Improving Quality, Change Management & Leadership

Introduction

Change management practice in the health and social care is important for the leaders and the health care managers to manage the workplace and provide high quality health and social care services to the patients with latest equipment and treatment. Change management is hereby beneficial to resolve the existing issues in the health and social care institutions as well as engage the staff for developing more creative decision for the organisation to deliver quality treatment and care to the patients in long run. The study focuses on the change management and leadership practice in the hospital of London, where it is mandatory to protect the patients from infection. In the recent pandemic situation, there is serious consequences of infection spread and the doctors and health care management team are concerned about mitigating infection spread by developing infection control unit in the hospitals, so that the patients can feel safe and get proper treatment and care from the health care professionals. As of January 31, there are 106,158 of the deaths occurring in the UK. Infection rates of viruses as well as there are patients who are suffering from other infections in the hospitals. Hence, the study is effective to analyse the recent situation of infection spread as well as develop effective solutions for infection control activities, so that it is possible for the health care team to maintain patient’s safety mainly in the east London hospitals. The essay is about change proposal, where the change management practice in the hospital as well as leadership style will be discussed, for managing the patients successfully.

Background of the issue

In the recent era of Covid 19, the hospitals and nursing homes in the east London are suffering due to infection spread, where they fail to mitigate the infection spread among the patients. The patients also feel afraid of staying in the hospitals, due to lack of initiatives of the staff in controlling infection. The staff members fail to manage infection control activities in the hospitals in London, where there is wrong documentation about the patients personal information and activities and medications, as well as not wearing appropriate personal protective equipment (PPE) where the staff members are not efficient to follow the quality standard by CQC or Care Quality Commission as they are not wearing gloves, safety masks and safety apron while serving the patients (Boswihi and Udo, 2018). There are contamination of infection and infection spread become serious in the society. There are other issues such as incorrect catheter care, dirt in the hospitals, lack of sensitisation and cleanliness, lots of clutter in the bedside of the patients, dirty dynamas, dusty medical equipment, using same equipment for more than one patient without cleaning in abs cuffs and oximeter probe. These are the major issues, for which the problem of infection spread among the patients occurred. Due to these factors, infection spread among the patients which further deteriorates the health condition of the patients in the health care as well as it also leads to poor patient outcome in future, where the hospitals is not efficient to maximise patient care under effective infection control and supervision (Li, and Meng, 2020).

There is effective guidance of the CQC as well as NHS for managing infection control and in the recent era of Covid 19, the doctors and nurses face difficulties in infection control where there is lack of infrastructure poor equipment structure and inefficacy among the staff members, which lead to infection among the patients. In the European Union, there are more than 4.5 million individuals per year, who are suffering for infection and more than 37000 deaths hand due to infection spread among the patients. Infection deteriorates the immunity system of the patients and thus it is the major responsibility of the hospital’s board members and medical team to protect patient’s safety and develop infection control unit for betterment of the environment. Due to lack of culture of infection controls activities and poor internal environment without cleanliness and awareness among the staff, the situation leads to infection spread among the patients, living in the hospitals in London (English et al., 2018). In this regard, Hospital acquired infections (HAI) arranged different programs for supporting the medical staff and health care professionals to manage infection control activities in the hospitals. It is the responsibility of the health care professionals to follow the strict guidelines of managing patient safety and security as well as maintain the health care quality standard proposed by CQC. The study is helpful to identify he issues related to infection spread in the hospitals and develop changed procedure so that the health and social care management team are able to take responsibility of the patient’s safety in the workplace (Wee et al., 2020).

The CQC as well as World Health Organisation or WHO provided suitable guidelines, of managing infection in the hospital, so that there would be no such issue of infection spread. Monitoring collection and disposal of infected wastes is also another major activity, which needs effective supervisions so that waste management activities can be handled efficiently in the hospitals. On the other hand, the health and social care management team is responsible to manage cleanliness in the hospital, so that it is possible for the care management team to maximise patient safety and provide them secure circumstances to stay safely. Infection spread becomes a serious issue in the recent pandemic situation, where the individuals become panic as there were no such medications, vaccinations and treatment (Wee et al., 2020). It is hereby one of the important activity in the hospitals to manage infection control unit and develop training program for improving knowledge and skill set of the staff members, who are working in the infection control unit (Li, and Meng, 2020). Hence, there is necessity of change management process in the organisational workplace, where it is possible for the organisations to create good culture of training and development related to infection control technique as well as develop suitable leadership style so leading the hospitals towards achieving success by providing high quality care and treatment to all the patients by managing their safety and security at the hospitals in London.

