Research proposal

Improving quality, change management and leadership: A case study on reduction of medication error

Introduction

Change management refers to a systematic approach to deal with transition taken place by supporting the individuals, staff members and the employees (Carnall, 2018; Baum, 2016). The aim of the report is to understand the change management procedure by acknowledging the change management practice and leadership approach which help the organisation to manage changes in the workplace and enhance the organisational performance by ensuring efficiency and capability in which the issue of medication error can be minimised. In the public health care institutions, it is necessary to have effective changes in the workplace of public health as there are many issues related to medication error within the public health care sector, for which the health and social care service providers face difficulties to maintain the quality standard of the health and social care and fail to deliver efficient service and effective treatment to the service users, where the service users also face problems in getting proper treatment, quality care and effective medication for their health issues. Hereby, change management process in this regard is necessary for the public health care institutions to enhance their performance and help the service user to get better benefits of public health, where the issue of medication error can be mitigated through implementing the change procedure in the organisation.

Background of the issue

Medication error is one of the major problems in the public health and social care institutions where the inefficiency of the staff members and lack of information management leads the staff members to induct the medication error for which the service users become sufferers in the public health and social care institutions as they do not get proper medication and quality care from the service providers which in turn deteriorates the health condition of the patients. Hereby, it is risky for the service users to take different medication due to high medication error conducted by the staff and nurses at the hospitals (Cameron, and Green, 2015). In the recent years, public health and social care sector face difficulties to provide effective health and social care service to the individuals who seek efficient care and support from the service providers as they conducted error to provide the right medication to the right patient. It is due to the inefficiency of the staff members as well as less technological infrastructure for which the health and social care sector fail to manage in providing the right medicines to the patients. Public health care is also suffering from manging the high-quality standard for which they cannot deliver quality service to the service users and the social communities as a whole. In addition to these, due to lack of technological upgradation, the health and social care professionals in the public health care centres fail to manage patient’s safety and security as they face difficulties in managing the information of the patients through computerised data management and maintaining the medications for a particular patient as per the health issues. This further creates issues as the health care service providers cannot manage the patients and it lacks patient’s safety and security leading to a risky situation due to medication error at the hospital (Carnall, 2018).

Due to lack of patient’s management and maintaining computerised data form arranging the right medicines for the right patient, the medication error arises in the health and social care organisations. The medication error is a serious problem in the health and social care setting which may deteriorate the patient’s health condition and may lead to ultimate death due to wrong treatment and error in providing incorrect medicines to the patient (Gaffney, Hatcher, and Milligan, 2016). The reasons for such medication error are such as overcrowding at the hospitals or the nursing homes, absence of proper communication, reliance on verbal communication, lack of technological upgradation, poor infrastructure for managing patients etc. for which he patients or service users cannot get proper medicines as per their health condition and disease they have. Overcrowding is one of the major reasons of such medication error where the nurses and the health care professional are getting confused to manage a huge number of the patients at a time which raises error in providing the right medication to the right patient (Doppelt, 2017). Moreover, absence of proper computerised system at the hospitals and lack of management of using prescription rather than using verbal communication are the reason of medication error for which the service users cannot get proper medicines. The staff members are not trained well to manage the proscription in a computerised system and maintain patient information through could computing and data base of the hospital which raises the issue of medication error and this must be mitigated through implementing change in the organisations.

Necessity for change management to reduce medication error

Change management in this context is necessary in the public health and social care sector through which it is possible for the leaders and managers of the public health institutions to manage the issue of medication error and implement the necessary changes in the organisations for successful planning of maximising performance and organisational values where the service users can get appropriate medications according to the diagnosis and health issues of the individuals. It is the aim of the public health care centres to deliver quality care and appropriate medication to the society as a whole, but it is now challenging for the public health care sector to maintain quality standard of the health and social care as it faces issues in providing the right medication to the right patient which create a serious issue of medication error at the hospitals for which the service users become sufferer as there is high risks of getting inappropriate medicines which may negatively affect the health condition of the service users (Cameron and Green, 2015).

Change management models and theories for implementing changes in the workplace

As the Kotter’s model of change management, it is important to increase the urgency of adopting change and build team work as well as develop vision so that it is possible to follow suitable path for change management. apart from that, communicating with all the employees and empowering them on the decision-making practice is necessary for change management.

