UNIVERSITI TEKNOLOGI MARA

BACHELOR IN ADMINISTRATIVE SCIENCE (HONS.) FACULTY OF ADMINISTRATIVE SCIENCE & POLICY STUDIES

ADS 607 MANAGING CHANGE PREPARED BY:

ROSSILAH BTE LALMUHAMMAD (2007120217)

PREPARED TO:

ENCIK FUAD ABDUL RAHIM

Synopsis This journal title: Implementing and sustaining transformational change in a healthcare lessons learnt about clinical process redesign by Katherine M McGrath, Denise Mbennett, David I Ben-Tovim, Steven C Boyages, Nigel J Lyons and Tony J OConell, are discuss about healthcare industry into managing a shift away for develop a healthcare system. There are some of the fundamental issues currently impacting healthcare around the world those can relate with this article and need to do transformation. The issues can categorized as an emergence of patient of healthcare delivery, demographic shifts and aging populations, globalizations, consumerism and demands of new technologies and treatments. The changes of transformation include the restructure of process to sustain the change in health care delivery into professional terms. Although, the focus on new strategies implement with knowledge of change processes will be support the community based care and approach by community oriented by health care. The most fundamental change is probably the shifting of the balance of power along the value chain among the consumers as patients and careers, the purchasers as government, insurer, employer and the providers as doctor, hospital, community clinic. This shift is being brought about by the combination of a number of drivers. The principal drivers are: Information technology and communications. Medical technology or genomics. Cost and capacity limits. The introduction of market dynamics through healthcare reforms. By research and practice initiatives, the managers or supervisor can create capacity learning with healthcare concerned towards community needs and demands to improvements the delivery of health care services in emergency departments and elective surgery programs in New South Wales and at Flinders Medical Centre in South Australia, with tangible benefits for patients and staff.

The new view embraces the need for broad, system wide change and integration, collaboration, economic relationships, and new expectations, as well as new business models and technology. Through experience with clinical process redesign, the industry must move from a transaction focus to a focus on effectively managing and exchanging information and sharing responsibility among stakeholders in order to improve healthcare and sustaining this process in the health care setting. The challenge in organizations can be success with help bridge knowledge gaps and enhance strategies for strength a community based healthcare supporting by community focused health improvements ways as example by shared vision of organization is also developing around the need for greater efficiency and promotion of wellness and prevention. However, the resistant to change in some areas clinical process may provide a platform for adopting a philosophy for community based delivery in terms to develop goals and objectives.

Advantages Implementing and sustaining transformational change in a healthcare lessons learnt about clinical process redesign. 1. Clinical and business optimization about healthcare industry has received major attention because of the expected advances technology and expertise in care delivery more efficient in every aspect and linked with vibrant economy.

2. Healthcare transformation is an emerging model in healthcare that optimizes the healthcare system to focus on the patient experience and outcomes for better health and well being. This advancement linked to technology driven by market forces and societal desire improvements of health care nations and reduces cost.

3. The system of healthcare as solutions to help advance the transformation healthcare to address healthcare issues with providing thoughtful leadership in management.

4. The transformation benefits to the organizations in terms of better compete with their rivals and develop with higher profits with proposed new direction. This helps management focus into methodology used to outcome a problems so that people do not questions things they have suggested.

5. The transformations with redesign clinical process benefit to the system those more persistence and flexibility and it become improvements of health service delivery to meet a set of agreed standards.

Disadvantages Implementing and sustaining transformational change in a healthcare lessons learnt about clinical process redesign 1. Clinical process redesign is not about changing clinical practice, but it does change the system of care delivery. Thus, clinical leadership is critical to success in terms engaging clinicians to implementing the solutions designed by staff.

