Organization Change Management

The Healthcare sector is rapidly transforming around the globe as new technologies continuously evolve for better patient care. The introduction of Electronic Management Records (EMR) systems has improved efficiency and created accessibility. However, it also poses many challenges. Hospitals that rise to the challenges of adopting information technology, face a high failure rate, mainly for staff-related reasons, especially, when medical staff resists its use. VLF's management team knew it had to achieve the buy-in of doctors as well as of clinical and clerical staff if it was to successfully implement SAP, a new system that would reformulate workflows throughout the hospital. Will VLF's management be successful in driving the transformation change? 

Questions:

You are required to answer all three questions:

  1. Do you think VLF’s management took the right decision to implement SAP in a Columbian Hospital? Explain your reasoning highlighting why this change was needed and what were the driving and resisting forces? (15 marks)

Yes, the decision was right. Some of them were resistant to change as they first began because the workflow was changed from the one they were accustomed to, and change caused resistance; so there was conflict when we adapted and made changes. However, as they learned more about the method, things started to ease over time and they all got more acquainted with it, and this encouraged them to regain an ordinary workplace. Furthermore, the efficiency of the machine increased considerably.

When they had an outstanding knowledge of their procedures and knew what the company is doing, Compunet consultant, which later joined VLF as a manager in its new ventures department, recalled this crucial point. The deal allowed the coordination of their desires, which is adaptable to the given by SAP.

Driving Forces:

Ambitious aims to support the outstanding health care facilities and the atmosphere for patients have been launched by the VLF hospital. The VLF delivered health services well organized 24 hours a day and won numerous distinctions based on scientific, logistical, and financial metrics based on their medical expertise and their employees. While their purpose and practices currently support the aims of the organization, plans to extend its offerings put immense pressure on its established processes.

The delivery of health treatment, the road to patients requires a vast number of clinicians from numerous backgrounds to assist in surgery, to rescue the health, to heal, and to discharge the patient. The treatment also involves close cooperation between patient and administrative staff. They are organized based on patient reports that contain clinical systems, prescription drugs, and materials.

Restraining Forces:

  • Resistance to change.
  • Employee behaviors that may hinder the change process
  • It takes many forms — for example, complaints, absenteeism, passive noncompliance, and others.
  • Some are concerned with change outcomes. Others are concerned with the change process.

The most critically important factors that drive the performance of SAP implementations in an enterprise include sustained management support/contribution and ownership, project team membership, and excellent project management, particularly on process design, testing, and training of end-users.

  • SAP Performance Factors is an SAP cloud-based framework for handling the organization's Human Resources (HR) activities. There are several different components of SAP Performance Factories, and students may obtain one or more certifications.
  • Core employee: The center module, which includes all employee details. To learn Success Factors, one must start with a central employee, widely known as SF-EC.
  • Quality & Priorities Management: Centered on the priorities of appointing workers, the company will identify top talents.
  • Bonus / Compensation: Granting staff bonuses depending on their performance.
  • Learning Management System: It has all the learning practices in a cloud-based component. It will also allow each employee to provide a career plan and to have all the required learning to develop their experiments and support the business to close the capability gap. It will store the e-learning that a business needs to provide.
  • Recruitment Administration: This module promotes the process of recruitment with the appropriate methods.
  • Onboarding & offboarding. On-boarding.
  • Central Accounting employee (related billing problems).

Often end users visualize multiple things they desire, the consultant will tell users whether they want a tailored product. His recommendation to Valle del Lili Foundation (VLF) was not to try and confirm the app to processes already provided by SAP but to conform it to the best practice provided by SAP. VLF agreed to adjust the SAP standards in the proper direction.

The application of SAP in a Colombian hospital led to the proper and timely handling of the work. For starters, pharmacy management (Pg18), which led to manual error reduction, was made simpler than before introducing SAP. SAP has also tended to reduce the turnaround time for the patient history to be billed and recovered. The introduction of SAP also helped document patient file management based on the conditions of their entry. It has strengthened and improved communication between medical and administrative divisions.

  1. Critique the change process. How did VLF deal with the main driving and resisting forces? (15 marks)

The key reasons for SAP hospital acceptance include automating or enforcing criteria based on the implementation, resource planning, and collaboration of team members in electronic medical records. The market method can be carried out and can be tailored to address the above explanations by most departments of the enterprise. Both market processes and an understanding of the part each person played have changed dramatically in SAP. If everyone does not play their part in online results, the following person would not be able to do their part in the series. This changed the way things worked, so all things had to focus on the whole process, not just the part they played and the part of others. It wasn't just that everything done before was computerized using pen and paper. Workflows have shifted. "Synapsis was not a project of technology, it was a project of process redesign; everyone had to learn to work differently than they had before." Hernando Garcia, Head of IT explained.

Implementation of IT has created problems for health care providers. One of these problems is that mistakes can occur in dailies, such as the lack of physical touch and coordination only electrically between physicians and other healthcare workers, such as nursing staff and medical staff. However, well before IT introduction, in a hospital of VLF scale, this possibility was possibly present. Computerized decision-making processes can also be vulnerable to certain processes and may not make use of one's own opinions in decisions on patient care, particularly in the case of people with specific or uncommon health reasons.

In any event, some VLF workers felt that, while IT provides benefits, some aspects never change. "Patient welfare is still inpatient and caregiver's hands regardless of whether they are healthcare staff or doctors," the Head of the transplant scheme explained from his viewpoint. This is a philosophy, a tradition we have had at VLF. It is nice that the machine tells me about allergies and medication reactions, product dose caps, all this is beneficial, but it can't override the doctor's decision. These programs provide us with further details. Doctors from beyond VLF may have had access to SAP, but we opted not. We don't want clinicians from a distance prescribing, we want to be sure the contact with patients and families is not missed.

