Organizational Development and Organizational Change in Medical Organizations

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Organizational Development and Organizational Change in Medical Organizations

Introduction

In the context of frequent healthcare reforms, a consistent and well-thought-out strategy for managing changes in the healthcare sector is of particular importance. Therefore, it seems appropriate to use the concepts of change managemental, organizational and economic changes in healthcare represent. All of them contribute to the development of the competitiveness of a medical institution. The development of innovative management in the field of healthcare and its modern concepts is aimed at clarifying the nature of changes. In addition, it is necessary to investigate the factors that initiate development, as well as to develop methods for introducing progressive changes in the activities of a medical institution.

Change management is a process of continuous updating of organizational capabilities, structure and direction in order to meet the ever-changing needs of society, the organization itself, its employees. It is necessary to consider the change management system as a mechanism for integrating organizational, technological, economic, and information innovations included in the organizations management system. Organizational changes need to be carried out quickly, as the overall pace of change at the present stage of development is higher than ever. The ability to effectively manage factors that either hinder or contribute to adaptation to changes becomes a key component of the success of any manager. Acting in the role of implementing changes, the manager must identify the problem that requires the introduction of changes. Then it is necessary to assess the environment for its implementation, determine alternative options for managing the change and its consequences.

Medical organizations seeking to ensure long-term growth and stability should prepare their employees for frequent changes. Such organizations should set clear goals, as well as form a culture that will facilitate individual and group adaptation to changes. It is important to take a responsible approach to choosing a mechanism for managing changes in the healthcare system. It is the procedure for implementing changes that determines the success of improving the medical, social, and economic efficiency of a particular institution and the industry as a whole.

Key Aspect of Organizational Development and Change

Psychological Aspect

Medical institutions, like any organization, function, develop and interact in a certain environment. At the same time, a stable balance is always formed between the external environment of the medical institution and its internal characteristics. It is necessary to achieve a balance between the level of technology, management dynamics, communication psychology, personnel qualifications, organizational culture, financial success. With changes in the characteristics of the external environment (legislation, competitive environment, financial and economic conditions and psychological factors), the internal environment must also change to achieve their compliance and adequacy (Oreg & Berson, 2019).. In a certain environment, a system or an institution can function successfully and sustainably, the design of which is adequate to this environment. On this basis, the principle of adequate construction is determined.

To ensure the stability and efficiency of the system, its design must be adequate to the characteristics of the external environment. Thus, small and successful organizations must go through the stage of consolidation. In response to changes in the external environment, it is necessary to maintain or increase the efficiency and stability of the system, change its internal characteristics (structure and functions) and external structures (consolidation, creation of medical holdings). To do this, it is necessary to constantly identify and measure changes in the environment and develop appropriate recommendations on them.

Application of Change Quality Indicators

Indicators are numerical indicators that are used to obtain objective information about the quality of organizational changes. They indirectly reflect the quality of their main components: structure, processes and results. Indicators have actual and target values. The ratio of the actual indicator value to the target value, expressed as a percentage, is called the goal achievement index. Indicators of the quality of organizational changes in a medical institution should reflect the main characteristics of medical care. Thus, the effectiveness, safety, timeliness of the changes carried out is evaluated by some indicators (Stouten et al., 2018). Among them are the ability to meet the expectations and needs of the patient, the stability of the implementation of the treatment process and the result. In addition, it is advisable to evaluate the changes carried out in terms of adequacy, accessibility, continuity and continuity, as well as scientific and technical level.

The implementation of the strategic tasks facing the Institution requires the search for innovative management solutions. To do this, it is necessary to plan organizational changes that will increase the pace and volume of medical work, develop the technological level and human potential, and adequately respond to the social demand of society. For a comprehensive assessment and monitoring of all aspects of the life of a medical institution during the implementation of changes, it is necessary to select the most significant, integral indicators. Such indicators fully include quality indicators.

Designing Changes

Development Of the Concept and Business Plan

Preparation for changes in a medical institution should begin with the development of a concept and a business plan for its development project. The purpose of the concept will be to ensure the availability of medical care and increase the efficiency of medical services. Their volumes, types and quality should correspond to the level of morbidity and the needs of the population, as well as the advanced achievements of medical science. The implementation of the above-mentioned measures will be aimed at achieving the following results. First of all, it is a reduction in mortality from all causes and an improvement in the quality of medical care. In order to fully implement the chosen concept, it will be necessary to adopt a number of regulatory legal acts in relation to some issues. For example, it will be necessary to bring the legislative framework in line with long-term development programs (Vaishnavi et al., 2019). It will also be crucial to check the possibility of establishing tax incentives for investors in private partnership projects or public financing of large infrastructure investment projects in healthcare.

