Introduction

The selected fictional organization is a Cancer Center located in the United States. Its specialisation is cancer treatment, prevention and detection. Cancer Center has two buildings, located in San Diego region, where its 120 employees are working. It was founded in 1980, and since that time continues to use the outdated management model. The basic income a Center receives for providing services for the diagnosis and treatment of cancer. Like the other health-care companies, nowadays, this Center faces dramatic changes in its environment - regulatory demands, customer behaviour, and market dynamics. That is why in in order to keep the leading position in the field of cancer treatment, company’s managers must undertake significant organizational changes to address external challenges. 

With these changes implemented, the Cancer Center will improve its performance, develop new capabilities, and strengthen its position in the market. Its managers also admit that their Center needs to build a strong relationship with its partners and customers, motivate consumers to use health services in the right way, and create more effective care management tools and reimbursement systems. Therefore, the company’s aim is to deliver greater value for its patients by increasing the quality of care at a lower cost. Developing cost-effective business model and opening new capabilities will help the company to meet the changing market needs. Thus, the purpose of this essay is to describe the suitable change process that can help to address the challenges faced by the chosen company.

Cancer Center’s Challenges 

To improve the Center’s performance by taking particular measures and implementing change, it is necessary to identify its challenges and difficulties. It will help to provide a foundation and an introduction to concepts of quality improvement and major topics for developing a changing program within an organization. These challenges can be divided into two types – external and internal.

The external difficulties consist in the fact that that, during the last years, the healthcare market was rapidly changing.  Mary Mosquera (2014) identifies several challenges that affect all health-care companies in the U.S. and thus can also be applied to the chosen company.  The first issue the company faces is the need to shift to value-based business model. The company has fee-for-service revenue. However, it has to reach the point at which the costs of building and maintaining its value-based business processes are not supported by its fee-for-service revenue model. Secondly, this company needs to respond effectively to the economic dynamics of the U.S. health-care market. In the case it is going to use the value-based model, it needs to deal with the realities and limits of the U.S. economy. 

 

A big concern for the company is the need to secure and grow its market share. The company’s managers must constantly weigh the company’s market strategy, which includes consolidation, partnership and strategic relationships with the partners. It is also important to improve customer service, customer engagement, and retail capabilities at the top of the company’s strategic plan (Quality improvement 2011).

The internal difficulties include the need to reduce the company’s costs while improving care for the patients. According to The Commonwealth Fund’s International Healthcare Review (2014), the healthcare system of the United States is the most expensive in the world. At the same time, this system has low dimensions of access, efficiency and equity (Smith 2014). 

To form a more stable financial base, the Center needs to develop alternative revenue streams (Mosquera 2014). Thus, it is vital to create cash reserves and strong margins. This way, the company will be able to make important investments in its development and support its patient care business. Such investments possibly can include business software development, telemedicine, pharmaceutical research, ambulatory care centres, and cloud-based solutions that can facilitate new provider collaborations and support customer-service initiatives. Furthermore, the company needs to reduce its healthcare costs basing on the concentration of the payer market and physician practice alignment (Brown & Falk 2014).

Another issue for the cancer centre is the need to find new approaches to managing the core operating costs. Company’s managers need to lower costs of the health-care core operations, reduce utilization through standardization, and manage care variations (Hughes 2008). The next challenge is capitalizing on new opportunities. Health plans have many disparate activities, which does not support customer service. Thus, its health-care systems need to be updated. Consequently, healthcare executives have to improve their performance by evaluating every key operational, clinical and governance function. They also need to develop a strong vision of the future, the ability to act based on growth perspectives, and the leadership to bring stakeholders along with them. 

Implementing a Change Process 

Description of the Change Process

In connection with the existing company’s difficulties, the best option to deal with them is to implement digital medical technologies. Though, a change process would be focusing on the organizational structure and processes. According to the Carlos Sato (2015) with this combination of the level of change and its focus a bold-stroke approach should be used. This approach characterises by the rapid change and lagre scale transformation throughout the company (Sato 2015).

