HND Organisational Behaviour - Assignment Example

10-08-2006 Changing Complex Information systems Medical records at Anersley Hospital Overview: In the present case study the old structure is becoming useless and badly needs change. As explained in the case study that Hospital becomes the center for psychiatric treatment in the city and surrounding area and more number of patients is treated as outpatients Basis. So increasing number of patients creates the need to improve the services of the hospital. It has old facilities to maintain patients record. It has desk and equipments, which are outdated and record keeping of the hospital is also not sufficient. But for the last one year functioning of medical records keeping has been changed. Consultants usually kept all the records and other information, observations and documents of patients and other practitioner's records also to be kept by him. But in the changed scenario information and records of patients needed by Government Statisticians and researchers for analyzing other aspects of the health care system. So it is becoming a complex situation that requires systematic working on record keeping, filing of records as well as to work out on security of these records. The working fellows of this hospital are very informal and casual in managing the records and are very cooperative with each other too. Records were being maintained on the basis of memory of the group or individual and personal relationship. Mrs. Price the senior medical record clerk working for 30 years in the Hospital and for 10 years in the filing section with almost same number of employees where as other section has grown faster with more employees .supervisors report to Hospital secretary. Now hospital secretary becomes unit administrator but every thing remains same. Mrs. Price commands respect from all quarters. The employee of her section work as a team and complete their work as well as help others and in the free time they become informal to each other. Change: Centralization of geriatric and psychiatric outpatients clinic s and catchments area number is increased in many folds that leads increased workload of outpatient clinics. To cope up with such changes the hospital has created a new infrastructure with new staff and appointments. Old staff with their limitations tries to cooperate with them as well as with newly introduced ideas and working culture. In the reorganization process, external consultants has been appointed whose reports includes the reorganization of the record keeping strategies also. According to the recommendations of the consultants, integrated department, having work of recording files, appointments, has been created. Another section with the job of statistical data recording and administrative office has been created. Infrastructural facilities have been improved which incurred heavy cost. A new officer i.e., Medical Report officer Mr. Fraser has been appointed who had gained a good reputation in his previous jobs. He was reporting to the unit administration i.e., Mr. Littlewood. He came after two years of the planning period. He assessed the future needs and gone for immediate changing issues. Circulations of these changes to various section incharge were circulated immediately with the intention to convey the messages to the subordinate staff and announce a deadline to the proposed new system. Now the filing procedure was almost the same and he hoped the changes in physical layout and conditions inculcates the new standard. The informal way of working has been become the thing of past and now professional standard and security in record maintenance has been the new way of working. He framed certain rules and regulations for record maintenance, employee conduct and behaviour. Problem: Due to changes, the services of the records library has been getting worst. Frequent delays and non- reliability of records happening all around. This was due to more stringent rules and regulations framed by Mr. Fraser. Mrs. Price suggestions had not been paid any attention and certain anomalies occurred in the present system. Differences between staff and Mr. Fraser became wider day-by-day and communication channel become one- way. Unit administrator has little time to see daily work and sort out the matter. Further procedural changes by Mr. Fraser, aggravated the problem. Even Mr. Fraser has little time to see the actual problem of the record maintenance and the problem becoming worst day-by-day. Once a consultant called Mr. Littlewood and told him about waiting a record of a particular for three hours. During the search Mr. Littlewood and Mr. Fraser has actually seen the position of record keeping and its management. After seeing the pathetic condition of record keeping three months time has been given to Mr. Fraser to sort out the problem and improve the situation. Again Mr. Fraser planned for improvement. He reviewed the technical difficulties, routines and movement of records. He was willing to involve Mrs. Price more in a supervisory role and filing, clerk should know the procedures of handling records. One additional fulltime has been done. Though the services of record keeping and their availability in time have improved but result in higher staff turnover, lower