Introduction
Organizational change is an indispensable feature that health sector regularly faces due to constant transformation of its environment. The healthcare environment is modified by factors such as fast technology development, alternative market roles, expansion of globalization and patients with newer expectations. Thus, these organizations should be in a dynamic state to provide quality care. In the UK, the National Health Service (NHS) is undergoing a substantial organizational change, and a new electronic health record (EHR) system will be deployed in hospital wards. To orchestrate this transformation excellently, it is paramount to collect information on organizational behaviour and team dynamics. Collection and analysis of data can give a comprehensive overview of the whole organizational context and the interactions of the various players. The implementation process of EHR systems in healthcare organizations should take a strategic approach that parallels data collection methods such as surveys and interviews aimed at collecting the intelligence and insights and may then help the leaders address better the staff readiness, perceptions and concerns. Through applying functional leadership management; adequate communication and leadership; as well as stakeholder collaboration, healthcare organizations can solve the intricacies of organizational changes.
Methodology
Surveys and Questionnaires
Surveys and questionnaires pose excellent opportunity to gather qualitative data on staff’s attitudes, mindsets, and willingness to change as the result of EHR implementation in a healthcare setting. This method, given its completion, could be employed to keep the employees abreast with knowledge and check how well they comprehend the new technology. Tengeh (2020) proposes that surveys and questionnaires can be utilized to gauge whether the EHR system training needs are being met with respect to the relevant knowledge level and the system’ confidence. Healthcare organizations should raise the issues regarding EHR perception barriers, for example, inertia of change, disruption of routine or concerns about job security. Such palliative approaches will ultimately make the transition more bearable. Moreover, by using surveys, one can gather staff members’ opinions on the advantages and disadvantages of using EHR and what they might be concerned about in such an implementation (Baniulyte, Rogerson, and Bowden, 2023). The knowledge can be used to enhance the plans of communication and change management.
Interviews and Focus Groups
Interviews and the focus-group methodology are the main qualitative research tools to get thorough insights from the main implementers of EHR systems in healthcare organizations. The interviews and focus groups would enable healthcare professionals, managers, and staff from different departments to report on issues within workflow, communication, and inefficiencies that may be eased by EHR implementation (Barnes et al., 2022). Moreover, organizations can gather the ideas of staff members through personal interviews or group discussions. One can discover their attitudes, beliefs, and preferences towards technology infusion in their daily work. This understanding can be a foundation for the design of learning programs and organizational transformation initiatives on the basis of unique user data.
Observational Studies
Observations comprise field visits, which include observing work practices within the ward setting, team relationships and the culture within the organization. Listening to team interactions within the context of their decision-making processes and informal channels of communication enables leaders to discover strengths and areas for improvement (Ismail et al., 2023). An outcome of this approach involves identifying workflow inefficiencies and bottlenecks. Direct observation can help health organizations identify points of the workflow where inefficiencies, duplications and bottlenecks are present (Pearson, 2022). This data can activate process improvement projects and align the EHR implementation with smoothing flows.
Direct observation can help health organizations identify points of the workflow where inefficiencies, duplications and bottlenecks are present. This data can activate process improvement projects and align the EHR implementation with smoothing flows (Pearson, 2022). Staff members’ collaborations, communications, and teamwork could be examined by means of observational studies, which allow observing the team as a whole. Knowing how teams work, a leader can deliberately contribute to the establishment of team custom, where team members will have an opportunity to learn to trust and support each other while implementing the desired change (Ismail et al., 2023). By looking at how employees interact with EHR systems in a real-world scenario, Organizations can apprehend the marketability of the technology with existing practices and spot training needs.
Data Analysis and Benchmarking
Existing data within the organization can be analyzed to compare the results with those of the electronic health record system, thus inspiring the change strategy. An outcome sought from this approach involves identifying areas for performance enhancement and quality improvement. Data analysis may indicate hidden patterns, trends, and improvement areas in patient results (Rehman, Naz, and Razzak, 2022). Through the identification of development areas, organizations will determine their approaches to quality improvement. According to Emmerich (2023), benchmarking against other healthcare establishments that have successfully implemented EHR systems can be used to set the standards of performance and check for progress. Studying what other entities have learned by implementing EHR systems can give a good view of what best practices are and provide insight into how to implement them. After observing best practices from external healthcare facilities, healthcare organizations can introduce new strategies and avoid common mistakes to achieve the intended results (Emmerich, 2023). Data analysis and benchmarking give organizations a clear, data-driven reason to integrate EHR systems.
