Change: Facing the Inevitable in the Healthcare Setting

It has been said that “The only thing that is constant in this world is change.” Often we would
ask ourselves, what really is change? Why is it happening? According to Merriam-Webster,
change is defined as to become different or to become something else. (Merriam-Webster,
2015) By being different or becoming something else, it gives us the ability to improve for
the better. This can only be done by being adaptable to the changes that is happening around
us. One of the sector that is vulnerable to such changes is the healthcare sector. They must
have the ability to adapt to cater the needs of the different individual seeking the services in
the healthcare sector. I have chosen the Cedar Manor Rest home and hospital to know the
different changes that this institution has undergone and how they were able to handle and
adapt to these changes. I have interviewed persons working in the mentioned rest home and
these were the result of the interview about change.

1. What is your idea of Change?

a. Change is good
b. Change brings in new people and create different aspects to the job
c. Change is inevitable & evolving, it is something that is needed.

With regards to their idea of change, they have different opinions and ideas about it. It gave
me the perspective on how these people are seeing change which will have a positive or
negative effect to the organisation.

The result of the interview showed that they are optimistic with regards to change. It gives
them the opportunity to meet new people and create a multidisciplinary environment that is
needed in the different aspects of the job.

2. What are the significant changes that has occurred in the organisation for the past (2)
two years?
a. From a full time status all of the staff are shifted a part – time status wherein
they are given 28 hours per week and can pick up a shift to a maximum of 40
hours. {Four (4) on, four (4) off}.
b. Appointment of Unit Coordinators
c. Senior caregivers giving orientation to new staff members
Change will make a significant effect to the organisation. The effect can either be short term
or long term in nature. It will also have a different impact to the organisation in general, to
the individuals working in that organisation and to the people valuing the organisation.

There were both positive and negative effect with regards to the change that has happened for
the past two (2) years in the organisation. One of the change is the appointment of unit co-
ordinators. The unit co-ordinators role is to oversee the little things that is happening on the
rest home and hospital. There is a more direct leadership for both the nurses and the
caregivers. They also make sure that all of the staff is equipped with the necessary skills
needed to give the residents the consistent service that they expect. Another change is the
implementation of four (4) on four (4) off scheme, their goal was to make sure that all of the
staff if given enough rest to be able to do their responsibilities consistently. The negative
effect is, that the staffs are not getting enough number of hours work per week. Which led to
a number of staff leaving the organisation. Another change is letting senior caregivers to
orient newly hired caregivers. With the experience that the senior caregivers have, they will
be able to impart to the new caregivers the appropriate knowledge and skills that is needed
for them to deliver quality care that is expected by the residents. It will also help the senior
caregivers the chance to develop their leadership ability and interpersonal skills.

3. What were the effects of these changes in the organisation?

a. With the reduction of working hours from 40 hours to 28 hours per week and
by implementing the four (4) on, four (4) off, and 22 of the staff has left the
organisation.
b. The Unit Coordinators are able to perform a more direct approach in handling
the nurses and caregivers. They are also able to focus more on the little things
and work in collaboration with the nurses.
c. The Senior Caregivers are able to give a more thorough orientation to the
newly hired caregivers since they are taking care of the residents.

One of the goals of the organisation is to ensure that its staff is having enough time to
rest, thus came the implementation of the four (4) on, four (4) off scheme. It also
resulted to more of its staff leaving the organisation. It affected the structure and the
 care given to its residents, but the organisation was able to replace them with new
staff members who are willing to embrace the change that has been implemented. It
also resulted to better and quality cares given to the residents.
The unit coordinators would focus more on the little things that is needed in their area
of expertise. They would guide the nurses and caregivers to ensure that quality care is
given to the residents. They would also serve as the problem solvers of the unit.
The senior caregivers are given the responsibility to orient the new members of the
organisation on the responsibilities and the routines that is performed in the unit. The
organisation has given its members the chance to develop leadership skills. Teamwork
and camaraderie is also developed among the healthcare team.

Theoretical framework

In the study that I will be using the Kurt Lewin change management model. This three (3)
stage theory of change commonly referred as Unfreeze, Change, and Freeze.
Stage one (1) Unfreezing stage is about understanding that change is needed. It also involves
the need of going out of the comfort zone. It is about creating the situation for the need to
change.
The more that the organisation or the people in the organisation feels that change is necessary
the more motivated they are to make the change. Unfreezing and getting motivated for the
change is all about weighing up the 'pro's' and 'con's' and deciding if the 'pro's' outnumber the
'con's' before you take any action. (Change Management Coach, 2015)

Stage two (2) is known as change or transition, According to Kurt Lewin, “change is not an
event, but rather a process. He called this process a transition.” The inner movement or
journey that is made in reaction to change is transition. This second change occurs when
changes that are needed is made.
This is the time that people are learning about the changes. They must be given enough time
to understand and work with them. It is important that support is given in a form of training
and coaching. Expect that committing mistakes is part of the process.
By allowing the people to develop their own solutions, it gives them the opportunity to make
the changes. Keep communicating the clear picture of the desired change and their benefits.
This is to make sure that they do not lose sight of where they are heading. (Change
Management Coach, 2015)
Stage three (3) is referred by Kurt Lewin as the freezing stage which is also referred to by a
lot of people as ‘refreezing’. This stage is about establishing stability when the changes have
been made. These changes are accepted and becomes the new norm. They would form new
relationships and are comfortable with their routines. (Change Management Coach, 2015)

Figure 1: Theoretical Framework based on Kurt Levin’s change management model

UNFREEZING TRANSITION FREEZING

1. Full time to 1. 22 staff 1. The staff members

part time members left that stayed were
status. the company the competent
2. Appointment 2. Search for staff.
of Unit qualified staff 2. Unit Coordinators
coordinators appointed as were able to lead
3. Senior Unit the particular unit
caregivers coordinators (hospital, rest home
giving 3. Added & dementia)
orientation to workload to 3. Leadership was
new staff the Senior developed on the
members. Caregivers Senior Caregivers.

1. Quality care is
1. New and given to the
qualified staff residents.
was hired 2. Proper protocol
2. Qualified staff was established.
was sent for 3. Teamwork
further training. among staff
3. Further training member was
for Senior established.
Caregivers