The existing challenges make the managers move the organization from one stable state (which was characterized by the problems faced) to the desired future (characterized by the solutions to those problems) in line with its development strategy. Therefore, the change management is the combination of plans and considerations that help to manage the internal and external disruptions in an organization (Change management best practices guide 2015). According to Sato (2015), the changing process plan includes the following elements: change management team, management structures, activity planning, commitment planning, audits, post-audits, and training. 

Change Management Team and Management Structure 

Since at the beginning of the changing process resisting forces in the organization usually outweigh the driving forces, they must be attributed defined roles (Hoogendoorn et al. 2007). The Senior Vice President is responsible for the Center operations and processes, though he is the global change manager in this case. As it can be seen from the Fig. 1, the global change manager is granted with driving forces and allowed to change the entire organization. Global change manager is responsible for giving instructions to the local change managers who are divided into change groups with different functions and areas of activity (see Fig. 1). Given that the implementation of new technologies is a very expensive and risky investment, top managers of the Cancer Center decided to implement new technologies in two existed departments: department of diagnostic imaging and department of general oncology; and create a new department of bioinformatics and computational biology.   

Organization Change Model

The model of organizational change of the Cancer Center includes activity planning, commitment planning, audits, post-audits, and training. This model is based on the three stages of change introduced by Lewin. Figure 2 depicts a simplified change management flow based on Lewin’s Model. 

 

Phase 1. Creating motivation for change (unfreezing) is the first phase of the implementing innovations in the Center’s processes.  This phase is characterized by the global change manager’s activity. The Senior Vice President should inform managers of the  chosen departments about the forthcoming organizational transformations, the reasons for their implementing, and the leverage points and opportunities for change (Hoogendoorn et al. 2007).  It is the so-called preparation for the possible resistance of some employees caused by their disconfirmation about the digital technologies and their concern that these changes will complicate their current work. During the unfreezing phase, the roles of each change member at all levels should be determined, and the Senior Vice President as the global change manager should create conditions for the psychological safety to overcome learning anxiety in employees. 

Thus, the Senior Vice President can establish trust using several approaches.  For example, a proven method for building trust and establishing a common ground is to engage the Center’s staff in planned change processes. It is also important to provide accurate and honest information regarding the changes that are going to be implemented in time. Furthermore, the Center should provide a full range of staff and leadership development resources, mentoring and coaching for the staff from chosen departments (A user’s guide to managing change in the health service executive 2008).  

Phase 2. Implementation of the changes (moving) is the second phase of the changing process. At this stage, the Senior Vice President should all members of the change team about the time when the new machines will be placed at their officers and the study process will begin (Hoogendoorn et al. 2007). Further, all involved members of the change process must take part in the identification and implementation of their new role into the changed model.  This step allows achieving the involvement of all team members in the change process who will start behaving according to the requirements of the new model.  The second part of the movement phase consists of the scanning for changing solutions and action research based on error learning. This part is vital, because involved employees need to thoroughly examine the specific of machines operating and servicing. 

Phase 3. Stabilization and internalizing new concepts (refreezing) refer to the last phase of the changing process. At the start of this phase, the change group should be deactivated. New digital technologies will be fully implemented at the departments’ processes and take the first patients. It should be noted that the third phase may be considered completed if the company’s processes correspond to the expected behaviour of the planned organizational model (Hoogendoorn et al. 2007).

Activities for Effective Change

There are several activities providing essential support for the successful implementation of digital technologies throughout the three chosen departments. Transformational change requires managers and employees of the departments to take personal responsibility. Revolutionary technologies will lead the center and its employees into the new digital era only of they will be able to transform themselves, their behaviour,mindsets and fundamental assumptions about the current outdated bussiness model of the Center (A user’s guide to managing change in the health service executive 2008).

The next important activity includes building strong and healthy relationships with the Center’s stakeholders engaged in the change process.  These include its patients, service providers, local communities, and others. In addition to this, a comprehensive communication plan should be implemented to provide a smooth communication and information flow within and outside the Center’s departments involved in the change process (NEFAB Project:  change management manual 2011). 