2. Change management methodology has occur problem if the redesign process not properly following it processes such as the staff of clinicians must alert and understand safety is an outcome redesign more attractive , so with making

essential steps in a patient journey work more efficiently and in eliminating waste. 3. Into transformation of healthcare system the overall of culture must be understand by the organization whereby can allows the rumor mill leaders to circulate incorrect or corrupting information about the changes redesign process.

4. Into transformation of healthcare system the overall of culture must be understand by the organization whereby can allows the rumor mill leaders to circulate incorrect or corrupting information about the changes redesign process.

5. The implementation is the hardest part of the process, a manager need to given the necessary change management skills to prevent negatively affects an organizations and without a plan to deal with every step of change the strategy as redesign processes possibly bringing down the entire organization. 6. Resistance to change in health systems as failures to drive out the transformation in certain aspect because senior professionals have been using the old methodology for some time. The battle between the old and the new in medical technology is for many clinicians the struggle between habit and science. And persuading clinicians to change their habits is one of the hardest things.

Similarities & Differentiate Similarities and differentiate of the journal title: Implementing and sustaining transformational change in a healthcare lessons learnt about clinical process redesign with the managing change that can be expand into lessons is about the magnitude of changes and affected by it. Today people with like illness are sharing quite openly about their illness. They actually know a fair bit about their condition, their treatment protocols, and interest in other treatment protocols. It would seem that this is a patient population that needs simplistic interoperability and considerable would drive more rapid adoption of interoperability in the clinical community.

The rapid growth in the use of the Internet for finding health information and the switch in emphasis from treatment to prevention fuelled by genomics, with a consequent rise in self-care, has changed the balance of this equation. The consumerism now better informed about their problem. Soon, consumers will be armed with comparative performance information with which to choose their preferred provider, rather than having their choice mandated by a purchaser or gate keeping health professional.

The biggest implication of this shift will be the emergence of networked health economies. These will consist of groups of providers that will collaborate to meet fully, for the first time, the needs of the empowered consumer in any given geography. In addition, the roles and boundaries of operation of the players in this network will change over time.

Advances in medical and information technology afford the health care business the chance to change the boundaries and barriers, reduce costs and improve quality standards - all at the same time. But to do so will require radical changes in behavior from different players, particularly governments and regulators. Governments will need to encourage new entrants to the business and prevent

regulators and vested interests the professions from erecting protective walls. Information technology is facilitating the collection and dissemination of evidence of best practice and outcomes. This will allow the development of rules-based practice, which can be taken on by lower skilled professionals, moving upstream in the chain of healthcare treatment complexity.

The model or approach that developed took a similarly simplistic and pragmatic approach because needed to manage adoption, expectations, and costs. The central principle of interoperability used was that sharing something or anything about the patient's health such as meds, current condition, last clinician of care, even in text form, would be 100% better than what has been shared previously. This is the approach that transformation healthcare was advocating and as an essential step in an incremental approach

The transformation needs because of the funding problem for health services goes beyond the current financial crisis to the longer term. For 40 years health expenditure in developed countries has grown at 1.5% above the growth of GDP (2% in the USA). Different with other industries health has begun to assume that resources automatically grow in line with increased demand. There may, however, be opportunities for change and improvement. Over the next ten to 15 years several forces, enabled by new information technologies, could come together to transform the healthcare industry.

Other industries have learnt to meet a rising demand with step changes in their method of delivery. Given that resources for health will not be able to automatically rise, every health care system believes that it will go bust for two consistent reasons. The first is the invention of new technology and the second is an aging population. Both of these problems are actually successes for the industry. It is partly the result of good health care that leads to an aging population and new technology can save lives and ease pain and distress.

In most other industries, new technology saves money by driving up productivity, but in health new technology is simply seen as a cost. The outcome of new technology is to keep people alive and therefore it must cost the health system more at the end of their life. But the financial problems for health are not caused by end of life care but the rising cost of long term conditions. As example in England these cover 70% of NHS costs.