Implementation of change

Change implementation is one of the effective strategies of the hospitals and nursing homes, where the health and social care professionals try to develop creative decision for running the hospitals strategically and providing the best quality care and treatment to the patients. In this regard for managing infection control unit, it is also necessary for changing the existing culture of the hospitals and renovates the internal culture of patient safety management. Infection control prevents or stops the spread of infections in healthcare settings and thus it is the responsibility of the health care management team to cooperate with each other and manage the changes in the hospitals so that it would be possible for the care professionals to control the issue of infection spread and mitigate infection among the patients, so that they can boost their immunity power as well as overcome their health issues fast with effective treatment and quality care. For change management practice, Lewin’s change management model is effective, to follow suitable steps of managing change in the hospitals and protect the patients from infection spread. As per the Lewin’s change management model, there are mainly three stages through which the hospital staff and management team can adopt new changes and control the issue of infection spread in the hospitals in London. In this regard, the major three stages as per the Lewin’s change management model are such as unfreeze, change and refreeze.

• Unfreeze :

  Unfreeze is the first stage according the Lewin’s change model, where it is necessary for the health care management team to identify the needs for change and create urgency for the needs in the hospitals. In this context, it is high time for the hospitals to manage infection, as the death rate due to infection spread is increasing over the period of time. It is highly required to take active initiatives for infection control so that the health care professionals including the doctors, nurses, social workers and others can ensure patients safety in the hospitals. It is also the responsibility of the hospital management team to provide safe circumstances to the patients so that the patients can feel safe to stay under neat and clean environment, so that there would be no risk factors for getting infected. Hence, it is important need of the health care managers and professionals to manage infection and creates new changes to control the infection management unit of the hospitals through intervention and training programs at the hospitals (Aij, and Rapsaniotis, 2017). Ensuring strong support is also another activity under this stage, and the health and social care managers at the hospitals must convince the staff for getting support during change, so that the professionals and nurses can engage with the changed initiatives and participate efficiently with their full potential and clinical experience. Managing and understanding doubts of the staff in the hospital is also mandatory and in this regard the management team try to communicate with other health care professionals such as nurses, social workers and doctors, as well as dieticians, general physicians, to clear their doubts and create a good vision of such change initiatives (Aij, and Rapsaniotis, 2017). The major vision of the changed initiatives is to ensure infection control in the hospital and ensure patient safety in the hospitals so that the issue of infection spread can be mitigated in future.

• Change :

  Changed initiatives are necessary to be implemented in the workplace and it is the main stage according to the Lewin’s change management model. In this stage, the health care managers in the hospitals need to communicate with all the internal staff members and social workers for managing changes and convincing them to take active participation for adopting the changes in the care home. Additionally, dispelling rumours, and empowering the actions are also crucial activities through which the health care leader and managers can lead the staff towards achieving the vision of developing infection control through intervention and training (Lu, et al., 2020). The major changed initiatives are developing training programs related to the activities of infection control, intervention of the staff and nurses in the hospitals to manage the patient’s safety and protect them, from infectious diseases. Maintaining neat and cleanliness in the hospital floor and wipe out the floor within regular time interval, so that there would be no germs on the floor. The ideas and actions such as cleaning oximeter robes and Dynama cuffs as after single use, avoid multiple use of the medical equipment for the patients staying in the hospitals, cleaning the bed side tables and other spaces in the hospitals are effective for successful infection control. Apart from that, as per the CQC and WHO guidelines, it is mandatory to manage the personal protective equipment (PPE) including apron, gloves and masks are mandatory for the doctors, nurses and social workers. Additionally, it is also necessary to maintain food safety so that the patients can eat the food items in the hospital safely. Washing hands within regular time intervals, using sanitization, cleaning the clothes of the patients and continuous motivation to the staff for infection control activities are the major intervention planning of the hospital management team to adopt the changes and lead the staff members towards achieving the future success by delivering quality patient care (Sfantou et al., 2017). Additionally, involving the health care staff in the change management practice is important for the changes procedure so that they feel empowered and share their opinion to contribute efficiently.