The following roles and processes were changed:

In this case, it was important to consider many different personalities. Higher management was completely behind this implementation and endorsed mechanisms in change management. The doctors were reluctant to reform because their billing schemes could be in effect. CEO Dr. Borrero sponsored the introduction of SAP very well. VLF has well-planned implementation coordination and transition management. Each department head assured that the project itself and its purpose in the hospital were completely realized by its participants. They were concerned with adjusting the workflow at all stages and not the smoothest transition. He reported that while SAP would do away with employment, the need for work in the hospital remained heavy with the new reforms. A linked advantage like MR control and better billing processes everywhere at any moment. VLF mounted machine lab with accessible 24-hour SAP modules to make the new device familiar to its employees.

ERP improves both ability and efficiency. The competitions and demands have never stopped here, and all of us are searching for facilities from management to patients that can ease efforts and save time. Implementing ERP in hospitals allows organizations to combat both management and patient pleasure contingencies. Implementing the ERP in a Hospital assists with Instant Access: the ERP incorporates the whole system into the hospital and thus provides the nurse provider with direct access to their patients. Capacity Standardizations: The centralized framework facilitates the compilation of information from multiple hospital units in a single archive, thereby increasing employees ' work capacity. Simple and cost-efficient administration: combines a multitude of procedures that are connected to wellness and lead to great hospital management. It increases warehouse maintenance, health information, laboratory reports, patient data, and sales.

Greater control: The primary goal of ERP architecture is to provide a coherent platform for managed operation. It offers a description of different divisions and therefore speeds up their efficiency and roles. It makes for more control over routine preparation, nursing, and procedures. Guarantees Patient satisfaction: Hospital quality relies mainly on happy patients. When the workers operate inside a corporation using a well-coordinated method, they can be of no use to their clients.

The centralized data and procedures have also been continued to support operating departments as billing and Supply Chain Management. The billing process has changed dramatically, as doctors have already put prescription instructions in the SAP to show which equipment and medications should be included in each situation, and where the insurer has asked the doctors to explain their use of a medication or process. In terms of knowledge traceability, insurance auditors reported major changes and the audit process became quicker and more reliable. The supply chain management systems have documented considerable improvement with information from the internet inventory; it was the case with planners who had detailed information to forecast inventory needs and mitigate out-of-store incidents.

  1. Discuss what aspects of the implementation and subsequent use and improvement of the integrated information system did VLF handle well? How would you assess the post-implementation stage? What could it have done differently? (20 marks)

‘A’ grade can be given for the execution of the ERP. This is because the implementation of the ERP project within VLF was completed on time and budget. All the incentives were also offered by introducing a hospital-based ERP system. It helped to control insurance, cash management, accounting, transactions without paperwork. It helped to strengthen communication among various hospital departments, such as OPD, emergency, etc. and documents on the doctors' advice for prescribing.

The project goals are fulfilled in which patient records will be switched from paper to electronic documentation and all therapeutic and logistical processes connected with them. In 2014, the project is the best hospital in Latin America and the best in Colombia, and VLF registered a revenue of 200 million USD. The only part is that after six months of service they have retained the same Compunet contractor. Also, the funding for the Helpdesk 24/7 ceases after six months.

In general, as a system goes online, the role of the contractor is over and the corporation is left to manage the new system on its own. The stabilization mechanism of the device and its ownership by end-users is not always well finished. There are known instances in which an entity has only partially implemented or discarded a new method and reverted to its former activities. Being mindful of this, VLF determined that Compunet should provide continuous assistance for ninety days after go-live to fine-tuning and stabilize the device. Six months after go-live the support desk was dismantled and a project branch was opened to handle challenges after deployment and to optimize the device benefit.

In June 2011, Compunet was employed as a consultant and assumed responsibility for all VLF staff's continuing assistance, enhancements, and new technologies as well as for SAP preparation. "It is impossible to tell exactly when the initiative of this type stops. Granados explained the reason for this decision. We understood when it started and when contractors came to a close, but we decided to own the system because we realized there was so more potential for change, and we were also confident that new demands would emerge which would warrant further developments.

Despite comprehensive preparation efforts before then, true learning started when people started to manage the machine. Finally, it was studying, training, and using the method every day, which increased the learning curve. Informal one-to-one sharing of information was also carried out; co-employee assistance became popular if anyone had SAP transaction problems. SAPs have responded in different ways in their everyday activities. The following testimony tends to illustrate the first three months of the events.

Few units have more readily embraced SAP than others. This is the case for ER, where doctors and other end-users soon started to use it. However, in the operating rooms, it was almost 1 year before its introduction that an anaesthesiologist objected to pre-ordering equipment for use during the procedure. Moreano, head of operating room medicine, recounted how it manages this situation: "I sat with the anesthesia community to discuss their concerns over using SAP when I was named head operating room doctor in early 2012.

Since its architecture was difficult to anticipate its needs at 100% precision, it is not entirely consistent with its process; the conditions of patients are different in terms of their condition and their reaction in anesthesia. We accepted and changed the system to help them more at ease. The anaesthesiologists have only one point. In Valencia's opinion, it was a matter of adapting. Perhaps the anesthesia group did not allow us to use SAP in its operating rooms, because they wanted to - and did - use it in other units like ICU and ER. It was a question of changes.

The stabilization of the system and the previous work speed took about six months. The system's learning curve has impacted at all levels: services sales conducted in 2011 were just 6 percent higher than the previous year. This was because most health care processes had slowed down; everybody concerned knew how to work with SAP. Also, during the design process and the first six months after live service, there were contractors and medical, nursing, and administrative support personnel. The cumulative project expense was roughly US $12 million – about 19% of heads – which impacted running costs dramatically. Both financial metrics have however changed considerably since 2012.

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