In additional to these, change management is necessary for public health and social care centre, so that it is easy for the leaders and the managers to improve engagement as well as develop effective team, so that they can fulfil their aims and pre-specified objectives of public health of providing proper medicines to the patient after proper diagnosis of the individuals (Cummings, Bridgman and Brown, 2016). As the health and social care service depends on team work where collaboration and communication are necessary, manging changes and improving effective team are helpful for the public health care to support the individuals with their specific needs and provide the best care and quality treatment with medication after successful diagnosis of their health (Harkness, and DeMarco, 2016). Additionally, increasing ability of the workers in the public health care centres as well as improving infrastructure in the care centres are also the beneficial for implementing the change management, where the leaders and the managers can implement and execute the planning of improving technological upgradation in the public health to manage the performance and provide the right medicines to the service users. Stakeholder management and high communication can be possible through change management process as well as the leaders and the managers can enhance their performance and promote the health care service in the society with effective care and proper medication which ensures that the medication error can be mitigated properly (Härkänen, Saano, and Vehviläinen‐Julkunen, 2017). As per the Lewin’s change management model, there are three phases such as unfreeze, change and refreeze. under unfreeze, creating the need for change, managing and understanding the doubts of the employees and ensuring string support are necessary to adopt the changes through communication and empowering the actions. After adopting the changes, it is necessary to refreeze through developing ways to sustain the change, providing training to them employees and evaluating the changes for future development (Cummings, Bridgman and Brown, 2016).

Change management process is hereby helpful to improve cooperation and collaboration by enhancing internal communication which in turn helps the health care service providers to improve quality standard of their service of public health and maximise patient’s care by providing proper medicines and treatment, which is the aim of public health (Kuipers et al., 2014). In addition to these, there is significant impacts of change management on the performance of the staff members as well as organisational performance as a whole, which further helps to improve organisational reputation and mitigate the mediation error, where the patients can rely on the health and social care service for the improvement of their health condition. Moreover, through change management procedure, it is also possible to manage internal conflicts and manage the employees, so that they can perform better through cooperation and communication (Hayes, 2018). Hereby, as per the client’s feedback, internal and external communication can also be increased through change management, where it helps to manage the patients and deliver them quality care and proper medicines as per their disease and health issues. In the recent context, according to the patient’s feedback, there needs proper change management for reducing the medication error, where implementation of upgraded technology in the workplace, providing training and improving communication are effective for the health and social care professionals to deliver the best care and appropriate medications to the service users (Härkänen, Saano, and Vehviläinen‐Julkunen, 2017).

Tools for changing change management for reducing medication error

Through Fishbone analysis, it is possible to understand the existing reasons for such medication error and it can be seen that, due to lack of technological upgradation, automation process as well as lack of equipment and high nose are the major reasons for the medication error. Through this tool, it is possible for the organisation to acknowledge the drawbacks for which the issue of medication error arose in the health care institution (Gaffney, Hatcher, and Milligan, 2016).

Though the fishbone analytical tool below, it is possible to develop proper strategy and technique in order to resolve the issue of medication error. As the figure below, access to care and proper finance needs to be invested in the medicine and pharmaceuticals department of the nursing home, so that the medicines are managed properly with safety and security in a systematic manner (Härkänen, Saano, and Vehviläinen‐Julkunen, 2017). Apart from that, it is necessary for the leaders and the managers to provide proper training and development program so that the staff members can manage their medicine stocks and deliver the medicines as per the prescription of the doctors.

Though the fishbone analytical tool below, it is possible to develop proper strategy and technique in order to resolve the issue of medication error. As the figure below, access to care and proper finance needs to be invested in the medicine and pharmaceuticals department of the nursing home, so that the medicines are managed properly with safety and security in a systematic manner (Härkänen, Saano, and Vehviläinen‐Julkunen, 2017). Apart from that, it is necessary for the leaders and the managers to provide proper training and development program so that the staff members can manage their medicine stocks and deliver the medicines as per the prescription of the doctors.

In addition to these, attitude of the staff and managing capacity and transport are also necessary to manage the warehouse of the hospitals, so that all the medicines are in stock and are maintained with safety and security. Proper documentation and management of the computerised data about the patients and the prescription made by the doctors as well as time management, being concerned about the dosage and drug, proper recording and assessment ae also required for resolving the issue of medication error in the health and social care settings (Friedman et al., 2017).

