The Singapore Nursing Board in which the standards of practice and where regulations are made to maintain the nursing standards in Singapore also encourages nurses to participate in researches to provide evidence-based practice and improve the quality of care to ensure that nursing practice remains up-to-date and applicable to the changing needs of clients. The healthcare industries have evolved greatly over the decades to keep up with new technologies and treatment methods to improve healthcare experiences for the patients and even healthcare providers.
The increase in health status and quality of life of the population suggests that innovation to healthcare is indeed necessary. Medical advancement to better diagnose and treat a patient or to prevent diseases also proves that it is important for a particular organisation to embrace innovation. Because innovation is a positive change, it can reduce health care costs and even the overall expenditure of an organisation. Even though innovation is supposedly something that has to be viewed optimistically, there are many challenges faced when something new is being introduced.
This is because people are generally resistant to change and opposed the idea of having to readapt themselves to the innovation. Most of them do not keep an open mind when it comes to changes and it is important that the leaders manage to overcome this challenge in order for the change to be sustainable. Ensuring that a new idea works successfully requires support from everybody in the organisation regardless of their hierarchy. Therefore, it is important to have effective communication among the people working in that organisation and this can be one of the many challenges faced.
Many factors will have to be explored in order to effectuate a change or innovation that an organisation wishes to implement. This essay will discuss about the factors that influence the organisation in a planned change, identify the theories of leadership and discuss the importance of it, explore the models of change, and evaluate the theoretical basis of change when applied to a change situation.
Changi General Hospital (CGH) is a healthcare organisation located in the eastern side of Singapore. The hospital provides a broad range of medical services and is dedicated to improve the health of the community in the east. The change that will be discussed is a change that has already occurred in the medical department in CGH which is to implement the Medical Emergency Team (MET) in the hospital. MET is basically a service provided in a healthcare setting to assist the nurses in coping with an emergency. MET consists of one consultant, one registrar, one ICU trained senior staff nurse and one respiratory therapist.
Before the implementation of MET, nurses whom identifies changes in a patients clinical condition will have to call the most junior doctors known as House Officers (HO), after which he/she will notify next on the hierarchy if there is treatment failure or uncertainty in diagnosis. This usual practise delays treatment for the patient as a lot of time is wasted when the doctor escalate the hierarchy. MET or RRT on the other hand, will attend to the patient requiring immediate medical attention within 5 minutes.
This can provide better outcomes for the patient as there is no delay in treatment and can prevent code blue. The decision to implement MET in the hospital is due to the high mortality from unplanned ICU admission. A study conducted by Changi General Hospital led by Dr Augustine Tee showed evidences that the mortality percentage is high from unplanned ICU admission. Hence the goals of implementing the MET are to reduce the occurrence of unanticipated life threatening emergencies which contributes to in hospital mortality and to decrease the chances of admissions to the ICU.
Studies from all over the world have also proven the effectiveness of initiating the MET in a hospital. A study done by the Department of Intensive Care in Austin Hospital, Australia and West Penn Allegheny Health System, USA showed the effectiveness of the Medical Emergency Team. The study demonstrates that there are reduced code blue incidences in the ward with the increased MET activation at a teaching hospital in Melbourne. In another study (Sharek, et al. 2007) has found that there is a substantial reduction in cardiac arrests occurrences and mortality rate in hospitals with the introduction of MET. With all the evidences that studies have proven with regards to the effectiveness of implementing the MET in hospitals, Changi General Hospital launched the programme on 5 January 2009. It is important to identify and understand the internal and external environment in order for the change to take place smoothly. Comprehensive assessment of the environment is a crucial component of strategic planning.
It provides a clearer picture of the current situation and greater understanding of environmental factors in which change is to take place. The external factors refer to the factors outside the organisation such as the customers. The external factors that may cause a change to occur in an organisation would be the rapid changing dynamics of the industries and competitive forces, the regulation or deregulation of the organisation itself, changes in clients expectations, changes in standards (SNB Standards of Practice for Nurses and Midwives) and technology changes.
CGH is a public hospital therefore it is important to keep up in terms of delivery of care and services provided to clients in order to establish good recognition among the population and other government and private hospitals. Clients are becoming more knowledgeable with the treatment care provided for them due to the accessible information in which they can easily obtain. They might have a dramatically positive experience from other hospitals which affects their increasing expectations.
It is important to also consider the internal environments during the planning of the change. The internal environment includes the doctors, nurses and other healthcare professionals working in the organisation itself. Human resource issues of personnel turnover and project implementation issues are factors that can help determine if the suggested change can occur. Another internal factor would be creating new inter-organizational interdependencies and collaborations in the form of joint ventures.