The problem is not the new technology for Long Term Conditions but that health systems find it very difficult to get rid of old technologies. If the productivity problem for health is a failure to dispose of old technologies then the skills we need improve are not those that concern commissioning new health services. Our problem is much more world class decommissioning or how a health system stops doing inefficient things much more quickly than it has to date.

The government must be engaged in health transformation at three level 1- as policy marker, 2- as employer 3-as provider of health care for the poor, the elderly and the disable. In each role of government must lead by creating and implementing policies that accelerate the adoption of an individual centered. it system focus on prevention, early detection, self management and best practice.

This is because government was control the budget of health care spending because of government policies greatly affects the system offer. The involvement of government in transforming the system is critical. This means the way of government currently works with regard to health and health care must be transformed. Morally, the government cannot turn it back. As president of Franklin Delano Roosevelt said, the success of failure of any government in the final analysis must be measure by well being of its citizens. Nothing can be more important to a state than its public health. The state paramount concern should be the health of its people

The challenge and the opportunities inherent in the world today make health transformation not a choice but a necessity. If we are to create our children and grandchildren a healthy and prosperous future, we must create a personalization, intelligent health system that saves lives and saves money. There are differences in the way healthcare is organized around the world. The most obvious is the role played by governments. At one extreme, they restrict themselves to policy making and leave others to implement the policy. At the other, they become directly involved in many aspects of healthcare management. But there are also many similarities. These include:

Supply and demand. The healthcare industry in most countries is driven by supply and capacity, not by demand. Patients have traditionally been relatively powerless in the system. However this is changing in the face of increasing consumerism and the ability of insurers to tailor their offering to suit demand. Ageing populations and developing medical technologies are also contributing to this trend

Costs and capacity. Volume handling and cost control are the main operating principles for most healthcare providers and insurers. They have difficulty managing costs and creating enough capacity to meet the demands made of them. Long waiting lists is a critically important issue in most public health care systems, as is the growing shortage of professionals in the industry

Immature value chains. The players who make up the value chain- physicians, hospitals, drug companies and laboratories do not yet, by and large, use information technology tools and Net enabled data transfer systems to interact with one another or share knowledge. Even within individual providers, like hospitals, the information flow is often inefficient. Health care, as an information intensive industry, has historically experienced low information technology investment rates. Other industries laden

with data, such as insurance or financial services, invest more than 10% of their budgets on IT. Health care has historically spent only 2-3% of its budget on information and communication technologies. The result is a poor service for the patient and increased transaction costs.

Limited competition. Healthcare systems in many countries are highly regulated. Barriers such as the need for huge investments, and intensive knowledge have made health care and industry traditionally difficult for new entrants to break into. Existing players are often protected from the effects of competition. Inside most markets, there is little competition among insurers (either public or private) or providers (physicians and hospitals). And end users as individuals or governments cannot really choose better care. The absence of choice and limited performance incentives are limiting efficiency and restricting change.

This Information technology will be available and early detection and prevention to create a culture of health, reimbursement will be driven by outcomes and the use of interoperable technology will be ubiquitous. The transformation is advantages solution marked by new levels of patient safety, quality care, and cost effectiveness. Into the demands nothing less than electronics, consumer center, personalized health system will improve individual healthcare, reducing cost, and build a better future for all citizens.

The demands as consumers, parents, voters, and leader a commitments to embrace, promote and demands the rights and responsibilities that come with this new system of health.

Morally, as well as economically, the choice is transformation and while change of such magnitude is not easy and need time to do changes, With the better health transformation it become a greater health, freedom, and opportunity for every citizens to have a greater services and satisfaction.

The individual system of healthcare work if individual is empowered and engaged. As having the information, knowledge and the capabilities will be able to keep up with the constant changes and advances related to the condition and relevant to the personal profile of patients.

In addition, the clinicians can help to drive the transformation and improve health care by selecting providers who embraced the principles and practices of a individualized, intelligent health system and by voting for policy makers who will advance such as manage a change system delivery.