Through PDSA (Plan, Do, Study and Act) is another analytical tool for implementing changes in the health and social care setting. Under the plan, the objective of the hospital is to reduce medication error through change management and in order to carry out the plan, the strategic planning includes proper data analysis, management of computerised data record keeping, monitoring and assessment for rechecking the medicines provided to the patients which provide a scope to develop proper planning and implement it successfully to reduce medication error. In this regard, study is necessity for proper assessment and data analysis, where the staff members try to manage their patients and provide proper medicines which are prescribed by the doctors. After developing proper planning, it is necessary to implement the changes in the hospitals through providing proper training program, sharing experience for improving knowledge of the clinical staff members, increasing the use of automation process and computerised data record keeping practice at the hospitals and proper evaluation through teamwork (Goetsch, and Davis, 2014). For managing these changes, it is necessary for the leaders and the managers to share their vision, managing the workforce, communicate with all the staff members and develop sustainable strategy to implement the changes in the hospital so that the above-mentioned changes can be implemented strategically (Gaffney, Hatcher, and Milligan, 2016).

Leadership approach for change management in reducing medication error

Cooperation and integrity at workplace are effective leadership approach for such changes taken place in the hospitals, where the staff members can understand the information technology and improve communication among them to deliver high quality treatment and medicines to the individuals in the society (Gaffney, Hatcher, and Milligan, 2016). Empowering the physician in the decision-making practice is another leadership approach as well as managing the technology to maintain patient’s record are also necessary, through which the service users can be managed well as well as their personal information can be kept secured. In addition to these, creating values for the staff members is necessary, where the leaders can encourage the efficiency of the staff and give them freedom to work as per their capability, and this is effective to encourage and motivate the staff in the public health to give their full potential to perform better so that it is possible to manage the quality standard of the health and social care service provided by public health care (Cummings, Bridgman and Brown, 2016). Moreover, it is necessary for the leader in the public health and social care centre to arrange training program for the staff members, so that the capability and knowledge as well as skill and performance of the staff members can be enhanced, which in turn helps to manage the quality standard of health and lead the strategic change of implementing information technology in the public health care sector. Through training, it is possible to manage changes in the public health and it also provides a scope to enhance communication and cooperation among the staff members which are beneficial in the change management procedure (Carnall, 2018; Baum, 2016).

In addition to these, overcrowding is another issue of such medication error and in this regard the nurses need to take the responsibility of each patient and manage them properly with communication and collaboration (Gaffney, Hatcher, and Milligan, 2016). In this regard, the public health needs to implement technology such as investment on computers for managing patient’s records and Information and Communication Technology (ICT) for enhancing internal and external communication as well as develop effective culture in the workplace by enhancing technological transition towards digitalisation (Cummings, Bridgman and Brown, 2016). this is one of the major strategies of implementing change where the staff can mitigate the medication error at the hospitals and provide the right medicines to the right patient. The leaders and the mangers in this context need to create urgency of implementing the change and in the present case, there is urgent need of technological upgradation and improving infrastructure and organisational culture through managing the staff members for resolving the issues of medication error for which the service users are at risk due to incorrect medicines, provided to them for lack of management of the patient’s information and prescription provided by the doctors (Härkänen, Saano, and Vehviläinen‐Julkunen, 2017).

Moreover, it is the role of the leader and the managers in the hospitals to arrange effective training and development program for the staff members so that they can improve their knowledge and enhance their technical skill to manage the patient’s information and prescription with the computerised data base of the hospital which reduces the medication error at the nursing homes (Goedecke et al., 2016). In order to mitigate the current issue of medication error in the health and social care organisations, change management, improving leadership and management technique and quality improvement through technological upgradation are necessary so that the service user can get safe and effective treatment, proper medicines and quality care from the service providers (Gaffney, Hatcher, and Milligan, 2016). The leadership style needs to be transformational where the leaders support the employees, staff members, nurses through building strong relationship with them (Carnall, 2018; Baum, 2016). In the present context, for managing change of implementing effective technology and managing the internal stakeholders of the public health care sector, it is necessary for the leaders to communicate with all the staff members through open discussion, group meetings so that they can manage the medication error and cooperate for providing the right medicines to the right patient (Baum, 2016).

Conclusion

Change management practice depends on leadership and management style of the organisation where corporate culture, employee’s engagement and the practice of decision making are crucial factors, that help to manage the strategic changes in the organisation. In the present context, public health face the difficulties on medication error for which the quality standard of health care service hampered and in this context, change management is necessary through which it is possible to serve the people in a better way by utilising latest technology and managing staff member in the organisation by ensuring mitigating the medication error, so that the patient can get the correct medicines as per the doctor’s recommendations and prescription. The leaders and managers need to cooperate and empower the staff in the change management process as well as provide proper training for implementing technology in the hospital for managing the patients by improving quality of health and social care service and providing the correct medications by managing transparently and accountability.

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