Improving Mental Healthcare Services

Introduction

Innovation in healthcare is referred to the process of translation of invention or ideas into better services or products to create value and high-quality care services for better well-being of the service users. An effective innovation is able to be replicable at a lower cost and is able to meet a specific need. In mental healthcare settings, it is seen that there is various existing stigma and flaws which are limiting proper access to mental health services to the people. Thus, effective innovations of services in mental health settings are required as would help to develop ways in which problems in the settings can be resolved to offer better psychiatric health condition to the patients. In this assignment, the key aim to inform about a certain innovation in practice within mental healthcare which can be established to provide better and high-quality services in a seamless manner to the people who are mentally ill and are trying to seek proper care. The innovation chosen which is to be explained in this assignment is accessing feedback from mentally-ill patients after they receive services for their health condition so that services can be improved to develop a better mental healthcare delivery system. The model selected to explain the way innovation is to be established through service improvement in this assignment is Kotter’s 8-step Change Model. In this assignment, at first the chosen change model is to be explained and it to be critiqued. The literature review is to be presented by explaining facts from different existing literature to support the need for innovation, including aspects related to healthcare dissertation help. The aim and outcomes of the assignment are to be mentioned. Further, the change model is to be implemented to explain the way innovation is to be established and later the innovation is to be analysed. Lastly, the implication of the innovation is to be discussed. According to the NMC Code of Conduct, the confidentiality of the patients is to be maintained by properly protecting their personal data so that any harm and abuse towards them can be avoided (NMC, 2015). Thus, no name or details of any patients is to be used while executing this assignment so that confidentiality can be maintained.

Description and Rationale of Kotter’s 8-step Change Model

The implementation of the change model to create innovation in healthcare setting is required because they assist to link the way the theory of change can be implemented to practice so that effective innovation is established. This is evident as the theory informs the key aspects to focus on to create innovation or change (Small et al. 2016). The Kotter’s 8-step Change Model is able to be applied in any nature of top-down change. The 8 steps are creating a sense of urgency, forming a guided coalition, creating vision, communicating the vision, empowering others, creating small wins, building on change and establishing the change (Fourman et al. 2016). The sense of urgency is needed to persuade the people required to make innovation or change to maximise the chance of getting success. The formation of the guided coalition is required so that powerful people are made to form a group to make change. The development of clear vision is needed to help all involved in making innovation determine the culmination of action being asked to be taken (Mørk et al. 2018). The communication of vision is done to inform others involved with the innovation about the aim they are to achieve. The empowerment of others is done to inspire the team to accept the change and creating small wins informs about the way the innovative idea developed would gradually create a successful change. The building on the change means change in the way the innovative idea is to be implemented is mentioned and the establishing the change indicates successfully the innovation being planned is implemented (Kuo and Chen, 2019). The Kotter’s model at the fifth step informs that to create innovation the people involved in the process required to develop checklist of things (Henry et al. 2017). This is because lack of ideas regarding the need for resources and systems to make the change or create innovation in services leads towards their failure as the idea cannot be institutionalised. In the innovation to be created, this aspect of the model makes it suitable to be used as it would inform and determine about the IT resources and nature of workforce along with work systems to be needed so that successful feedback from the patients without any hindrance can be received. As mentioned by Edwards et al. (2019), Kotter’s model informs regarding the way employees can be managed to change their intention in accepting the change without creating any hindrance. This is because the model at first creates a sense of urgency among the staffs to make them realised the need for change. As argued by Parston et al. (2015), lack of collaboration of all healthcare staffs while making a change within the healthcare field leads to failure of creating innovation or change. This is because each of the staffs has different experts and care responsibility for the services which are shared among them to be delivered through teamwork in the mental health settings. Thus, the model is suitable to be used in this innovation as it would create the establishment of the ideas in a seamless manner with collaborative participation of all healthcare personal and staffs.

