Change management is essential in today’s world (Orridge 2012). Every industry needs it, and the healthcare is not different. Ever-changing socio-economic environments necessitate various healthcare organizations’ adaptability in an organized, dependable, and stable manner (Todnem & Burnes 2013; Numerof & Abrams 2012). One such case is the recent shift from physician to patient-centred care, and, related to this, the emergence of value-based care in the United Kingdom. The shift is a monumental one for physicians and healthcare service providers. The UK government, through NICE (National Institute for Healthcare Excellence) and NHS (National Health Service), has made several attempts in the past to switch to value-based care. The previous attempts have been met with various levels of disapproval and failure. The newest attempt is RightCare, which is a system primarily aimed at “Reducing unwarranted variation to improve people’s health,” (NHS RightCare 2017). RightCare is set to be a permanent feature of healthcare systems in the future (Bach & Kessler 2012; Austin, Bentkover & Chait 2016). Organizations operating in the healthcare industry must adapt to the changing environment or risk irrelevance to offer quality services to their clients.
Change management, in such a case, requires a strategic approach. Hewitt-Taylor (2013) advises a discussion among stakeholders to set standards and ensure that fluid environment during the shift does not give room for lower standards. Such stakeholders include physicians, the UK Department of Health including NICE and NHS, health insurance providers, as well as consumer protection agencies (Sutherland 2013). Necessarily, the first step will be harmonizing human resource department operations within categories of stakeholders.
The introduction of RightCare has gone through numerous consultations. They have proven that the concept is viable since they have concrete facts from the few local healthcare economies they were working with. The aim of this is to create a situation where desirable outcomes that are observed from one institution can be applied with minimal changes to other organizations (McBride & Mustchin 2013). Costigliola (2012) and Martin (2012) agree to this, adding that regular consultations among the stakeholders will help in establishing best practices throughout a change period.
Change Management Models
Change management models that can be used by various actors in the healthcare industry include Kotter’s 8-step approach, McKinsey’s 7-S model, and Lewin’s change management plan (Ginter 2013). Each of these offers a unique practical approach to the problem, but they are all based on the same fundamental theory of step-by-step discrete approach. In this particular scenario, McKinsey’s model may not be of much use (Malan 2003; Inozu et al. 2011). The healthcare industry in the United States is immensely complex. If change management is conducted through this method, there is a very high likelihood of failure. The reason for this is that the model does not account for interrelations among the 7-S approach (Bingham & Main 2010; Hayes 2014). For instance, if insurance providers change their structures and systems, it will lead to a necessary change in hospitals’ and physicians’ strategies and management styles. Sutherland (2013) asserts that Lewin’s model is too ambiguous to be of much use in a healthcare setting. The shift from provider to patient-based healthcare is a vital evolution that should be managed as comprehensively as possible.
Kotter’s 8-step model seems to be the most ideal to the paradigm shift in the healthcare industry. One of its key strengths is that it focuses more on preparing people to accept change, which is a vital aspect of a healthcare system (Kotter 2012). Individuals tend to resist adjustments, and Kotter’s model directly addresses this issue. The result is that transition is simplified with the scheme. Grol et al. (2013) and Barr and Dowding (2015) agree, and further add that the model takes a lot of time since no steps can be skipped, and it addresses change acceptance, not the actual change itself. When managing change as large and significant as this, time is needed. The model provides for this as well.
Indeed, the model used by NHS England and NICE in implementing RightCare is a reinterpretation of Kotter’s model. They are making use of a twenty-step process to monitor and evaluate the progress being made on the country-wide rollout.
Several potential challenges have been identified concerning the shift from the conventional healthcare system to a value-based one. One such issue, as predicted by Suchman, Sluyter, and Williamson (2011), is in the integration of new practices into the operations of healthcare providers. Despite a majority of providers agreeing that value-based care is the future, many are facing significant problems in implementation. According to Antwi and Kale (2014) as well as Hertzog (2014), the implementation challenges that they face may lead to lower integration and absorption rates of new systems. Many of them claim that the main challenge is the lack of timely data. Effective data storage and analysis is a big problem when managing the change to patient-centred care (Murdoch 2013; Jain 2016). With all the information available, there is a dire need for people who can extract valuable information from it. Another data-related issue is its unstructured nature ICD-10 forms (filled at point-of-care) and the high error rates (Manyika et al. 2012).
Patient engagement is one of the biggest challenges to the transition. It is necessary for a transition of this magnitude to include consumers in every step of the way. If providers, insurance, and government systems are altered without including the consumer, then vital feedback on best practices is lost (Martin et al. 2012; Shirley 2011). Without the consumers’ acquiescence, the whole transition will collapse.
The transition that is occurring presently in the UK healthcare system is a vital one that will redefine this industry for decades to come. Thus, the change must be shepherded with the greatest of care. An appropriate model must be found on which to structure the change. The twenty-step process seems to be working well so far. In addition to this, potential barriers must be predicted and anticipated. The need for effective change management is evident. Change management provides sound theoretical foundations on which to build the newly evolved healthcare system. Without properly grounded change management, the enterprise is very likely to be a costly failure.
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