Management Approaches for Strategic Change in Healthcare Organizations

Discuss about the Methods and the Apparatus For Implementing Model.

Discuss about the

Any business organisation operates in two environments, internal and external. The company can manage the internal factors of the company but in order to overcome and use the dynamics of the external business environment the company requires strategic management approaches. There are several academic researchers who have developed concepts and models of strategic management in various aspects (Hayes 2018). Change management is a part of strategic management as an organisation is expected to develop and grow keeping the factors of the external environment aligned. Change management is the process by which companies take decisions based on logical reasoning in order to initiate and implement change in anticipation to receive positive outcome (Hayes 2018). Change is initiated by a company to improve the existing circumstance, improve the performance, and understand and employee the scope of growth and development. In order to understand the implications of change management in a polyclinic of Saudi Arabia this assignment is undertaken.  

The company was established in 2000, and over the years the company has garnered considerable goodwill in the industry among the stakeholders but providing the clients with high quality services. It is now one of the largest private healthcare groups in Saudi Arabia. The company has incorporated change and development with the help of innovation in order to provide the customers with specialized services in various categories. The employees are considered as one of the major strengths of the company. The management is focused on the quality of the services that they provide their customers in order to ascertain their growth in the future. The company operates on several values and principles like ethics, quality, diversity, empathy which make up the culture of the company (Alamalclinic.com 2018).

Mission of the company  

To provide a wide range of high quality health care services which is aligned with the needs and requirements of the people of Saudi Arabia and other GCC countries.

Vision of the company

To maintain premium quality health care services at an affordable price and also to keep up with the international medical standards (Alamalclinic.com 2018).

Change in implemented in the company in order to grow and develop the process and services. As the organisation strive to meet the needs and requirements of the customers, they keep on implementing and initiating changes in the technology used, procedures in general as well as in order to provide a platform to improve the performance of the employees. Change is also implemented in the company in order to keep the process aligned with the international standards of health care services (Hayes 2018).

Al Amal Polyclinic: Introduction and Overview

The factors in the external business environment are also the reason the company has to keep changing. Factors like Politics, economy, society, technology and legal impact the strategic management decisions taken by the company (Langley et al. 2013). The management of the company is in constant analysis of these factors so that they can recognize a scope for improvement, mitigate any risk, work on the strengths in order to meet the threats in the environment etc. The strategic decisions taken by the management of any organisation is based on the objectives that are set (Van der Voet 2014).  Depending on the resources that the company has the management takes decisions of change (Cabrey et al. 2014). Change can be initiated in the process or a change in the product or service portfolio. Al Amal is an organisation that has the opportunity of expansion of the services they provide, as a polyclinic there are a wide range of services that the company can adapt. As a new company there is need for changes in order to expand and improve the services of the company (Matos Marques Simoes and Esposito 2014).

Though Al Amal is an organisation that has been trying to incorporate a number of services in their portfolio, there are a number of others which are yet to be added. The company has a number of opportunities in terms of expansion of the service and this requires a big investment. In order to expand the services the company will require resources in terms of technology, space and people along with several other aspects (Helfat and Martin 2015). The process of expansion of the services is changes that will help the company reach out and meet the requirements of the customers better as it will be easier for them to find require service under one roof. As a company which can be placed in the growth stage, change is a part and parcel of the management. With the help of change in various aspect of the company not only in the services the company can achieve the objectives and cater to the customer’s requirement (Alamalclinic.com 2018).

The human resource department in any organisation is an essential part of the business process. The role of the HR department is not only restricted to hiring of people but also extends to anything associated with the people of the organisation. Al Amal also needs to employee management changes in the process of the company, first of all it is important to focus on the performance management of the employees so that they can improve and develop in their career along with the company. Managing the performance of the employees is an essential part of the human resource department. It ensures motivation among the employees as well as bestows trust in the company. The performances of the employees are directly responsible for the reputation of the company as this is a service oriented organisation it is essential for the employees to ensure customer service. The performance management is a significant part of Human resource department in an organisation. It not only maintains transparency among the management and the employees but also motivates and encourages the employees to perform well. One of the roles of the human resource department of any organisation is to align the interest of the employees with the objectives of the business. Hence the change that the company needs to employee in the operations of the business is to introduce a performance management framework. This will not only help the company to promote and appraise the employee but also help the employees to understand their strength and weaknesses as well. Performance management implementation will also help the employees to understand their prospect in the company as well as improve their shortcomings.