The Lewin’s Change Model is not used for making the change because even though the model is rational and goal-oriented yet it does not consider the way human feelings are to be controlled in the process of change to make it successful (Wojciechowski et al. 2016). However, Kotter’s model considers the way gradual change in human perception is to be made so that they accept well as participate in making the change in a successful manner (Kuo and Chen, 2019). In addition, the analysis of the change made through Lewin’s model leads to create a division between people who accept and who oppose the change (Schweiger, Stouten and Bleijenbergh, 2018). Thus, effective collaboration between all staffs within the healthcare may not be seen in establishing the innovation by using this model. Therefore, Kotter’s 8-step model is to be used as it helps to develop analysis of the innovation required in such a way so that collaboration from all staffs is received. Moreover, the Kotter’s model is preferred over Lewin’s change model as it informs the way preparation and acceptance of the innovation can be done indicating the aspects to be focussed and roles to be played (Kuo and Chen, 2019).

Literature Review

Concept of Innovation

The innovation is referred to the process of changing opportunity into new concepts or ideas which are put into wider use for improving the current services through change (McGahan, 2019). The innovation is totally different from invention which is evident as invention means creating new services or products which do not exists whereas innovation is making improvement or creating significant change of an existing service or products (Patterson and Zibarras, 2017). The innovation is important because it leads to develop creative ideas which can be implemented to achieve better services and products, in turn, satisfying the raised needs of consumers in any field indicating the growth of the organisation (Kim, Gaukler and Lee, 2016). Thus, innovation indicates creative development of services and products. As mentioned by Bernardi, Constantinides and Nandhakumar (2017), innovation leads leaders of any organisation to develop sustainability in the market. This is because innovation makes the leaders develop continuous improvements by reframing and reorganising existing services and products which in turn improve their service delivery skills to show continuous creativity. As argued by Abuhejleh, Dulaimi and Ellahham (2016), innovation makes the leaders effectively respond to the trends and competition in the market. This is because innovative thinking makes the leaders become well perceived of the trends that are to be raised in future and innovation leads them to accomplish it by creating change in services and skills.

Types of Innovation

There are different types of innovation such as architectural innovation, radical innovation, incremental innovation and disruptive innovation (Von Zedtwitz et al. 2015). As asserted by Coccia (2017), incremental innovation is referred to as the common type of innovation that uses the existing technology to increase value to the customers in the existing market. This means the addition of new features into any existing products to present in a new way to the consumers, in turn, acting to improve value. As commented by Galea (2018), disruptive innovation is referred to as the process in which new technology is adopted in the current market of operation by the company. This is a stealth nature of innovation as new technology would be often to be regarded as inferior in the existing market. However, the newer technology would be found to be more expensive than the existing ones and would have fewer features making it hard to be used. The innovation is only gained after certain iterations when the new technology finally surpasses the existing ones (Ashish et al. 2015). The architectural innovation is referred to the process in which lessons, skills and information regarding overall technology is accessed and it is implemented in a different market (Lessard et al. 2017). This indicates that this type of innovation is used to enter a new market. As mentioned by Coccia (2016), radical innovation is the process in which new industries are formed and includes the creation of revolutionised technology. This indicates that it is nature if innovation in which an existing product or service is made to be used in a different way at commercial level.

Innovation in Healthcare

The innovation is seen to have an effective role in the development as well as delivery of care services in the healthcare field (Lee, 2015). This is because by creating change through innovation in services and products the healthcare professionals wish to offer better well-being and health of the service users. As mentioned by Crommelin et al. (2019), the nurses and health professionals are encouraged to inform new way of delivering services and creating change in system and structures of the existing healthcare framework by leaders and managers. This is because the improvement in existing services can be made so that raised needs and demands of service users are effectively fulfilled. As argued by Bernardi, Constantinides and Nandhakumar (2017), innovation is required in healthcare so that the existing gaps in delivering care services to the service users are resolved. This is evident as through innovative ways to improve skills of service providers can be identified and the way changes in service delivery are to be made can be determined in turn allowing proper access to reliable healthcare. The innovation is also required in healthcare so that communication gaps between the health professional and their patients are resolved (Fernández, 2017). This is because in the existing condition it is seen that many doctors are unable to keep proper track of their patient’s health to ensure their well-being. As mentioned by Denis and van Gestel (2015), innovation in healthcare is significant as it would inform ways in which health records of patients can be accessed to determine their previous and current health condition. Thus, with innovation, the patients would have better quality of healthcare to be received as well as many issues and gaps faced by the health professional in delivering services can be resolved.