SWOT-Analysis

A SWOT matrix (strengths, weaknesses, opportunities and threats) will be used to conduct a full-fledged analysis of the necessary changes in the healthcare system. This research method has proven itself reliably in management, especially in strategic planning and environmental assessment. The experts will be both senior managers and ordinary doctors with experience in medical institutions for at least 10 years (Raya, 2019). The results of expert assessments of factors affecting the development of the healthcare system will be summarized in a table of necessary changes.

Thus, among the strengths, it is possible to identify significant human resources and material and technical base. The advantages can also be called the extensive experience of medical institutions, holding events within the framework of the healthcare modernization program and a wide range of medical services. The weaknesses include a personnel deficit of up to 50% in a number of specialties (Browne et al., 2018). In addition, the lag in the level of equipment from the normative indicators or the lack of mechanisms for regulating new legal relations between patients and medical institutions may require adjustments. Moreover, among the frequently encountered negative aspects are low construction rates, a high degree of deterioration of buildings or an outflow of personnel from healthcare.

Among the possibilities, one can highlight the implementation of national programs, optimization of the network of medical institutions and the use of international experience. In addition, the potential has the development of human resources and the involvement of young professionals in the industry. The threats are the risks associated with the development of large financial resources. Difficulties in strategic planning can also be caused by the variability of the regulatory framework.

Development Directions

Based on the results of the study, a number of directions for the development of changes in the medical institution will be determined. They will be aimed at developing measures for regular monitoring of the health status of the population for the prevention of diseases in the early stages. The changes are also related to the introduction of technologies for the formation of a healthy lifestyle among the population. The improvements will consist in the development of the material and technical base of medical institutions (first of all, equipping with modern medical equipment) with the involvement of funds. The business plan may also include expanding the range of medical services provided and improving training and retraining programs for medical workers. An important step is the promotion of legislative initiatives necessary for medicine through social movements, parties, state bodies at all levels.

Implementing Changes

Main Priorities

Within the framework of the program, it is planned to concentrate efforts on further improving the quality of medical care to the population in the most important areas for the region based on the estimated amount of funding. The basis for improving quality will be the introduction of standards for the provision of medical care in a medical and preventive institution. The scale of changes is proportional to the available set of premises, equipment with modern equipment and staffing with qualified personnel (Farmanova et al., 2018). The main priorities of the program are improving the provision of medical care to pregnant women and children. The provision of medical care to patients with vascular diseases, neoplasms affected by external causes will also be corrected. At the same time, changes provide for the further development of a system of phased treatment of patients, including preventive work.

General Directions

Changes will be implemented in several directions, based on which a plan for implementing them has been drawn up. The material and technical base of healthcare institutions will be strengthened, including major repairs of healthcare institutions, and the purchase of equipment. Modern information systems in healthcare will also be introduced. It includes both the introduction of telemedicine systems and electronic document management systems and the maintenance of medical records of patients in electronic form. In addition, standards of medical care will be employed, including the establishment of additional guarantees for the provision of quality medical care to non-working pensioners.

Main Activities

The main activities within the framework of the first direction will be the reorganization of work in cardiac surgery, traumatology, gastroenterology departments. This will allow them to be equipped in accordance with the standards and provide qualified medical personnel. In the long term, this will increase the percentage of favorable medical and social prognosis. As part of the second direction, the work of the staff will be reorganized as a result of the modernization of hardware and software, servers and the introduction of software modules. The hardware and software of the registry, womens consultations, reception departments and organizational and methodological departments will also be improved. Funds will also be allocated for measures to introduce a unified register of medical workers, an electronic passport of a medical institution and a passport of the system. The reorganization of the hospital information resource will be a change that will reduce the time spent working with documents.

Maintaining Changes

Implementing Quality Control

Maintaining the benefits of the changes made in the medical institution will be solved through quality control. The concept of system quality assurance will provide for continuous work to maintain the created conditions. The required quality will be produced at every stage of medical care, and control will be an integral element of this system. Thus, there is a need to create and implement a quality management system. A quality management system developed, documented and maintained by a medical institution will serve to achieve these goals. It must comply with the requirements of international standards applied in many countries of the world in the field of healthcare.