Opportunities for Expanding Service Portfolio and the Need for Investment

These two aspects of the business are chosen for change as the company is relatively new and in a very short period of time has gathered a good reputation among the customers and other stakeholders, the company has the resource and the opportunity to expand the service portfolio which will also help the company reach out to the target market better (Matos Marques Simoes and Esposito 2014). On the other hand, it has been recognized that the company understands that the employees are an important asset and are the resource that is involved in developing a valuable relation with the customers. Therefore in order rot keep the people motivated and to encourage their work as well as help them develop in the specialization. With performance management framework implemented in the process the company can communicate better with the employees as well as recognize the areas where they need training and development (Helfat  and Martin 2015).

The company operates in the health care segment, the industry is dynamics and has developments in the field very often therefore to be at par with the changes in the industry as well as incorporate development in the organisation strategic change is necessary. However there are some of the factors in Al Amal Polyclinic that drive the need for the implementation of change.

Strategic decisions: the objectives of the company are important strategic management decisions and the company strives to achieve these objectives, in order to be successful in achieving these objectives the company has to initiate changes in the business operation. For example: if the objective of the business is to grow the business by 6 percent during the next financial year, the company has to implement growth policies in terms of service and product portfolio development (Cabrey et al. 2014).

Internal business environment: The factors in the internal business environment have its own dynamics which the company has to implement. These factors are associated with events, factors, people, systems, structures, and conditions inside the organization that are generally under the control of the company. The company has to implement changes in the process in order to utilize the factors as the strength.

External factors: as discussed above the trends in the industry and the factors of the external business environment impact the change management decisions taken by the company. The opportunities and threats in the industry are recognized with the help of the external business factors which initiate changes in the organization (Helfat  and Martin 2015).

Performance Management Framework: Importance in Healthcare Organizations

Risk and crisis situation: The rigidity in the operations of the business may impact the company comparatively more than a flexible management. For example: a crisis situation like economic depression may call for some emergency changes in the management, the company should be ready to combat risks and crisis with the help of change management strategies (Cameron and Green 2015).

The gap in the performance: when the strategic management decisions that has been taken cannot satisfy or help achieve the goals and objectives of the company, changes is required to be implemented.

Financial resources: Despite the company being a successful venture in the health care sector the company needs considerable amount of financial back up in order to initiate the changes in the service portfolio. Even if the management decides to take one specialization at a time the installation of the instruments which are required in the segment as well as building a space for the same is expensive.  The company will also require considerable human resource to run a department which is completely new. On the other hand, implementation of the performance management framework does not require direct financial investment (Hayes 2018).

Human resource: in order to implement both the changes in the organisation there is a requirement for skilled human resource who will run a new segment in the service as well as skilled employees in the human resource department who will be responsible for formulating the perfect ways in which performance can be measured correctly. If the company does not have proper human resource then the process of improvement of the service portfolio as well as implementation of the performance management framework would be incomplete and unsuccessful.

This model is focused on the goals of the organisation, the model explains five outcomes that the company or an individual must achieve in order to successfully implement change. This concept is coined by Jeff Hiatt and the five elements are: awareness, desire, knowledge, ability, reinforcement. The complexity of change on an organisational level will impact a number of factors.  This framework allows the mangers to focus their actions on what will drive individual change and therefore achieve organizational results. It is a holistic approach towards change where it ranges from the inception of the ideas of change and covers the factors that would help the change to persist in the process. Each of the five elements that have been discussed above is goals that the management has to achieve in order to successfully implement the change in the process.

Factors Driving the Need for Change in Al Amal Polyclinic

Figure: ADKAR Model

Source: Prosci.com 2018

The model explains that there are three stages of change: current, transition and future (Michaels and Greene 2013). The current state is the present condition the company is in and this is explains how the company performs presently, the future state is how the management of the company envisions the operations and the transition stage is the gap in between the current and the future stages (Michaels and Greene 2013). Awareness and desire are in the goals that have to be achieved in the current state, whereas knowledge and ability are the ones that have to be implemented in the transition stage. Lastly in the future stage reinforcement is implemented in order to maintain and monitor the changes (Prosci.com 2018).