Rationale of the study

In the UK, 1 in 4 people is estimated to experience mental health problem each year. As per the data published in 2016 by the NHS England, 5.9 in 100 people are suffering from general anxiety disorder, 3.3 in 100 people from depression and 2.4 people in 100 from phobias (mind.org.uk, 2019). This informs that mental health issues are quite common in the UK. In relation to the rising number of mental health issues, it is seen that various organisation along with the NHS have taken proper initiatives to provide mental health services to the individuals. The organisations offering care services access feedback during the ongoing care delivery from the patients where they ask them to comment and complain regarding services being provided (NHS, 2019). However, no initiatives are seen to be operational among the mental health service delivery where feedbacks from the patients are taken after the care delivery to understand the actual impact of the care. The feedback regarding mental healthcare services after their receivable is required as it helps the professionals to be aware of the areas in care to be improved and strengths of the care services (Gondek et al. 2016). This is because patients report their areas of satisfaction and the improvements to be made in the services to ensure better care in the feedback. As argued by Wilson et al. (2016), lack of feedback regarding care after its receivable leads the health professionals to remain unaware of the complications faced by the services on receiving care. This result many organisations and professionals to be at risk of offering poor services as they do not know what further changes in their services has to be done to improve them. This is evident as the Care Quality Commission (CQC) in their reports mentions that nearly all mental health NHS trust present within England are offering poor care as many are reported to have issue with cleanliness, the dignity of care, quality of care, the impact of care and others. In addition, out of the 39 banded mental health trust, the CQC has band five of them to be one, 16 to be two, 2 trust as three and 16 trust in brand four (BBC, 2014). The band one indicates highest risk of poor care and band four indicates the lowest risk of poor care. Thus, it informs that lack of feedback of care after it being received is leading many mental health organisations in the UK to be unable to understand what nature of service changes they are to make leading them to continue deliver poor care.

The lack of accessing feedback after care received leads professionals unable to identify the reason behind the presence of gaps in their care (Shepherd et al. 2015). This evident as lack of feedback access after mental healthcare service delivery to the patients in the UK has lead professionals unable to understand how even after 31% of the mentally-ill people began treatment at the start of the year yet at the end of the year there are still 32% people remaining to access treatment (theguardian.com, 2018). Thus, the innovation is planned where the way feedback after receiving mental care is to be informed to lead the health professionals and care organizations understand the improvement in services to be made as well as gaps to be resolved to deliver high-quality care to the service users.

Aims and Outcomes

The innovation aims to develop effective feedback receivable system after care services are received and used by the services to determine the improvement and progress in services to be made. The anticipated outcomes for the mentioned innovation are to resolve gaps in healthcare as well as improve quality and dignity of care for the service users. Moreover, the other outcomes anticipated to be received through the study are helping professionals understand the extra skills they require, changes in healthcare delivery mode to be made and new care services to be added to provide better satisfaction of care to the service users.

