400846 Role of Leader in Facilitating a Change Process Assessment Answer

In the context of health care, effective leadership facilitates change management. Leadership is pivotal in the context of change management as effective leadership links with the capabilities to solve problems during change, develop appropriate strategies and decisions regarding initiating, monitoring, measuring and controlling and fulfilling the change, implement evidence-based changes, determine the improvement areas and motivate organisational teams to develop a healthy and positive workforce culture. With the implementation of an effective leadership approach, it is possible for healthcare organisations to successfully initiate and achieve change. This essay explores to identify relevant and applicable leadership and change management theories and how these theories are applied in practice. With that aim, the essay explores and analyses the role of leadership, as well as, change theories along with how they link capacity building within Royal Children’s Hospital (Melbourne) as they implemented an Electronic Medical Records (HIMSS Outpatient EMRAM^SM ) system (HIMSS Analytics - Asia Pacific, 2018). 

As opined by Daly et al. (2014), managing organisational culture is increasingly perceived as an integral component of health system reform. The healthcare sector needs to tailor the delivery of healthcare practices to suit the needs of the patients and to improve the quality of patient care delivery. Consequently, change policies and system improvement regulations are frequently observed in the sector. According to Doody & Doody (2012), leadership is vital in change management as it provides organisations with the capacity of effectively initiating and managing the change, keeping workers motivated and inspired, developing consolidated strategies and informed decisions. Effective leadership is further a central element driving the identification of the needs for change within existing healthcare systems. In the current context, changes in the healthcare systems around the world can be most notable in the form of digital transformation, restructuring and system upgrades. The Mount Auburn Hospital, for instance, implemented a computerised physician order entry (CPOE) system in 2018. The implementation of the CPOE led to the enhancement of work pace along with improving service quality and delivery capabilities due to the physicians being able to use the system to send medication orders and treatment instructions to patients and hence, making services quicker, interactive and more efficient.       

Effective transformational leadership is integral in the context of initiating and achieving complete change management in the context of healthcare as with transformational leadership, any organisation can have access to the capability of keeping the workplace motivated and inspired to achieve a shared goal and improve performance-related outcomes.

The essay begins by setting the overview of the paper and reflecting on existing pieces of literature to develop background knowledge on the central components of the essay that include the importance of change management. Further, the essay proceeds to discuss the role of leadership in the context of healthcare change management in association with workplace culture and its relevance to workplace change. The significance of considering the organisational mission, vision and goals have been evaluated thereafter. Further, the essay critically analyses a change theory and how it can be considered in planning organisational change, as well as, the barriers and facilitators to facilitating change. In the end, the essay draws on further literature to evaluate the role of leadership in team motivation and development before, during and after a change is implemented along with signifying the importance of a learning organisational culture in achieving effective change. 

According to Marquis & Huston (2019), the role of transformational leaders connect to the 'manager' who is committed and has a vision concerning how the organisational practices, as well as, services can be improved and then can use proper strategies and techniques to keep the workforce motivated and inspired intending to empower organisational teams in terms of effectively achieving a change.

According to Sarros et al. 2008, leadership, as well as, organisational culture is linked significantly to the process of change and only through effective leadership, an organisation can develop the capability to develop, as well as, nurture an organisational culture that is adaptive to change. The personnel in the leadership positions within organisations have significant functions to play in terms of defining, as well as, shaping the contexts of work, activity and performance that contribute to innovation at an organisational level. As specified by Sarros et al. 2008, through the effective implementation of transformational leadership, any organisation can achieve the environment and culture necessary to survive for a long-term due to the empirical endorsement that transformational leadership has in the context of supporting, as well as, promoting organisational, team and individual innovation.