Figure: stages of change in ADKAR Model

Source: Prosci.com 2018

The model identifies business dimension of change there are a number of phases in a typical change project:

• Recognizing a scope for the business which can be used an opportunity to grow or overcome some of the threats or weakness.
• Defining the change or the project that has to be implemented this includes the objectives and the scope of the project.
• Plan and design the solutions to the problem that has been identified. this includes new processes, structures and evaluation process
• Development of the new processes and systems
• Employ the strategy in the operations of the business (com 2018)

Some of the advantages of the model are that it is versatile and can be used by the managers in various situation and circumstance. The model is also easy to comprehend and implement by the mangers. The model will not only assist in plan the change effectively but will also keep check on the progress and help in monitoring the progress (Michaels and Greene 2013).

In 1996, John Kotter introduced the eight steps to change framework in his book “Leading Change”, this model is relevant as it has been revised in 2015 according to the changes in the business environment in the current time (Campbell 2008). The steps that are involved in this model identifies the complexity that is involved in any kind of changes be it a big change or small. The following are the steps involved:

Figure: Kotter’s Eight-Step Model

Source: Kotter 2010

Create urgency: this is associated with the motivation to initiate a change and drive the project from the first. Creating urgency in the situation will help the company to convince the other stakeholders associated to have a positive impact on the change project that has been proposed it may also lead to less resistance as the people mostly are convinced that the change is urgent and is required (Campbell  2008).

Developing a powerful coalition- leadership is the important element in this step. The leaders who can welcome change and can convince others in a positive way should be encouraged during the process of change.  Sense of organisation and team should be initiated and should be encouraged.  Inclusion of influential people in the team will help in reducing the resistance of change among the people (Smith 2011).

Forming a vision and strategy- Whenever the management of a company is developing a project it is essential to have a clear vision. Developing a clear vision includes determining the values and principles of the process. The leaders associated with the company can explain this vision to the people in order to derive an understanding (Campbell 2008).

Communicating the vision- This is a continuation of the above stage where the vision that has been culminated for the project is effectively communicated with the people associated in the company so that they share this vision with the management and employ efforts to accomplish the same in the long run (Campbell 2008).

Elimination of the barriers in the process of change- this is an important move as there will be a number of challenges on the path of change that the management and the people have to overcome. The management needs to foresee the challenges and the barriers and work on, build strategic decisions to eliminate these obstacles (Smith 2011).

Creating short-term wins- success is a motivation therefore developing short-term goals and achieving it will instill motivation among the people. The management should develop short term targets so that the team working upon it can be motivated by its success.

Consolidating gains- it is the duty of the management to cumulate the success of the short term gains and help in achieving the long term objective of the change project. The company has to methodically examine the possible pros and cons of the objectives of the target. It is important to gain success in the early goals of the project (Smith 2011).

Incorporating change in the corporate culture- After a change has been implemented and successfully carried out the management should encourage more development and change in order to improve the situation of the company. success stories should be shared with every opportunity. Here there is scope for the management to learn about continuous improvement with concepts like Kizen and encouraging fresh new ideas in the process (Kotter 2010).

The first model that has been chosen is ADKAR model of change management; and it is appropriate as the model is relevant to the business as Al Amal can be categorized in the small and medium enterprise category (Hornstein 2015). The model will help in providing a holistic view on the two changes that are needed in the organisation. The change of incorporating performance management in the process can be easily planned and strategized using the aspects of these models (Michaels and Greene 2013). As a change in the process of business this model will help the management and the department associated with project to maintain the outcome as well as evaluate the success of the process (Parker et al. 2013). This is a contemporary model of change and is intended to simplify the complex process of change. As considerable amount of communication is required in the process of implementation of the performance management framework, this model will be useful for establishing strategies to derive the targeted goal ( Kazmi and Naarananoja 2013).