motivation. Even Mrs. Price never intervened the working style of Mrs. Fraser and willing to leave. Analysis: Change is inevitable. In every direction, from computing to financial services, from telecommunication to health care everywhere change is taking place. People need time to get used to change but there is no time anymore. The pace of change is now so fast that any organization face change for its survival. Now people say 'change or die' mastering change is one of the crucial areas for any organization. The present organization has to change with the need of the patient. The practice of record keeping in the hospital must be revamped with the growing needs of the consultants, academicians, researchers, statisticians etc. and specifically with the patient. So change in the technology and deficiency in the existing organization are the external and internal factors respectively. To bring changes in the organization services of the external change agent (O & M) has been availed. Thomas & Bennis defined planned change as; ' the deliberate design and implementation of a structural innovation, a new policy or goal, or a change in operating philosophy, climate or style'. The planned change has various steps i.e., identifying needs, elements for change planning for change, assessing change forces, change action and obtaining feedback. The organization identified and felt the need for change and the record section has been identified for initial change. Therefore the external consultant (outside from the department) has been appointed to implement the change. But he must have more confidence on his abilities as he had provided consultancy and having abilities to control a bigger unit. Perhaps his entry in the organization was a little late when the planning phase was over therefore, he could not be able to tackle problems associated with the phase. The initial phase of any part of the planning is one of the most important things. As from the very beginning of his joining he drafted a long set of instructions and send it to various sections to implement the changes with cutoff deadlines. Which shows his autocratic approach or imposing style of working. This imposing act of changing agent (Mr. Fraser) occurs and resulted in resistance to change. Fear of unknown, ego defensiveness and tolerance for change has been seen in the employees who were routine workers. Employees have done what Mr. Fraser instructed but the motivation and the eagerness of working together was almost diminished. The record section employees were didn't show the team spirit. Neither they were willing to cooperate with Mr. Fraser. Later on Mr. Fraser as a change agent again imposing his ideas and not listening the views of the employees of the hospital as well as Mrs. Price who command regards from the employees. This type of leadership never commands respect. The main problem, which occurred during the process of change, is lack of communication between employees and change agent, which creates confusion and suspicion among employees. One-way communication channel has been blocked and feedbacks are not available at all. Employees has never been taken into confidence and informed about needed change. No prior training or any formal deliberations has been organized to aware the employees about change. Training always prepares the employees through knowledge, skills and attitude, which is necessary for any change. Style of leadership also plays a major role in the change process and in the present case it was autocratic and not facilitating change. Leader never talked to his team and never got feedback directly therefore communication process has been broke down completely. Respect for seniority and experience has never been shown by change agent, which hurt ego of employees. They are unwilling to give feedback to change agent. Change agent could not spare more time to hospital due to shared responsibility. So lack of time to sort out problems plays havoc to the problem. Informal channels have been blocked and people do not have social interactions. This results in suspicion and demotivation resulting resistance to change, more turnover of staff, and deteriorisation of record maintenance. So in short we can conclude the reasons for failure in implementing change i.e. 1. Employees of the hospital have not been properly informed or aware of the change and needs for change. 2. Change has not been properly planned. 3. Employees have never been taken into confidence for change. 4. Change agent has been appointed late. 5. Leadership style of change agent was autocratic which never facilitate change. 6. Lack of communication and no feedback mechanism. 7. Centralizations of power. Referencec: 1. Douglas, K. Smith, (1996), Taking charge of change, Reading Mass: Addision-wesley. 2. Ghosal, Sumantra. (Jan.21,2000), Preventing the failure of success, Economic times, p.1 (supplement). 3. Newstrom, John W. and Davis, Keith.(1997), Organisational behaviour: Human behaviour at work, New York: Mc-graw-hill. 4. Paul, Hurray and Kenneth,H.Blanchard,(1988), Management of organisational behaviour . Englewood cliff.N J: Printice-Hall. 5. Thomas, John M. and Bennis, Warren G.(eds.)(1972), The management of change and conflict, Baltimore Penguin, p.209. Read More