Health service integration (HSI) seems a logical and desirable strategy to improve both the efficiency and quality of service delivery (Le et al., 2016). A study conducted by Allan and Stevens (2007) examined a medium-sized urban Australian health district’s endeavour to carry out an integration of acute and community services for serving a target population. The integration planning failed due to a number of challenges faced, the most crucial ones pertaining to lack of strong vision, inappropriate organisational structure, the absence of suitable leadership, a shortfall of resources and cultural conflicts. The failure to carry out a successful implementation of HSI demanded more advanced and planned strategies that would lead to the achievement of the desired outcomes. The present paper outlines a suitable change management plan, and strategic implementation plan that can address the key issues faced successful implementation of health service integration in the organisation. The aim of the paper is to propose strategies that would be highly beneficial for leading to a logical and appropriate health service integration process through enhanced transparency and planning.
The purpose of the present change management plan and strategic implementation plan is to resolve the problems faced in the health service integration process, including inconsistent application of resources, lack of strong vision and inappropriate leadership styles that are autocratic. A desirable health service integration needs to be based on sound and planned change management practice that is outlined in this paper.
With the change management plan and strategic implementation plan in place, the health care system would be better able to implement the health service integration. It would cut across traditional care provider-focused service management system by putting the emphasis on diverse needs of the target population.
Change Management Plan
Overview of the plan
For bringing about the desired changes in the organisation, it is necessary to eliminate all scopes of disinterest, distractions and negativism that can hinder the successful implementation of a plan. Certain elements are to be put in place in an organisation for bringing about the required changes and to hold on to these changes. These elements are to be addressed for the present Australian organisation for successfully implementing the health service integration (Kash et al., 2014). The elements are a shared and agreed-on direction and vision for practice, an effective and functional structure for leadership and a culture promoting change. By addressing these elements, it is expected that the organisation would be successful in fulfilling its objectives (Gesme & Wiseman, 2010).
For engaging in strategic planning, it is pivotal that a vision statement is made. The step of articulating a strong vision would encourage input from the concerned stakeholders, that is managers and healthcare providers within the organisation. The strategic vision would change the thought process of the individuals, and they would recognise the underlying principles of integrating acute and community services for better patient outcomes. The resulting vision is to be communicated to all the members of the organisation, and there is a need of reinforcing the vision so that culture is fostered where everyone is ready to accept the changes required for moving towards the set vision (Gopee & Galloway, 2017).
In addition to establishing a shared vision, there is an utmost need of suitable leadership within all levels of healthcare providers. The key to the desired transformational change in the organisation would be to have leadership that can support, understand and explain the required changes. Then only can be organisation commit to the change. The correct approach would be to construct an appropriate leadership structure (Kumar & Khiljee, 2016). This process would be two-step one. The first step would be the recruitment of senior leaders, while the second step would be leadership and training. Since the organisation is faced with a wide range of complexities, it would be good step to consider candidates from outside the organisation who can contribute towards leadership development in the organisation. The skills that would be the cornerstone of leadership are population health management experience, innovative thinking, transformation change management, clinical expertise and patient safety expertise (Sonnino, 2016). Healthcare leaders from outside organisations would potentially bring a fresh perspective within the organisation and the required skills and mind-set for the present organisation's members (Al-Balushi et al., 2014). The nest step would be leadership training. As per the suggestion of Delmatoff and Lazarus (2015), the modes of transferring leadership skills would be specific job-skill sessions, customised programs, conferences and one-to-one mentoring. The focus of the leadership program would be developing leadership skills, building knowledge and staying abreast of the developments in the field of health service integration. The program would bring together competent leaders and those who need further development under one roof for transfer of skills and knowledge. It can be expected that through thee development of leadership the organisation would be better able to embrace the changes required and demonstrate increased engagement in HSI (West et al., 2014).
Shift in organisational culture
Kelliher and Parry (2015) highlight that for shifting the culture of the organisation to the one that satisfies the need of change a head start is crucial. The physicians have a central role in this. As the physicians are caught up in inertia, the step taken could be to provide information to them. This step rests on the principle that information has incredible power and this holds true more for physicians. The practice’s referral base would be one of the primitive areas where information would be provided for the cultivation of the readiness of change. Benchmarking the data and comparing the practice’s performance on the basis of chief practice indicators would be helpful for encouraging a readiness for change (Jacobs et al., 2013).