Building further on the concept of transformational leadership, Penava & Šehić (2014) mention that the fundamental functions of the leaders following this approach relate to collaborating with organisational staff members across the businesses to identify necessary areas for change and developing visions to implement and guide the organisation through change. Transformational leaders must keep the workers inspired and control the different processes of change in collaboration with other committed parties within the business entities. According to Daly et al. (2014), throughout the process of change, it is necessary that healthcare organisations can provide and fulfil the requirements of the ongoing services and consequently, it is necessary for effective clinical leaders to ensure that a high-quality healthcare system is maintained with the strategic positioning of organisational staff members. Leaders need to understand the fundamental capabilities and weaknesses of the KSAs of the workers to ensure the strategic positioning of the staff members. This function of leadership in the context of managing change relates to a consistent provision of efficient and safe healthcare to the consumers (or, in other words, patients).

Al-Abri (2007) explored the integral components involved in managing change in the context of healthcare. According to the author, organisations that employ a hierarchical and bureaucratic structure tend to be less amenable, as well as, flexible along with having almost little to no capacity in terms of empowering staff members which are a pivotal element in successfully achieving any change. With the implementation of the EMR system, it was necessary, in the context of RCH that the professional employees were empowered to be innovative and insightful in their practices to obtain full value from the change. Consequently, it is the role of leaders to comprehend the process, as well as, issues entailed within the change and having the capacity to manage and lead the change efforts effectively. According to Al-Abri (2007), it is the responsibility of leaders to assist employees, as well as, stakeholders at other levels structure and develop effective teams through the creation of a shared vision emphasising on the authentic output of workers.

Therefore, leadership is necessary to effectively maintain and manage the change processes, inspiring and guiding the organisation through the change processes, creating a vision that can be shared by all organisational stakeholders and implementing efficient strategies to fulfil that vision.  

 The notion of workplace culture and its relevance to workplace change builds on the idea that change is a gradual process and instead of the quick succession of meetings or messages, organisational staff members must be provided with the time to adjust with the idea of the transformation. 

According to Jones (2007), organisational or workplace culture refers to the set of norms and shared values that shape how the team members within the organisation interact with one another, with suppliers and vendors, consumers, as well as, other stakeholders that are linked with the organisation. The workplace culture within an organisation can often be reflected in the context of the mission, vision and strategic goals concerning how the organisational members treat each other along with the people that engage in transactions with the organisations. Workplace change, on the other hand, is defined by Jones (2007) as the systematic process that is utilised by organisations to move from the current state of the entities to the desired state in the future to improve efficacy. At a basic level, organisational change is associated with the identification of ways to enhance performance, operations and service delivery among other elements with logical and efficient utilisation of internal capabilities and resources to generate value. The digital transformation that was implemented in RCH in the form of an EMR can be considered a transformational change that is massively radicalised. Albion & Gagliardi (2007) states the transformational change does not merely involve the introduction of new structures and systems but is rather associated with the upheaval of presently used systems and structures. All of the existing processes, consequently, need to be adjusted and alternated to suit the needs of the newly implemented system. As per Jones and Redman (2000), it may be sometimes important for leaders to destroy a workplace culture when undertaking work or process redesign when a change is contemplated.

Therefore, workforce culture shapes the practices and processes and how they are performed by the organisational members. It further impacts how organisational people behave with one another and those accessing the services offered. When contemplating a change, it may be sometimes necessary for leaders to destroy a workplace culture to ensure that the organisational or process change is efficiently implemented.  

The organisational strategy addresses the desire of an organisation to attain something and the relevant arrangements concerning the desire and such 'strategy' are profoundly influenced by the MVGs of organisations.

Many changes can be observed at either the external or internal environments of organisations from economic circumstances, availability of workforce, government policies to technological capabilities and service efficiency As postulated by Maddern, Courtney, Montgomery & Nash (2006), these elements within a firm's environments deeply influence the future directions of organisations, as well as the necessity to implement a change or restructuring the organisation or a process. In the context of RCH, the change that has been implemented is associated with the restructuring or the improvement of the organisation's technological capabilities. As postulated by Maddern et al. (2006), the development of strategy is a process that goes on consistently to allow a firm in terms of responding to the alterations within the aforementioned environments. In a wide range of situations when a change is contemplated in the context of either the intrinsic or extrinsic environment, it is necessary to review how the organisational strategies are carried out or organised. A strategic change that is being implemented by an organisation is likely to influence the adopted organisational structure along with the traditional way in which groups and teams functioned for ensuring service delivery. It further affects the requirement managerial approach for function-related support and the flow of communication and information. 