Narrative of the Project
The deployment of an electronic health record system in a ward is a major shift in healthcare practices, with the major aim of improving the efficiency and overall patient care. This paradigm shift is fuelled by different reasons geared towards a system that is streamlined and driven by data. Implementation of e-records has the ultimate potential to overhaul the conventional system and revolutionize healthcare delivery based on the evidence that proves its effectiveness (Ndebele, 2021). Salleh, Abdullah, and Zakaria (2021) assert that EHRs possess the capability of reducing medical errors, improving communication among healthcare providers, and increasing patient outcomes. Hamad and Bah (2022) noted that the introduction of EHR systems decreased medication errors from 22.76 to 18.76 after implementation. Moreover, healthcare facilities that have adopted electronic health records have already witnessed an improvement in patient care quality and impressive operational efficiency (Fennelly et al., 2020; Janett and Yeracaris, 2020). Therefore, the widespread adoption of EHR systems signifies a pivotal advancement in healthcare practices, promising a future characterized by streamlined processes and improved patient outcomes.
The journey towards installing EHR in a ward is not only led by the necessity for healthcare institutions to adopt cutting-edge technologies but also by the need to satisfy strict regulatory requirements. In an age where facilities and processes in the healthcare industry must change rapidly to keep up with the rest of the industry, healthcare institutions face increased pressure to modernize (Al-Jaroodi, Mohamed, and Abukhousa, 2020). The transition to electronic health records is considered a crucial attempt in the ongoing work to modernize and bring about improved healthcare delivery.
E-health records implementation can result in advantages in a multitude of areas, including healthcare providers, patients, and administrative staff. To healthcare providers, introducing EHR systems offers the benefit of instant access to patient data in a real-time setting, with decision-making being more informed and better coordination among the multidisciplinary teams. This eventually results in better clinical outcomes for patients. Survey outcomes in Jedwab et al.’s (2021) study revealed that 32.2% of nurses reported that EHR results in high work satisfaction and reduced burnout. Additionally, the merger of patient data enables physicians and health care workers to provide tailored and targeted treatment to the patients which allows for an uninterrupted workflow and a higher quality health care service delivery.
Implementation of EHR systems in wards may be beneficial for patient’s treatment process. The incorporation of EHR technology will change the patient experience, allowing them to have better communication with their doctors, improve care coordination, and avoid fewer medical errors (Gill et al., 2020). By having their medical information on hand and being able to share it with their care team, patients can look forward to receiving personalized care. The administrative staff members will be among the ones to derive physical benefits from the implementation of the eHealth record system (Scheibner et al., 2021). With the EHR system, hospital processes will become more automated, data storage and management will become faster, and the department will function in a more organized and systematic way in matters such as billing and scheduling.
Although the EHR field has made significant progress, implementation and adoption still need to improve, and the benefits fall short of the expectations due to challenges in changing from traditional systems. Tsai et al. (2020) assert that the implementation of EHR systems in the healthcare field is associated with resistance to change by healthcare workers. Similarly, Huang et al. (2020) reported that this can be linked to their acquaintance with known workflows and hesitation about changing the habit. The new system might have only some of the necessary functions or may fail to integrate smoothly with the system workflow. However, this restriction brings about a feeling of unsatisfaction among the users since they cannot accomplish their ordinary routine tasks as timely as before (Huang et al., 2020). The backlash to change among staff is the one more reason that makes the EHR implementations too complex.
Capacity building and learning are the pillars on which any change is based. Users’ inexperience may stem from the absence of dedicated courses covering EHR basics which, at times, could cause errors (Jung and others, 2021). As there are no mentors, healthcare professionals usually lack the ability to adapt to new technologies, which in the long run make them uninterested in changing anything. Therefore, integrating any new EHR into healthcare bodies is not an easy task to accomplish due to soaring costs. According to Huang et al. (2020), these costs are a result of several elements such as the purchase of software, the training of staff, the reviewing and refurbishing of the current system by incorporating the new software. The financial aspect of adopting such undertakings becomes substantial, particularly for smaller healthcare units that are financially constrained, and this is the main hindrance to the use of new EHR systems.