• Refreeze :

  It is the last stage according to the change management model, proposed by Lewin, where the health care managers and board members in the medical team try to create new culture with harmony and freedom to work, as well as managing transparency and accountability in the hospitals and fulfilling their commitments towards the health care professionals and the patients. Moreover, the culture of partnership working practice, involving the patients in the care plan and enhancing communication and cooperation at the workplace are also fruitful for the hospitals to sustain the changes and deliver quality patients care (Bi et al., 2020). On the other hand, providing training and development programs related to infection control and efficient supervision are also beneficial to sustain the changes and take care of the patients in long run, where the managers and health care professionals can provide safe circumstances to stay securely without any issue related to infection spread. Hence, the change management processes would be beneficial or the hospital to control infection and maintain patient care successfully.

‘5 Why’ analysis

As per the analysis, there would be five questions, which are necessary to be answered well through analysis and evaluation. The questions are such as,

• Why the patients are getting infected in the hospitals
• Why do the staff members efficient in the health care system to control infection
• Why the staff are not motivated to manage infection control activities
• Why is there lack of training and developmental activities in the infection control unit
• Why do the staff fail to control high-quality standard of delivering safe treatment and care to the patients

Through continuous improvement as well as change management model, it is possible to answer the questions and develop effective strategic planning to control infection in the hospitals and prevent infection spread in future (Rinfret et al., 2020).

Quality improvement model PDSA

PDSA model is effective to improve the health and social care activities in the hospitals, where the main vision of the management team is to control infection spread and mitigate the issue of getting infected in the hospitals by taking corrective actions and intervention of infection control. The stages are planning, do, study and act, where the health and social care management team try to manage their efficacy and develop suitable planning for managing the patients (O'Hara, Thom, and Preas, 2018).

For planning the whole structure of infection control, the objective of the care team is to protect the patients from infectious diseases and infection spread in the hospitals through intervention and training, the health and social care managers, leaders, medical board members social workers, physicians, doctors and nurses are involved in this process as well as it is possible to fulfil the objectives within effective time, as the hospitals in London are efficient and financially stable to take active initiative for preventing infection spread among the patients (Sabbah et al., 2020).

For doing the planning, documentation is required as well as the collected data are necessary to be evaluated to identify the major issues and it has been found that, infection spread becomes a serious issue among the hospitals in London, where the nurses and health care professionals fail to manage patient safety. For studying, prediction of the data and summarising the decision of intervention and training in the infection control unit are necessary to be implemented by involving the staff and empowering them during the changes. Additionally, to act in the hospital, the plan is necessary to be executed under proper supervision, so that it would be possible to mitigate the issue of infection spread (Rahbi, Khalid and Khan, 2017).

Leadership approach in the health care

Leadership in the health and social care is important to manage the strong team of health care professionals to deliver quality care and continuous support to the patients. For change management and infection control intervention, it is mandatory for the hospital leader to follow transformational leadership style, which is beneficial to motivate the staff and lead them successfully (Grant et al., 2020). There would be suitable culture in the workplace with harmony and freedom to work. Partnership working practice is also developed in the hospital, so that the staff members can collaborate and gain knowledge about infection control activities. Effective empowerment of the staff, continuous guidelines, and support from the leader are also suitable to create values for the health care professional and encourage their creativity to fulfil their job responsibilities.

Additionally, providing training and developmental program as well as increased organisational commitment in the workplace are also suitable to lead the care givers and create value for long run (Comar et al., 2019). Continuous professional development is associated with the better patient outcome and improved quality of care and transformational leaders focus on providing training and developmental program, so that the care givers can improve their knowledge and clinical skill to serve the best quality care and control infection through effective intervention. Hence, the transformational leadership style would be advantageous for change management process and implement the infection control practice in the hospitals for better management and ensuring patient safety.

Conclusion

Creating good culture in the hospital is hereby mandatory for the leaders of the hospitals and medical board members in order to motivate the staff and lead them towards adopting new changes for fulfilling the vision. The health care leader focuses on managing infection control unit to mitigate the issue of infection spread among the patients and it would further jells the medical board to manage their patient care and safety in the hospital. In this regard, the change management process by involving the health care professionals including doctors, nurses and care givers, creating partnership working practice and empowering them in the changed initiatives are fruitful to intervenient in the system and adopt new changes to control infection spread. Managing neat and cleanliness, providing training programs related to infection control activities as well as managing personal protective equipment (PPE) are the major changed initiatives through which the health care professionals can ensure patient safety and mitigate the issue of infection spread. In this context, transformational leadership style is contributing factors which would be beneficial to lead the staff with motivation and empowerment where the staff members become efficient to utilise their clinical skill and knowledge to protect the patients form getting infection.

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