Quality Control Criterions

The decision to create a quality control system operating at the enterprise that meets the international standard should be made by the head of the medical institution. Advantages will be provided for the work of polyclinics and medical centers that maintain the quality of medical care provided. The assessment will be aimed at identifying the maintenance of the maximum performance of professional functions and the optimal use of resources received as organizational changes. The minimum risk for the patient and his maximum satisfaction from interaction with the medical subsystem will also be maintained. These components are important from the point of view of the control system (Hanelt et al., 2021). One of the most important principles of its application is the creation of a new management model. It is aimed at customer satisfaction and allows to successfully implement the strategic goals and plans of the medical organization by improving processes.

Benefits of the Quality Control

A change control and maintenance system are a set of organizational structure, responsibilities, procedures, processes and resources. They are necessary to manage the quality of services and are a means to ensure that the services provided comply with the established changes. For the consumer of the institution, it is a guarantee of the quality of medical care received. For management, the use of the system is a guarantee that the organizational tasks assigned to the team will be fulfilled.

The implementation of the quality system is not a one-step action, but is a process that depends on the state of the therapeutic institution. It is necessary to apply a methodology for monitoring the quality of the treatment and diagnostic process and medical care in the context of specific changes (Li et al., 2018). At each stage of the institutions development, the criterion for the correctness of the creation of a quality system is a positive result. A quality control and maintenance system based on principles and experience can help maintain the highest standards in medical and technical qualifications. The introduction of a quality management system will allow to take control of the rooting of organizational changes.

Conclusion

Summing up the overall result of the work, it can be concluded that there are reasons to have a fairly high level of positive expectations from the implementation of organizational changes. The system of competent health care management is a producer of strategies aimed at approving and developing specific norms of its functioning. In the organization, the executors of organizational norms are representatives of the health care facility administration, who are forced to resort to certain tactical tricks. They allow not only to fulfill the requirements of the quality of medical services and ensure their own place in the system, but also to extract economic benefits. However, they also have the capacity to implement strategies and apply economic or administrative tools. For example, the organization of the quality of document management that accompanies the process of providing assistance can significantly affect the efficiency of the institution.

The administrations of medical institutions find themselves in a special position. On the one hand, it is determined by the need to dominate and build strategies for interaction with employees. On the other hand, the maintenance and implementation of changes is also provided by tactical maneuvering and the search for possible ways to meet new organizational requirements. The possession of administrative power and the ability to strategic and tactical actions allow you to influence the ways of implementing the norm. This makes it possible to compensate or strengthen the strategic pressure exerted by the holders of political power in the management process. In turn, this factor determines the state of the organizational environment. In the current conditions, adaptive actions of representatives of the professional community can consist both in changing their own behavioral tactics and in transforming the environment.

References

Browne, A. J., Varcoe, C., Ford-Gilboe, M., Wathen, N., Smye, V., Jackson, B. E., & Garneau, A. B. (2018). Disruption as opportunity: Impacts of an organizational health equity intervention in primary care clinics. International Journal for Equity in Health, 17(154), 2203-2215. Web.

Farmanova, E., Bonneville, L., & Bouchard, L. (2018). Organizational health literacy: Review of theories, frameworks, guides, and implementation issues. INQUIRY: The Journal of Health Care Organization, Provision, and Financing, 55(8), 1-17. Web.

Hanelt, A., Bohnsack, R., Marz, D., & Marante, C. A. (2021). A systematic review of the literature on digital transformation: Insights and implications for strategy and organizational change. Journal of Management Studies, 58(5), 1159-1197. Web.

Li, S. A., Jeffs, L., Barwick, M., & Stevens, B. (2018). Organizational contextual features that influence the implementation of evidence-based practices across healthcare settings: A systematic integrative review. Systematic Reviews, 7(72), 115-138. Web.

Oreg, S., & Berson, Y. (2019). Leaders impact on organizational change: Bridging theoretical and methodological chasms. Academy of Management Annals, 13(1), 200-202. Web.

Raya, V. (2019). A theory of racialized organizations. American Sociological Review, 84(1), 26-53. Web.

Stouten, J., Rousseau, D., & Cremer, D. (2018). Successful organizational change: Integrating the management practice and scholarly literatures. Academy of Management Annals, 12(2), 752-788. Web.

Vaishnavi, V., Suresh, M., & Dutta, P. (2019). A study on the influence of factors associated with organizational readiness for change in healthcare organizations using TISM. Benchmarking: An International Journal, 26(4), 1290-1313. Web.

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