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Summary
Orlando Health is a comprehensive not-for-profit network of healthcare organizations based in Florida. Founded in 1918 as a single 50-bed hospital, nowadays Orlando Health incorporates multiple facilities and serves approximately two million patients in Central Florida annually (Orlando Health, n.d.a.). The network offers primary and specialty care provided by over 500 physicians qualified in such areas as cardiology, gastroenterology, oncology, neurology, and orthopedics (Orlando Health, n.d.b.). After the rapid spread of the COVID-19 pandemic, Orlando Health introduced organization-wide telehealth services, which cover various patient needs without the need to arrange onsite medical visits.
Recent Change: Telehealth Services Introduction at Orlando Health
The planned introduction of the telehealth services at Orlando Health was based on a twofold rationale. Firstly, the leadership wanted to maintain a consistent workflow, keep providing the patients with accessible care, and ensure patient engagement in the care process. Secondly, our organization attempted to reduce the risk of COVID-19 transmission by implementing an online format of provider-patient communication. According to Lieneck et al. (2021), operational workflow and patient engagement were among the primary facilitators of telehealth introduction in the United States during the pandemic. In this regard, Orlando Health’s motivation for the organizational change was driven by common factors.
As an Orlando Health employee who had witnessed and experienced the process of telehealth implementation firsthand, I was mostly satisfied with how the change effort worked. The leadership informed my colleagues and me of the upcoming change and provided sufficient training in telehealth services use. More importantly, support remained continuous as representatives of our technical partners provided onsite assistance and readily solved any issues. In addition, we were instructed on how to communicate the change to the patients, which, in my opinion, improved patient satisfaction with telehealth services. These actions of Orlando Health leadership aligned with Helleman et al. (2020), who found that end-user involvement promotes a positive attitude toward telehealth. As a result, my colleagues and I were able to attain patient support, making our experience with the change effort more positive.
Overall, Orlando Health leadership acted decisively and established effective communication with such stakeholders as employees and patients. According to Lieneck et al. (2021), effective leadership and change communication serve as the key enablers of telehealth technology. As a result, resistance to change was relatively weak, as even more stubborn colleagues were convinced to support an organization-wide telehealth implementation. In the end, the change effort worked significantly better than we had expected.
Given the positive outcomes of change, I believe that Orlando Health’s main mistake prior to the pandemic was indecisiveness. The leadership did not act proactively without an unfortunate yet powerful driver for change, such as a pandemic. Consequently, a promising and convenient telehealth technology was not introduced in a wide scope. However, the employees were also responsible for this mistake since we did not advocate the change from the bottom. We were satisfied with the situation and did not provide the feedback that could have prompted the leadership into action. The COVID-19 pandemic mobilized Orlando Health as an organization — the leadership decided to undertake the necessary steps in the face of crisis, and the employees answered the call, making an organization-wide change a reality.
In this regard, I took three key lessons from the change event. Most importantly, a healthcare organization must establish effective internal communication channels. Line employees, such as physicians and nurses, should be able to generate feedback and quickly transmit it to the leadership. Secondly, healthcare organizations’ leadership must take the employees’ feedback seriously and act decisively, whether by introducing the change or explaining the conditions that would make it feasible in the future. Finally, change development and implementation must consider the patients’ interests. A change effort has a low chance of succeeding if the patients, the end-user stakeholders, resist the change out of fear or misunderstanding.
Change Leadership Action Plan
Given the circumstances, one can argue that Orlando Health performed reasonably well at implementing telehealth technology in the wake of the COVID-19 pandemic. However, drawing a research-based change leadership action plan for emergencies would be wise. This plan could be shared within the organization, preparing the staff for change and reducing the potential anxiety and resistance associated with the change implementation. According to Li et al. (2021), transparent internal communication within an organization helps employees cope with change-related uncertainty. Therefore, having a universally recognized action plan can be considered a priority for change promotion.
The proposed change leadership action plan consists of five steps, covering all aspects of change — from problem assessment to change reinforcement and monitoring. This development and implementation algorithm would allow Orlando Health to act logically and consistently in difficult situations that require organizational change. As a result, employees would find the confidence to cope with temporary inconvenience and accept the change effort without producing significant resistance.
Problem Assessment
Scientific evidence from research on decision-making underscores the necessity of proper problem assessment before change development. Rousseau (2018) claims that understanding the need for change is preferable to seeking a solution for a poorly identified problem (as cited in Stouten et al., 2018, p. 758). As such, leadership should start change effort development by gathering sufficient information on the problem. This information should be used to explain the need for change implementation to the employees.
Vision Formulation
Change effort should be justified by a compelling vision — introducing change merely for the sake of it is counterproductive. Therefore, a vision that pursues change should include important and attractive end goals (Unsworth et al., 2013, as cited in Stouten et al., 2018, p. 760). In the case of the telehealth implementation, a vision was built around two goals — COVID-19 safety and patient convenience. Such vision formulation should be conducted before every significant change effort.