On the other hand, Kotter’s 8-step change model is perfect for the first change that has been discussed above i.e. expansion of the services that the company offers to the clients (Ceptureanu  2015). Service portfolio change is a prolonged process and will help the company to grow hence the model will be appropriate as it does not only stop one project it ensures there is a continuous growth in the process (Osiyevskyy and Dewald 2015). The model has been revised owing to the latest dynamics of the business environment making it even more relevant for a new company like Al Amal (Auguste 2013).

Service portfolio development: the department that is going to be introduced is Cardiology. The first step that the management has to decide is to evaluate the resources that are available and the resources that are required to initiate the new department. In order to develop a new department the company will as discussed earlier require financial resource and Human resource as the specialization demands specific skill and knowledge. Apart from this the company will require to develop a plan for infrastructure to accommodate the department along with that there are technology that has to be installed in order to assist in the service and ensure that the quality of the service is top notch. The management of the company are the stakeholders who are majorly associated with the change as the existing employees are not impacted with development of a new department directly. The management plays a significant role in strategizing the process which includes: planning the investment, contacting the right people for the right responsibility, the HR department will have to employ right people who share the same values as the organisation. Another responsibility of the HR department is that the people have to be chosen from the existing employees to manage the new department; these people also require certain training and development opportunity which will help them to understand the dynamics of the new department so that they can assist in the change and deliver their best. The company should employ some marketing strategies as well in order to communicate with the customers as well as develop the service in such a way that it is perfect and is according to the requirement of the customers as the core principle of the organisation is to provide high quality services. In order to communicate the customers with the new development in the service portfolio there has to be a promotion plan developed for the cardiology department. The promotion plan will be based on the investment that is decided to be incorporated in the process.

Incorporation of performance management framework: the company has to communicate and make a transparent two-way communication process with the employees and in order to achieve this objective inclusion of a proper framework in the performance management is being implemented. Complains have been raised regarding the same, the process is to first undertake an initial research and understand the ways in which other SMEs implement performance management in the same industry. based on the analysis the framework will be created, there are several academic concepts of performance management like 360 degree appraisal, general appraisal, employee-self assessment, manager performance review etc. Then the HR department along with the management will have draw a framework that is best suited for the organization. After the designing it has to be approved by the authorities and implemented. The process of implementation should begin with communicating the change with the employees. Internal e-mail can be used to address the process and explain the procedure and the leader of the organisation should have a wider approach towards clearing the doubts of the employees. The implementation of the change should be from the next financial year.

The internal stakeholders of the company have the most important role in both the changes that has been discussed. The management, owners and the employees will ensure that the change is implemented in a successful way. The strategies and the planning is performed by the manager and the owners of the company.

However, in expanding the service portfolio the suppliers have an important role as there will be requirement for supply of new equipment and technology that will be supplied by the existing suppliers or new ones will be introduced to meet the need of the department.  

The government has regulations which the company has to follow while developing the new department.

The main shareholder of the venture to expand the service portfolio is the customers, as services are developed according to the preference and the requirement of the customers, therefore it can be said that in this venture the role of the customers are significant. On the other hand, in the operations change of performance management the customers have no role to play as it is a change in the process.

The change that has been recognized should not have any resistance especially in the case of the expansion of the service portfolio. However in the process of implementing a framework in the performance management the company should employ steps to overcome resistance like:

• Maintain transparency in the process of communication
• Solving the doubts of the people associated with the framework
• Communicating the benefits of the change
• Inclusion of the people in the process of change (Rosenberg and Mosca 2011)

In order to implement the changes the company can adapt to some of the following recommendations:

• The company should have a far-sighted approach for any change management decisions that are taken by the management.
• The organisation should assure strategic implementation of the process of change
• There should be an evaluation metric of the change in order to indicate success or failure of the venture
• The company should also employ leader from among the employees in order to motivate the others. The managers of the company should also be encouraging and inspiring enough to ensure the change sticks to the company and is used in a positive way.

It can be concluded from the above discussion that Al Amal is in the growth stage and has opportunity in terms of resources as well as skills to explore the health care industry further; the company has a very strong organisation culture which is based on their core values and principles. The customers and the employees are the most important stakeholders of the company and this is the reason changes has been recognized. The expansion of the service portfolio is based on the importance of the customers, where as implementation of the performance management is based on the employees. It has been observed that the ADKAR model and the Kotter’s eight-steps are the best suited change management models for the company.

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