One of the major problems with the adoption of new EHR Systems is Interoperability. Different platforms can ignite the discussion about the passage of data freely from one platform to another and get different systems into sync (Sreenivasan and Chacko, 2021). Accordingly, the need for interoperability is necessary for the relatively unencumbered movement of patient data among healthcare providers, which can even affect the quality of patient care and, eventually, the decision-making process. Besides, Huang et al. (2020) found that the implementation of new EHRs was associated with data security and privacy issues. With the transition phase, healthcare entities must guarantee the secureness and integrity of patient data. The problems of unauthorized intrusion, data leakages and system weakness, however, have a mounting impact on patients’ trust as well as the lawfulness of data privacy regulations.
Methods used
Change Frameworks
The depiction of change in a ward setting, centred around the implementation of EHR systems, can be shown through John Kotter’s 8-Step Model. According to Kotter’s Model, for the change process to be on track, a sense of urgency, a guiding coalition, and a compelling vision should be established (Mancini, 2023). Rangarajan (2020) conducted a study of EHR implementation and championed the use of Kotter’s Model to overcome change. Therefore, the Model would work favourably for the implementation of the EHR systems because it underlines the importance of developing an understanding of the sense of urgency and communicating vision. EHR implementation requires a proper transition plan that will involve new organizational processes and culture; thus, a thorough case for change that will persuade all the parties involved must be built (Rangarajan, 2020). The Model’s emphasis on establishing a sense of urgency aligns with the imperative for healthcare facilities to keep up with technological advancements and regulatory requirements.
Moreover, Kotter’s Model attaches value to empowering employees, creating a common perspective, and communicating effectively so that everyone will accept the change and align with the organization at all levels. In the process of putting an EHR system to use, involving professionals in healthcare, patients, and front office staff in the change process is essential (Alrabie, 2023). This is the key to addressing potential resistance, promoting cooperation and driving successful adoption and application of the new technology. The Kotter strategy presents a similar approach by creating a network of champions for change and initiating transparent communication pathways (Trawick and Carraher, 2023). This is essential in assisting in getting through the technological changes in healthcare organizations
Kotter’s 8-Step change model can be compared with Lewin’s change management model in several aspects, such as relevance and critiques. While Kotter’s Model is more complex than Lewin’s Model, it is very suitable for extensive transformations, including EHR (Trawick and Carraher, 2023). The framework consists of eight steps, which create a path of learning and provide the organization with an index for all the change process stages. In keeping with Mouazen et al. (2023), Kotter’s Model underpins the role of leadership in the course of change implementation. By using communication, efficient leadership serves to unite the base, release the vision, and reduce the resistance. Besides that, Kottor’s Model states that the human aspects cannot be overlooked, including establishing trust, involving employees and encouraging teamwork (Alrabie, 2023). By accentuating the emotional and psychological sides of the change, Kotter’s Model acts as a supportive system of environment, which is designed for positive changes.
As healthcare organizations transform into a more digitalized and data-driven environment, Kotter’s Model becomes uniquely applicable. According to Alrabie (2023), this Model serves as a foundation for firm culture integration, continuous innovation, and improvement of the system during periods of technological revolution. Moreover, Kotter’s Model is unparalleled in dealing with complex changes in the cases of widespread organizational change that is involved in EHR systems implementation (Mouazen et al., 2023). A detailed blueprint of the company gives guidelines on how to deal with these challenges during the transformation of processes, systems, and behaviours across multiple departments and stakeholders (Alrabie, 2023). Whilst Lewin’s Model is advantageous in its simplicity and clarity, it does not have the detailed guidance needed for the management of more complex change projects like implementing EHR systems (Marshall, 2021). The Model is not part of a structured approach that has specific steps for how change is navigated from the beginning to the end. Moreover, Lewin’s vision of change might not carry the same degree of attention to the human aspects of change – for example, establishing trust, assembling stakeholders, and resolving resistance (Marshall, 2021). In healthcare environments, change can often influence staff and patient care in profound ways.