Forming of Change Guiding Coalition
Once the vision formulation stage is completed, Orlando Health leadership should recruit a coalition of change champions among the employees. These champions would prepare their peers for the upcoming change and ensure transparent and meaningful communication with the top management. According to Kellogg (2012), a coalition of influential employees helps reach a consensus for the change (as cited in Stouten et al., 2018, p. 759). In other words, the coalition of champions would facilitate visual communication to the employees who might be unsure whether the change is needed.
Vision Communication
The vision is communicated to the organization’s line staff in the fourth stage. The previously-recruited coalition of champions plays a crucial role in this process. Research shows that employees tend to exhibit a more favorable attitude to change if they perceive it worthy and meaningful (Rousseau & Tijoriwala, 1999, as cited in Stouten et al., 2018, p. 761). In this regard, the coalition of champions would provide staff members of Orlando Health with an adequate explanation of the leadership’s vision.
Implementation, Monitoring, and Reinforcement
Successful vision communication opens the way for the last step of the plan — actual change implementation and result monitoring. At this stage, leadership utilizes education and training to promote change-related knowledge and competencies. These processes help eliminate uncertainty and create self-efficacy, thus bolstering the employees’ motivation to accept the change (Kao, 2017, as cited in Stouten et al., 2018, p. 765). Once the organizational change is implemented, monitoring and continuing mental and technical support reinforce the effect, turning the change into a universally accepted practice.
Strategic Steps to Leverage Employees’ Insights
Change leadership requires strategic leveraging of employee insights in order to obtain the necessary support and overcome potential resistance. According to Erlingsdottir et al. (2018), such empowerment enables employee creativity and participation. As a result, the change occurs through trust and coaching rather than dictating (Erlingsdottir et al., 2018). This favorable outcome can be achieved at the strategic levels of leadership processes, norms and values, and multi-professional teams.
At the leadership processes level, employee insights can be leveraged via the redistribution of responsibilities. These strategic steps allow an organization to maintain staff involvement in leadership once the change implementation process is over (Erlingsdottir et al., 2018). As a result, the traditional hierarchical leadership system gets replaced with a more flexible structure that allows staff members to demonstrate their leadership capacity during the visual communication and change implementation stages. The role of the official organization’s leadership becomes limited to vision formulation.
The level of norms and values leverages employee insights through an increased sense of loyalty. According to Erlingsdottir et al. (2018), staff members appear to become more attached to the organization if allowed to participate in the creation of shared norms and values. By letting the staff discuss the purpose and objectives of their duties, an organization achieves better commitment to the end goals articulated in the vision formulation stage.
Lastly, strategic leveraging of employee insights at the multi-professional team level is achieved via establishing a sense of commonality and unity among the staff members. Physicians and nurses learn about each other’s competencies and acquire an understanding of what support they can receive (Erlingsdottir et al., 2018). Consequently, staff members become able to work as a well-structured team, which is especially helpful in the change implementation, monitoring, and reinforcement stage.
Change Process Alignment With Organizational Values
Orlando Health proclaims an utmost commitment to people and cares quality as its highest organizational values. This people-oriented attitude encompasses all organization’s stakeholders — patients, physicians, guests, and team members (Orlando Health, 2021). In this regard, the proposed change process plan aligns with Orlando Health’s most important organizational values. In particular, the problem assessment stage is dedicated to a detailed explanation of the change to the employees. The vision formulation is based on setting attractive and worthy end goals that would benefit both the patients and staff members. The change-guiding coalitions are essential for boosting the employees’ confidence; in this regard, the plan prioritizes people’s psychological comfort. Lastly, the visual communication and change implementation stages are based on staff members’ feedback, which demonstrates the value of Orlando Health’s employees to the organization. Overall, the plan advocates for a people-focused approach to change, which aligns with the organization’s commitment to providing the best possible care for its clients.
References
Erlingsdottir, G., Ersson, A., Borell, J., & Rydenfält, C. (2018). Driving for successful change processes in healthcare by putting staff at the wheel. Journal of Health Organization and Management. 32(1), 69-84.
Helleman, J., Kruitwagen, E. T., van den Berg, L. H., Visser-Meily, J. M., & Beelen, A. (2020). The current use of telehealth in ALS care and the barriers to and facilitators of implementation: A systematic review. Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 21(3-4), 167-182.
Li, J. Y., Sun, R., Tao, W., & Lee, Y. (2021). Employee coping with organizational change in the face of a pandemic: The role of transparent internal communication. Public Relations Review, 47(1), 101984.
Lieneck, C., Weaver, E., & Maryon, T. (2021). Outpatient telehealth implementation in the United States during the COVID-19 global pandemic: A systematic review. Medicina, 57(5), 462.
Orlando Health. (2021). Code of conduct. Web.
Orlando Health. (n.d.a.). History. Web.
Orlando Health. (n.d.b.). Corporate information. Web.
Stouten, J., Rousseau, D. M., & De Cremer, D. (2018). Successful organizational change: Integrating the management practice and scholarly literatures.Academy of Management Annals, 12(2), 752-788. Web.
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