Therefore, it is necessary to link the change strategies to the MVGs of an organisation to successfully develop appropriate strategies to ensure that the change(s) do/does not impact the organisations at a strategic or structural level negatively.   

The implementation of the Unfreezing-Change-Refreezing model allows organisations in terms of determining and examining all the elements, as well as, forces influencing specific situations in the organisational context. In the context of change, leaders are required to reject knowledge gained before the decision to change and substitute the rejected knowledge with new and insightful information.

Developed by Kurt Lewin in 1951, the UCR model is a three-stage model that builds on the notion that with the appropriate determination and examination of the potency of the elements, as well as, forces, it is possible for the leadership of organisations to effectively evaluate which of the forces need to consolidated further or diminished completely to introduce organisational change efficiently. The first stage within the model is unfreezing. In this stage, the leader, along with the relevant team members, must emphasise determining a method to assist other organisational members to reject a traditional work culture or process in which work was done (Cummings, Bridgman & Brown, 2016). A change may be subjected to significant resistance across the organisation as team members may be considered knowledgeable of how to carry out the activities in an old system and it might be perceived by the members that with the implementation of the changed worked process, their roles and responsibilities might become more difficult and complex. Therefore, the unfreezing stage is further associated with facilitating group conformity and supporting individuals to overcome resistance by involving and engaging them in the decision-making process. This allows the members to understand how the change might improve their performance and efficiency of service delivery. Leaders, in this stage, implement disequilibrium strategies to disrupt the present system. In this stage, leaders can identify the driving forces for the transformation along with the restraining forces and further strengthen or eliminate these forces. The second stage is changing or moving from the old process to the new process or system. In this stage, the leaders approach the members to change their behaviours and feelings. One integral strategy that can be implemented by leaders in implementing an EMR at RCH is to persuade the members that the status quo of operating or writing medical and treatment instructions by pen and paper is not effective and beneficial, consumers significantly more time and is inefficient in terms of rapid service delivery. The leaders may involve organisational members in partaking in the decision-making processes to collect their sentiments and thoughts on the desired change and carefully eliminate the fear and uncertainties among the members associated with the change. Clear and supportive communication is pivotal in terms of achieving the change. Finally, the last stage is unfreezing wherein the leader establishes the change as the new status quo within the organisation. In this stage, instead of removing the old system overnight, the leader can invite few practitioners or clinicians to try the new system and provide them with an experience to facilitate their comprehension of the benefits of the new system. Thereafter, the members should be consistently involved in maintaining the process to turn it into a habit so that it can be implemented for the long-term.

Therefore, the UCR model of Lewin is established on identifying the resistors and facilitators of the desired change, freezing the process to disrupt the existing system, eliminate the fears and uncertainties of team members and finally, attain the new equilibrium and maintain it.

Leaders must identify the barriers and facilitators to implement changes effectively and to either strengthen or eliminate them to ensure that all organisational members are on board with the change process and to obtain endorsement from other stakeholders.