Extensive studies of the Kotter model simultaneously create a greater justification for the applicability of the Model as an effective strategy for organizational transformation such as the implementation of EHR systems. Research indicates that Model’s strategy including forming a guiding coalition, communication, and empowerment of employees among the basic principles that one should follow in order to be successful (Alrabie, 2023; Hutson-Stone, 2022). Rabie (2023) proposes that by applying the Kotter Model in healthcare organizations they can successfully utilise its functions to address the problems which in turn emerge when they shift to EHR. Additionally, healthcare leaders can utilize the Model to promote favourable changes in the way treatment and provision of services are carried out.
Overcoming Change
Employing electronic health records(EHR) needs the realization that will, ideas, and implementation cannot accomplish the change without the collaboration. The human dimension to this comes from the acknowledgement of the motivation to change that is based on understanding the reason for change as outlined by Kortegast (2020). Trust building and psychological safety is fundamental aspect for the staff during the implementation of EHR. Internal trust-building assures employees can speak out and share their concerns and become actively involved in making the necessary changes (Gustafsson et al., 2021). It results in psychological security, which fosters free communication and teamwork.
Appreciative inquiry is also a practical tool that can be applied in the change process. Through this recognition of the accomplishments and the areas where the employees have been carrying out well, the workforce feels more self-confident and driven to the change approach (Abujaber, 2023). This technique supports the development of a reflective and optimistic mindset that is required for successful change management processes to occur. Moreover, role modelling and advocating these changes play a key role in the deployment of EHR. Leaders who are examples of the desired behaviours and actions related to the new system influence others to follow them (Abujaber, 2023). According to Usman (2020), leaders can show their commitment to change through actively participating towards the completion of the transition. This, in turn, gives the rest of the team an example to follow so they, too, will be able to embrace the change willingly.
Moreover, the trust triangle, which consists of empathy, authenticity, and vulnerability, is the Model that helps leaders develop trust and social ties inside the organization so that it promotes better relations within the organization. Empathetically relating to employees’ concerns and authentically conveying their messaging while admitting the challenges visibly, a leader can foster a psychologically safe and welcoming atmosphere for change (McKimm et al., 2023). Cooperative interaction with people should be the key to effective change management. According to Ballaro, Mazzi, and Holland (2020), interactive listening between leaders and employees can assist in knowing their viewpoints, needs, and concerns to facilitate the change process by building such essential relationships. Thus, the people-centric strategy contributes to the feeling of belonging and loyalty in the employees and makes them accept innovation.
Adaptive leadership that stresses personal linkage becomes indispensable in EHR implementation for coping with difficulties. Leaders who are sensitive to the emotional reactions that change may trigger in individuals and offer support throughout the process provide a sense of security and stability in the organization (McKimm et al., 2023). Leaders can harness the human dimension of change and lead their teams towards successful EHR implementation by way of recognizing and addressing its emotional effects. Ferguson et al. (2022) assert that sustainable change is built on emotional bonding and authentic relationships. Employees who feel part of the organization and have strong ties with their colleagues and the goals of the change are more open to accepting and helping with the change process. Underpinning this cultural transformation needs interpersonal relations, which may then lead to the acceptance of change and improved, innovative skills.
Moreover, applying problem-solving skills to drive change is an efficient method for solving EHR implementation issues and overcoming obstacles. Engaging employees in problem identification, solution generation, and change implementation helps organizations better utilize the combined abilities and creativity of the entire workforce. Such collective problem-solving initiative enables the company staff to take charge of the methods for transforming the culture, and at the same time, it nurtures a culture of continuous improvement.
Leadership role in facilitating change
In the leadership role of facilitating the process of change that involves the implementation of EHR systems in the ward setting, I took a proactive approach to bring people on board. I emphasized to everyone the importance and the urgency of transitioning to that new technology. In order to foster a feeling of urgency, I pointed out the serious requirement of replacing outdated record-keeping systems with modern industry standards. It is consistent with Dhaka et al.’s (2021) recognition that EHR can achieve better patient care, workflow simplicity and, correspondingly, it has positive outcomes on the efficiency of health care. I stressed that EHR systems improve patient care, diminish adequate reduction of error, provide collaboration among healthcare workers and enhance data collection and decision making (Gatiti et al., 2021), Recognizing the importance of showcasing the positive side of the new technology would help establish a work setting where the staff members were coaxed to embrace the new change.