To transformation from aspect culture and society for healthy community the changing of policies, institutions and environments affect choice made by citizens. Example the transformation of knowledge deliver to the patients should offer a healthy product, explanations of certain aspects of healthcare, record of medical, information of illness faces and so on. Likewise, the encouraging healthy care for community care helps the transformation access to better implementation.

To create an effective delivery system transformation to be more efficient and productivity in terms health care delivery the adoption new technology is important to create a healthcare culture. The innovations are much more rapidly driven through the system will require a different type of delivery system.

There will be more patterns to increase of information technology in system health professionals to consult to the patients. Health information technology ability to dramatically improve the quality of care and to save thousands of lives cannot be ignored and its really works. Otherwise, the issues of financial as transform into a new model of system paying for healthcare. The changes including payments system pays doctors and providers for sampling delivering care, regardless of the outcome. Doctors,

hospitals and other providers that deliver better care for the most paid at the same rate as those who provide poorer care. Like any rational market, need a reimbursement takes account the quality of care that is delivered not simply that it was delivered.

As the world largest purchaser of health care services, the federal government must take the lead. If the federal government were to pay for risk adjusted quality outcomes and less for poorer outcomes, the private market should be follow. Finally, everyone above certain level buy coverage meanwhile should provide tax credits or subsidies private insurance for the poor.

In additional, a national pool for those suffer catastrophic illness or disease so needs to be establish to ensure that patient low faces traumatic and costly health paying are bear by initiatives by governments.

Forces for change The above inefficiencies are not inevitable. Several forces could combine to transform the healthcare industry. These new forces will probably result from the combination of existing traditional forces in the industry and the emergence of new ones. There are five main drivers for change: demand development; advances in medical technology; optimization of the value chain; market dynamics, and e-health.

Demand development. The size and nature of demand seems likely to change markedly in coming decades.

Advances in medical technology. Developments in medical technology will improve predictability, boost prevention, and increase the effectiveness of treatment.

Optimization of the value chain. Rising costs and a more demanding consumer will lead to the development of a very different and more efficient value chain. Net-facilitated cooperation, integration and

transparency will push players who were previously part of a highly segmented chain, in which cooperation was comparatively poor, towards integrated networks in which there is a high degree of cooperation.

Market dynamics. Many countries have adopted reforms designed to introduce performance incentives, ascertain the extent of markets and introduce less or more planned competition in the healthcare system. The dynamics of the market will lead to the need for differentiation in services and branding.

E-health is both a driving force and a major enabler for the drivers. Ebusiness has the potential to change the way the various healthcare players undertake activities and processes. It can help individual providers carry out their own activities faster and more flexibly and does the same for the whole system.

The transformation of the healthcare industry in the ways outlined above would have many implications for the various aspects. From governments to service suppliers with transformations are deeply embedded in medicine and medical technologies. However, industry structure, business processes and information technology have not changed at the same pace.

In the years to come, cost containment pressures, consumerism, market dynamics and the Internet, among other forces, will make healthcare transform the industry much more than ever. Combined new and old forces will make change inevitable.

Conclusion

As a conclusion, the advancement in medical and information technology afford the healthcare business the chance to change the boundaries and barriers, reduce costs and improve quality standards all at the same time. But to do so will require radical changes in behavior from different players, particularly governments and regulators.

The involvement of patients, practioners, and hospital leadership are recognizing the need to engage in an integrative approach to health and healing. Including integrative medicine principals and practices will require changes in the culture of the hospital and nursing with brief and describe some of the components of this change process.

Each organization will approach change with its own unique solutions and staff. By making patients care the most important focus, the transformation and sustainable organizations make will be profound.

Finally, the redesign process will benefit and keep more potential into the system of healthcare transform. It has provided advantages for clinicians by enhancing access and patient flow, and increase safety as well as improving the experience and health outcomes for patients.