The barriers and facilitators to a change process can either increase or decrease the magnitude and the complexity of change. In the context of RCH, the implementation of the technological change, as a transformation process, may be affected by several barriers and facilitators (Daly et al. 2014). Some of the barriers to be potentially faced by the organisation include leadership instability, competing demands, staff resistance to change, scarce resources and technical problems. The facilitators, on the other hand, include organisation-wide involvement, leadership support, adequate training, persistence and frequent monitoring. To anticipate and manage these changes, the organisation may involve all relevant staff members and other relevant stakeholders in group meetings and brainstorming sessions to identify the concerns and doubts regarding the system. Furthermore, with the implementation of the first stage of the UCR model discussed previously, leaders could disrupt the existing system to identify the driving factors and forces. This stage can be further used to involve the relevant parties in group meeting sessions to eliminate their doubts and queries through motivation and inspiration. The concerns and doubts that the team members may have can be mitigated by explaining to them why the change is necessary and how it would benefit the organisation, as well as, them at individual or group levels (Baars, Evers, Arntz & van Merode, 2010). This may create staff interest and motivation in terms of acknowledging the need for the change.

Therefore, it is pivotal for leaders to engage staff in the decision-making process regarding the desired change through group meetings and brainstorming sessions. The fundamental agenda of these meetings and sessions are driven by the need to collect and disseminate information regarding the change and its impacts among the employees leading to the elimination of change resistance from the workforce.

Leaders inspire and motivate teams by explaining how a change would benefit their personal and professional performance and provide them with necessary training facilitating future career progression along with allowing employees to link with the organisational mission, vision and goals more profoundly.

Career development refers to the process of training and developing the KSAs of the organisational teams at both group and individual levels to ensure they have the necessary KSAs along with the confidence needed to attain present strategic goals. It is further associated with ensuring that they have sufficient knowledge and confidence concerning learning how to meet organisational challenges in future and develop the necessary capacity to change. In the context of workforce development, consistent education and communication are one of the pivotal steps. Education and communication can be used as common mechanisms to interact with staff and other relevant stakeholders whenever inaccurate or the complete lack of information is noted. It may allow leaders to persuade the staff members to assist in the implementation of transformation (Kotter & Schlesinger, 2008). The second step is the involvement of stakeholders and staff. Through participation in different change management processes such as decision-making, initiation and freezing-controlling-unfreezing, it would be possible for leaders to eliminate concerns and doubts of the relevant parties so that they can full-heartedly participate in the implementation process with full focus. The role of leadership further associates with facilitating the access of training methods and resources to the team members to ensure that they have equal opportunities to access the methods and enhance their KSAs appropriately to suit the need-of-the-hour. Finally, workforce development must occur consistently to ensure that the team members, as well as, the organisational culture is future-ready for further changes or alterations.

The development of a learning organisation culture allows organisations to continually reinvent itself depending on the intrinsic, as well as, extrinsic forces and thereby, makes organisations, groups and individuals prepared in terms of coping with changes and their impacts.

The concept of learning organisation builds on five basic dimensions that create an environment in which an organisation can become more dynamic along with enabling the constituent parts within the organisation share common goals (Nyhan & Kelleher, 2002). It refers to the capacity of organisations in terms of creating, accessing, implementing, as well as, disseminating knowledge through achieving an organisation-wide synergy where individual, group and organisational learning are converted into a process involving collective learning. The collected and disseminated knowledge can be used to make new status quos in the context of organisational work and practices and developing new ways of thinking. It is based on recording knowledge that is gained by the team members while working on a new processor changed the process and garners the experience generated from functioning with the model. Additionally, at the organisational learning level, the experience and knowledge gained by the individual team members can be shared with the other group members and ensuring that all bits of knowledge concerning are shared with others are available when they are operating within the system.

Therefore, organisational learning instils collective learning within an organisation and inspires individuals to consistently develop their knowledge, skills and attributes at the individual, group and organisational levels. Furthermore, organisational learning also improves future-oriented performance associated with change. 

To conclude, it can be stated that leadership enables organisations to predict and determine the necessity of initiating a change, evaluate the potential barriers and facilitators that may affect the change and make strategic arrangements to ensure effective implementation of the change. Effective leadership further associates with shaping the change to suit the mission, vision and goals of the organisation by changing or augmenting the organisational and workforce structure and culture. In change management, effective leadership further associates with keeping the workforce motivated and inspired throughout the process of implementation and making a change to the new status quo.