I developed a strong enabling vision and successfully disseminated it to the stakeholders for a successful implementation process. I drew the picture of an organization that is operationally and administratively efficient, has access to good data, unfolding of better patient outcomes, and improved processes (Rudin et al., 2020). Through presentation of a clear and appealing scenario of what the merits of EHRs would be, the audience would recognize their relevance and, therefore, be more determined to work in the same direction as me. I was responsible for the formation of a guiding coalition that was integral in ensuring smooth advancement of the EHR implementation driven by the champions within the ward. This group of people from various departments played different roles, and they were the role models of the organizational change or the implementers of IT. I blended the team input and created an implementation program that had the criteria, dates, funds, and communication channels.
The steering team whose members worked together used a process that was collaborative enough to lead to a thorough EHR integration plan that was grounded in organizational goals and objectives. We identified possible barriers, including staff resistance to change, and we planned and allocated resources correctly to support staff during the shift. According to El Aaraj et al. (2023), training employees is essential for overcoming resistance to change. Therefore, I advocated for designing training courses and establishing support services to bring employees up to the mark of the necessary knowledge and skills that were required to be used for the EHR systems.
The collaborative and transparent atmosphere was critical in eradicating the obstacles associated with feedback and fostering open communication during the change process. I thoughtfully allowed my team to express their thoughts, worries, and feelings, thereby designing a cordial and participative culture. I provided opportunities for frontline staff to express their viewpoints in regard to organizational shifts, responded to their requests, and brought their feedback into full consideration during the decision-making process. Consequentially, I ensured that everyone was appreciated, their concerns addressed, and they took an active part in the change.
Personal Reflection
I will use the Gibbs reflective model to mirror the change process involving the implementation of EHR. Gibbs’s Model would be effective in this case since it utilizes an individualized approach (Sharples and Levett, 2020). In contrast, John’s Model focuses on external feelings and influences (Patel. and Metersky, 2022). Gibb’s Model consists of six stages: description, feelings, evaluation, analysis, conclusion, and action plan. It provides a structured framework to reflect on experiences and identify areas for improvement.
Description
In the beginning, it was tough for me to adapt to EHR implementation in my healthcare agency. There were dramatic fluctuations in the flow of work, the way of communication, and the functionality of the organizations.
Feelings
I experienced a variety of feelings while going through this process of change – I was thrilled about EHR advantages and worried about mastering some new technologies. Moreover, I was stressed since the initial workload was high, with some of my colleagues already being resistant to the new system.
Evaluation
After reviewing the whole process, I realized that EHR systems, which are designed to foster efficiency, accuracy, and patient care, are indispensable. Additionally, there were occasional communication breakdowns, and some team members opposed the implementation, which also hindered the process.
Analysis
Recollecting that valid communication with key actors was a vital element that turned out to be a decisive one in a successful change management process. Open and consistent communication enables us to manage anxiety, enhance trust and hence, move the change more smoothly. During the change process, one aspect that I learned about myself was that I needed to improve at communicating with others.
Conclusion
An imperative factor is active listening, transparency, and empathy to transform into a better leader for change and improve my communication skills. These features help me comprehend the points of view of my teammates, solve their problems and create collective and collaborative workspace during change projects.
Action Plan
I aim to enhance my communication competencies as a leader through the incorporation of communication models, such as the transactional Model. This Model describes communication as a process through which communicators generate reality within social, cultural, and relational contexts (Ashman and Cruthers, 2021). I aim to understand this approach since it promotes the growth of relationships between the parties involved. I can achieve this by researching effective communication.
Conclusion
Implementing EHR systems in healthcare facilities involves collecting intelligence and insights through techniques such as surveys, interviews, observational studies, and benchmarking. With this approach, organizations can assess the staff’s readiness, perceptions, and concerns regarding the implementation of the new EHR systems in the ward. Moreover, successful implementation of EHR in healthcare settings should combine technically adaptive leadership, effective communications, and stakeholder engagement. More integrated change management tools like Kotter’s 8-Step Model, in conjunction with elements like trust building, innovation facilitation, and overcoming resistance to change, can help make the highly intricate change process in health organizations more manageable. Constant training, reminiscing oneself, and skill development on the part of leaders will help to improve their abilities and promote positive changes in the way healthcare services are provided. A culture of openness, collaboration and innovation should form the keystone of the effort to cope with the implementation of EHR, realize full benefits for the patients and increase organizational effectiveness.
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