Description and Critical Analysis

According to Kotter’s 8-step Change Model, all the steps are to be covered for creating a successful change as skipping one would lead to the failure of the whole project. The stages of the model are as follows:

Creating sense of urgency

The sense of urgency is to be created as the first initiative because without making people feel the need of the change they would not cooperate or consider accepting towards participation in making the change (Fourman et al. 2016). As mentioned by Al-Kaabi et al. (2019), sense of urgency is to be accomplished in making change by informing people through effective communication about the need for change. This is because it would persuade the individuals to understand the purpose of change, in turn, making them support towards the change. This indicates that to make the innovative change of accessing feedback on the receiving care from the mentally-ill individuals the nurses, health professionals and others staffs involved in the process of care are to be informed the way the innovation proposed is going to create better outcomes from them. The health professionals and nurses are to be informed that receiving feedback from patients on the basis of received care would make them realise the gaps in care service delivery and the extended improvement they are to make to ensure better care (Yousaf, Grunfeld and Hunter, 2015). Moreover, patients are to be informed regarding the way their better satisfaction towards care can be achieved through participation in the feedback after receiving care. This is required so that sense of urgency in making the change is created from the delivery of care as well as people who are accepting the care. The communication mediums to be used for creating sense of urgency regarding the innovation are intranet facility, verbal communication with the mental health professionals and nurses, phone media awareness and others.

Guided coalition:

The guided coalition is to be made as change cannot be created in single-handed manner and require effective teamwork as well as collaboration of various professionals and staffs (Wentworth, Behson and Kelley, 2018). As asserted by Mason, Cogua and Thompson (2018), the effective coalition is required as it helps to share skills and support with others. This indicates that guided coalition is important to brainstorm ideas regarding the way the proposed innovative change can be institutionalised. It informs that to make the change in successful manner, collaborative participation from the top to bottom members, individuals, professionals and staffs within different mental health organisations along with services users and their family members are to be received. This is because without effective support from all in the system of healthcare a change cannot be established (Rajan and Ganesan, 2017). In order to form proper coalition, effective communication is the key aspect to be focussed as well as trust between team members are required to be developed through proper negotiation so that collaborative participation is seen in making the change (Dirik et al. 2017). Therefore, it informs that in framing the team who is going to work in establishing the change of receiving feedback after service delivery trust between members are be built and professionals from different level are to be included in guiding the process of change as well as effective leadership is to be used. The transformational leaders are those who work with the team in determining a change and creating vision along with guide to accomplish it (Dirik et al. 2017). Therefore, transformation leadership is to be used in developing the change.

Developing vision and strategy:

The clear vision for the change to be developed as it indicates the future benefits to be received as well as providing effective reason behind the change being asked to be established (Nelson‐Brantley and Ford, 2017). The leader of the coalition requires to mention each member in the team who have participated in making the change about the vision so that they have proper idea regarding their reason of participation and orientation in making the change (Gutmanis et al. 2017). This informs that clear vision regarding the establishment of feedback receivable after care delivery need to include all the details about benefits for both health professionals and patients. In addition, the strategy for change is to be developed so that the way the change is to be established is clarified among all (Sweeney et al. 2016). The strategy would be to ask patients after accessing mental healthcare provide feedback regarding their satisfaction and changes in care to be made through a questionnaire provided to them via email or manually.

Communicating changed vision:

The changed vision is be effectively informed as it is going to boost service users and professionals who are participating in the change become assured how the change is going to bring positive impact for all (Jones-Schenk, 2017). This indicates that different types of communication such as verbal and written communication are to be used for communicating the change vision to all. In this purpose, email, intranet, letters, social media and others are to be used. The effective communication of changed vision among the team members with whom coalition has been formed to make the change helps the leader to get support in making the change (Koivunen et al. 2015). Thus, to establish efficiency in communicating to the changed vision to all, leader making the change is to use simple words to frame the vision and is to repeat the information for ensuring its widespread reach.

