synergy among the stakeholders helps identify the levels of synergy and antagonism. The best stakeholders are those who posses high synergy and low antagonism. Once the organization has identified the stakeholders, setting up of a communication plan to enables the entire organization to be responsive to the changes that occur. The stakeholders spearhead the communication process allocating responsibilities and monitoring the progresses. Identifying the staff development needs assists in enhancing positive change in the staff that is an important component in the whole change process. One method used in identifying the staff development needs is the Workforce Planning Model used to evaluate the workforce and enable the organization to meet their changing needs. Identifying the direction of the change in the organization is vital in understanding the staff needs. WPM requires the organization to identify the following;

• Data concerning the current and future workforce acquired from the records office, interviews and demographic data will assist identifying the gaps in staff development
• Strategy formulated from the data acquired helps in planning and evaluation such as collaborating with universities and colleges, recruiting and maintaining the workforce, training and mentorship programs.
• Planning an approach that takes care of future needs of the workforce
• Evaluating the plan from time to time to ensure important information through methods such as interviews and other data collection methods

3.3 assess how to monitor recent changes in health and social care services

            Every change brings about outcomes both positive and negative in an organization. Some of the overall impacts of change are cost-benefit, waiting and response time and efficiency of the employees. Efficiency of an organization is an indication of the effective level of an organization in meeting its goals and vision (Scragg, 2010, np). Ones change occurs in an organization, the organization should become more effective. Efficiency is associated with effective resources utilization to achieve the best out of the organization’s structural change. An organization is said to be efficient when it maximizes its resource base for maximum output. An example of an efficient service provision is the GP surgery that has enhanced in its service delivery.

            Cost-benefit is another effect brought about by change. For a given organization, the benefits accrued from its operations should be larger than the costs. For an organization to benefit from cost, the questions of what and how is vital. For the organizations that are not concerned with profit making, it is paramount that a point of balance between cost and outcome is necessary. According to Zaforteza, et.al (2015, 82), referral systems refer to the relationship between primary health care facilities and hospitals in a higher level in the event of a transfer to such hospitals. Referral rates provide a measure for effectiveness of health organizations.

            Waiting and response time is the time a patient waits when he or she gets to the hospital to the time he or she is attended to. According to Manchester et.al (2014, 85), waiting and response times are still high in many hospitals but reducing significantly as technology continues to improve the health sector.

            Based on the discussion above, it is clear that change is inevitable and health and social organization need be ready to experience change at certain points. When every step discussed above is taken into consideration, it is possible for organizations to go through change successfully. The aim of change is to enhance efficiency in the provision of services to the communities and other stakeholders. Before changing the community, it is paramount for the organization to evaluate its programs and systems to ensure they withstand both positive and negative effects of change. The organization has a mandate to ensure the process of change is running smoothly and positive change implemented in communities that require the services. The organization need to respect people’s values, and views in the attempt to initiate change. This is necessary to avoid conflict that is likely to occur in the event of change.

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