Readiness for change
For getting best results of the planned changes, it is necessary to identify who all would go for it and who all would go against it. It is advisable to approach those who are keen on supporting the initiative on the immediate basis. Resistance to change would be normal, and fear of change underlies resistance at most times. It is, therefore, crucial to be sensitive to the impact of change on the ones who are directly involved. Conducting sessions with the individuals to mark out their issues would identify what holds them back to hold on to the change. The way to address the apprehensions is to show the individuals that mean by which the change would help them carry out their roles and functions in a more effective manner (Gesme & Wiseman, 2010).
Strategic implementation plan
The change management plan can be implemented at a pilot scale in the initial basis for six months. Depending upon the effectiveness of the plan further changes can be suggested aligned with the growing needs (Antwi & Kale, 2014). Strategic implementation of the proposed change management plan would require to rest upon four basic principles- communication, building up of a team culture, identification and empowerment of champions and provision for feedback and positive reinforcement.
Steps for implementation
Communication at the individual and operational level would be pivotal that would be emphasis on the two-way flow of information and interchange of ideas and viewpoints. For launching the transformative change, the staffs need to be given the opportunity to put forward their perspectives on the concept of HSI. This can be accomplished through regular meetings where clarifications, questions and concerns can be discussed, and suggestions can be proposed. In managing the change process, the participation of the stakeholders is essential. A team culture can be built and nurtured by impeding a climate of mutual respect and trust. Clear and realistic expectations are to be set that can empower individuals. The change would need identification of visible champions who have a strong commitment towards the goal. Teams are to be created with individuals who can take the responsibility of leading their peers (Hayes, 2014).
Gathering feedback and considering a positive reinforcement would be the last, yet most significant step in the successful implementation of the change management plan. Healthcare professionals might want to know whether their attempts and initiatives have made any difference to service delivery in relation to HSI. Just as data was used for fostering change readiness, the same would be continued for documenting progress. Weekly reports are to be made on the results achieved. External data can be useful and credible feedback leading to sustainability of change. Findings of the viewpoints of the patients as well as the healthcare professionals about the change are to be combined for generating accumulated data highlighting the areas to be addressed urgently. In this regard, it is to be stated that taking the lead and encouraging others is the role all senior level managers must take up in a proactive manner (Lewis, 2016). Acknowledging the efforts given by the professionals would contribute towards sustainability of the change. Successes and milestones are crucial for fostering team cohesion. This is to be embedded in the strategic implementation plan if best results are to be achieved (Grol et al., 2013). As pointed out by the authors, successful change can only take place in an organisation where all individuals think that thee change for their benefit and they have a major contribution towards it.
Though a evidence-based change management plan and strategic implementation plan has been outlined with potential benefits, it is likely that the organisation might suffer challenges in implementing it, highlighting the limitation of the plan. The cost-to-benefit ration needs to be assessed regulary for understanding whether the cost of change is outweighed by the benefits. Internal resistance might overpower the readiness to change and therefore needs to be taken care of. Lastly, change is to be compared with progress for fulfilling the set goals and objectives (Hayes, 2014).
Health service integration is the management and delivery of health services with the aim of providing clients with a continuum of curative as well as preventive services that cater their needs across different levels of the health care system. Against the backdrop of increasing healthcare demands of the Australian community, application of such a robust health service integration system would be highly beneficial. The case study discussed in the paper has marked some of the key and vital issues faced while implementing health service integration. These issues mainly revolve around the lack of leadership, inappropriate resource allocation and effective communication between members of the organisation. The above-outlined change management plan and strategic implementation plan is drafted with the aim of achieving the desired outcomes for health service integration. The plan would act as a solution for overcoming the arising problems and keep the functioning of the organisation at an optimal level. It is expected that with the proposed change plan there would be an increment in the organisational capability, thereby influencing the service delivery
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