Empowering people:

In making the change, all the people involved in the process are to be empowered in such a way so that each one of them has the required skills, tools and information regarding the strategies to be used in making the change (Aggarwal, 2016). This indicates that mental healthcare professional, nurses, other professionals, healthcare staffs, service users and their family members are to be analysed to understand their skill sets and accordingly are to be trained to ensure their effective participation in the innovative change. The team members making the innovative in this assignment may experience problem regarding the way to use technological system to deliver questionnaires to received feedback from all service users using mental health services. As commented by Omura et al. (2017), training in the healthcare field helps the professionals to develop as well as update their skill and knowledge in executing their tasks. This informs that training the health professionals and nurses regarding the way to use technological system in delivering questionnaires for accessing feedback would make them empowered to have proper skills and understanding about the tools to be used in getting the feedback from the mentally ill service users and their family members regarding the delivered care. This, in turn, resolves the hindrances and obstacles which could be faced by the professionals due to lack of skills and information in using technological systems to provide questionnaires to receive feedback from patients. As argued by Aase et al. (2016), lack of empowerment of the patients to deliver feedback regarding their care leads their needs and demands to remain unfulfilled. This is because they are unable to inform the changes in care services they required so that their demands are fulfilled in satisfied manner. Therefore, training and educating the mentally ill service users as well as their family members regarding the way to deliver feedback for the care received by them would lead them to feel empowered on controlling improvement of their care.

Creating short-term wins:

The creation of short-term wins is required for long-term success as without quick wins the people would lose faith and may give up in working to establish the change (Amin and Servey, 2018). This is because lack of success or indication of wins demotivates people to work as they feel their efforts are not being successful. It indicates at first a small team of services users are to be offered the feedback questionnaire developed for the change to provide their opinion regarding the mental health care that has been delivered to them. The information received is then to be analysed and according changes in care is to be made for service users. Later, again the specific set of service users are to be provided the feedback questionnaire to mentions their opinion regarding the changed care. The data collected is then to examined by the health professional and nurses to ensure if the feedback received on care delivered and working on them to provide better care is able to create a change in satisfaction as well as care for the service users in mental health. As criticised by Jones-Schenk (2017), short-term wins help to analyse the fine-tuning to be done in any project for change so that it can deliver better outputs. This informs that the leader involved in the change is to identify from the short-term wins what further improvement in the mentioned projects are to be made so that it can provide better results.

Building on the change

The further improvement identified through the short-term wins are to be analysed and effective actions are to be taken to upgrade the change in the building on the change step (Small et al. 2016). The analysis of the short-term wins regarding the innovative change planned informs that inclusion of peer-support is to be established. This indicates that health professional and nurses along with service users and their family members are to be informed through their peer about the importance of providing feedback for the care services they received. It is necessary as it would make the service users as well as mental health professionals who still have doubt regarding the efficiency of using feedback questionnaires to effectively participate in the change process to bring in a holistic change.

Establish the change

The establishment of the change is the final step in which sticking to the new approach to be used is the main motive (Kuo and Chen, 2019). In order to create effective establishment of change, the leaders making the change are to develop an improved culture. It is to be done by informing all health professionals and staffs in the mental healthcare field about the benefit accessed due to the change with substantial proof. This is going to make the people in the mental healthcare field to follow the new approach in delivering and accepting services as they are assured it is going to benefit them in turn successfully creating the change.

Evaluation of Innovation

The evaluation of innovation is executed to understand the impact along with its efficiency and effectiveness to resolve any issue or improve any services on implementation for the target group (Carayannis, Grigoroudis and Goletsis, 2016). The innovation mentioned regarding receiving feedback from patients after receiving mental health services is to be evaluated by using techniques such as focus group and survey for the service users. However, to evaluate its efficiency and impact for the health professional and care organisations the tools such as department meetings and audit is to be used. As mentioned by Kanama and Nishikawa (2017), survey is significant method of evaluation for innovation as it helps to gather numerical data along with information regarding the behaviours and attitudes of people regarding a certain change. This is because the population in the survey are provided objective questionnaires, as well as the interview, is executed for them to understand the impact that has been caused by the innovative change. Thus, it informs that executing survey of the target group who are mentally-ill patients and their family members receiving care in the innovation would help to identify if they are satisfied with the feedback being taken and whether any effective changes have been seen in the way they are receiving care. As asserted by Koskela et al. (2015), focus group is referred to gathering certain nature of target people to discuss perception regarding any change or area of interest in the surroundings. This informs that executing focus group survey for evaluating the innovation would lead the professionals to understand how accessing feedback after receiving mental healthcare is been perceived by their target population. The department meetings are executed to provide the opportunity to the people within the organisation to share information as well as led the employers to make announcement regarding decision-making (Petersen et al. 2016). The departmental meeting for the mentioned innovation is to be done on a monthly basis where the professionals would be asked to inform regarding changes and efficiency brought through the innovation. This an effective evaluation method as through discussion in the meetings the actual progress of the innovation to receive feedback from patients can be determined as well as information can be shared regarding the way any problems being faced in following the innovation to be resolved. The organisation audit is the process in which the activities executed within the organisation are examined to assist improvement in its operation (Pedersen et al. 2018). According to this method, the organisational audit of the mental healthcare institutions is to be made to understand to what extent they are using the innovation and inform them further details that are to be followed to ensure better progress of the innovation.