Senior Vice President as the global change manager should also ensure the availability of resources for change, such as staff, financial, technological and  infrastructural. He can delegate this duties to the local change managers who will be responsible to conduct a regular examination of these resources and replace them if necessary. Furthermore, attention must be paid to the broader organizational factors that support effective group work since teams and groups of employees are essential for the successful delivery of change throughout the organization. 

A vital activity for an effective change process is to maintain a balance between the change activity and daily management tasks of the departments. Senior Vice President and local change managers need to take additional efforts to do the routine job while at the same time monitoring the change process. It should be noted that an essential activity in this regard is to support continuous staff learning and develop effective feedback mechanisms at all stages of the organizational change. It will allow global change manager to ensure a regular review and audit of the changes and reinforce them if required. 

Measuring the Progress

The Change Management Best Practices Guide (2015) demonstrates the importance of measurement and reporting during the change process faced by an organization.  According to it, appropriate metrics for measuring and assessing the progress ensure that the organization does not lapse into old behaviour. Thus, establishing targets during the change process is vital for focusing and motivating the staff  around a change and supporting the change goals.

Advantages and Disadvantages of the Change Process

Understanding the advantages and disadvantages of the change process in the Cancer Center will help to determine the appropriate organizational changes and reduce the negative possible negative effects on the Center. There are different benefits and drawbacks associated with the digital technologies’ implementation in the organization.

Advantages

Investing in new technologies will allow the company to gain a better competitive edge in the market of health-care services. Moreover, it incorporates gaining new skills by company’s staff as well as developing products and services that will bring higher profits. Generally, change process also trains managers and staff teams to effectively deal with any new direction proposed, and will increas morale among the staff and a sense of its empowerment and control. 

Such changes can also help to completely change the course of the Cancer Center development. Moreover, according to that fact that this Center has not undergone any changes or transformations for many years, it can be stuck at the same level of development and consequently lose its market share in the dynamic modern market. Therefore, using the ndigital technologies can improve the organization operations and processes.

Disadvantages

Implementing digital technologies in the Center’s operations and processes is a risky and expensive investment. Choosing a wrong solution during this process can negatively affect a whole organization. Thus, to avoid the failure of such investment, it is necessary to create a change plan with clearly defined steps for every change and substantiate the need for changes. Nevertheless, while change can be risky for the Center, its advantages outweigh the potential drawbacks. Consequently, change will allow the Center to ensure the steady progress and keep the leading position in the market of cancer prevention and treatment. 

Conclusion

This report outlines the aspects of managing the change process in the fictional health-care organization – a Cencer Center. Among the external challenges faced by the Center, it is necessary to distinguish the rapid change of the healthcare market and the risk of losing the market share. The internal difficulties include the need to improve care for the patients and reduce the Center’s costs. 

To address the difficulties that may arise in the course of change implementation, a planned change process should be undertaken. The aim of the change process its to implement new digital technologies in the activity of three experimental departments of the Center.  The change process is based on the Lewin’s Three-Step Model, which includes unfreezing, moving and refreezing phases. The first phase is based on creating motivation for the change. During the second phase, changes are implemented. The third phase consists of the stabilization and internalizing new concepts for the organization. The change management team is responsible for implementing the aims of the change process, which has three levels. On the first level, there is a global change manager (Senior Vice President) who is responsible for the whole changing process. On the second level, there are change groups, formed from the choosen departmets staff. The local managers of these groups are responsible for the implementing the change process at their departments. Lastly, the third level includes other employees of the departments, who are subordinated to the local manager.

Advantages and disadvantages of the change process were also outlined. Properly introduced change is beneficial to the organization’s activity since it helps to correct the course of the company and achieve its short-term and long-term goals. It also has a potential to create better conditions for the company to compete on the market of health-care services, implementing the cost-effective business model and increasing the patients’ satisfaction. On the other hand, investing in new technologies is expensive and  threatens the stable development as a wrong solution can negatively affect the whole organization.

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