Implication for practice

In future, the innovation of accessing feedback from the mentally-ill patients after receiving care can be developed to be used for analysing the mental health conditions of the patients after they are mentioned to be cured or no further presence of mental health issues are seem. This is required so that the health professionals can understand to what extent their care deliver is effective in providing long-term as well as short-term well being for the patients. The innovation can be adapted to be used in the physical healthcare field to understand what side effects are faced by the patients after receiving care and to what extent they are able to cope them in leading a normal life.

Reflection

The execution of this project to undertake an innovation in the mental healthcare field has personally benefited in various ways. The most key benefit was that I was able to determine the way staffs are to be networked and teamwork is essential in making any change in the healthcare field. It led me to understand the way trust is to be built among team members and its significance in continuing the teamwork. I was also able to develop knowledge regarding the importance of feedback and the way they are analysed to develop the right information in making progress for the care delivered to service users. Before the project, I experienced challenges with communication but with its execution, I was able to develop information how interaction is to be developed in an unhindered manner. This is because I took information regarding the way to make successful communication from my peers as well as professionals involved in supporting me to make the change. I was also able to learn the importance of collaborative working and the importance of including service users in certain decision-making process for their healthcare. I was benefited from the project in the aspect that I learned how planning is important and The use of Kotter's 8-step Change Model benefited me to understand the way innovation can be implemented in any aspect of work in a systematic manner. The benefit of using the model is that it helped me to understand the essential need of convincing people to accept any requirement of innovation. The model also benefited me to understand that only a single leader cannot bring change but it required the collaborative effort of all people within any organisation or field to create the change in successful manner. Moreover, the model benefited me by providing a checklist of things that I need to consider and think during the process of implementing the innovation. This is evident as it informed me at what step resources are to be arranged and the need of empowering people involved in making the innovating change. However, the drawback of the model which was experienced by me was that in step 7 I could not find much guidance regarding the way a better sustaining idea of the innovation can be built. In the future, the experienced gathered from the project would help in nursing practice by allowing me to have information how to work in team to deliver better care to the service users. Moreover, the experiences will also help me to understand any changes within the nursing practice can be done to ensure better well-being of the patient. In addition, the experience will impact me in future nursing practice by making me also concerned to receive feedback from patients regarding the care they have received to determine the flaws present that are to be removed.

Conclusion

The above discussion informs that the innovation planned is accessing feedback from patients on the care after they have received it. The innovation is required as no mentally-ill patients are seen to be approached to understand the complaints or satisfaction they have regarding the services after it is provided. Moreover, this lack of feedback is leading many organisations to make the services remain poor as they do not have information in which aspects improvements in the services are to be made to ensure quality care is delivered. The Kotter’s 8-step Change Model is used to make the change as it helps to bring innovation in a systematic way. The evaluation methods such as audit, meetings, survey and focus group interview are to be used to understand the efficiency and effectiveness of the innovation. In future, the innovation planned can be adopted in the physical healthcare field to ensure better service delivery.

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