Leadership and Change Management

Effects of Change 

Change is inherent in organizations especially given the need to create improvements or facilitate processes that are a reflection of modern management systems. Change processes create the need for leaders to have an in-depth understanding of change can be effected within the organization without creating conflict or dissatisfaction. Organizational rigidity to change is among the precipitating factors for leadership failure and ineffectiveness of organizations processes. Emphasis on learning organizations in healthcare implies that change is inevitable. Learning organizations consist of coordinated departments or parts that serve the common purpose of the organizations, in this case providing patient care and improving outcomes (Maccoby, Norman & Margolies, 2013). Learning organizations embrace change through their process and continuously work to create improvement. Change is inevitable in modern health organizations hence its impacts on people and systems need to be analyzed and understood by organizational leaders. A system shake-up that resulted in the appointment of a new director at the organization is evidence of how change occurs and its effects in providing organizational improvements. The effects of change at the organizational level become apparent immediately the change occurs and continue to be felt in the long-term. The effects of the changes introduced by the new director are a reflection of the impact that change brings in an organization. 

Dynamism in Organizational Processes 

Change management advocates for dynamism in organizational processes and the approach to issues by the management and employees. Organizational dynamism is built the organizational processes to become resilient and adjust to any shocks that happen in the industry. Transformational leadership in healthcare seeks to create positive change by introducing dynamism to processes, departments and treatment approach (Lee, Weiner, Harrison & Belden, 2013). To gain a deeper understanding of organizational dynamism, the perspective of organizational change must be considered. Organizational dynamism seeks to continuously strengthen key resources in the department while at the same time focusing on employee performance. Learning organizations characteristically display dynamic tendencies through strategic management practices. The new director at the hospital introduced a transformational and strategic philosophy which constitute dynamism in the hospital. 

Transformational leadership is goal oriented in the sense that the organizational leader creates a vision and sets goals that motivate workers to work towards their achievement. At the departmental level, each employee is given specific goals on a monthly basis. They are then encouraged to work towards the achievement of the goals through incentives. Transformational leadership creates dynamism by developing a culture of objectiveness throughout the organization. Employees at the hospital developed a drive to provide better health care services to the patients since the new director took over. Organizational dynamism is desirable in health care since it patients and their families are increasingly becoming aware of the need to receive the best care at every situation. Health care reforms are transforming the way patients receive in care in hospitals approach (Lee, Weiner, Harrison & Belden, 2013). In light of that, dynamic organizations are likely to adapt to these changes and grow as opposed to bureaucratic and autocratic organizations. The hospital system also encouraged strategic leadership at the top level and the running of different departments. The change in leadership at the top level introduced a different approach to leadership, greatly adjusted from the previous style. The previous director preferred the top-down style where he would give directions for the juniors to execute the tasks. Comparatively, strategic leadership builds on the abilities and the experience of the leaders to act from within the pack and act as an example to the followers. This style enhanced dynamism by serving as motivation to the hospital employees. Department heads were required to handle tasks as an example to the staff. Observed improvements in moral ensured that patients received better care and outcomes improved. 

Organizational Growth 

Growth in an organization is reflected through both the physical growth observed in increased assets and staff the hospital and the non-tangible growth in systems and processes. Infrastructure changes are a necessity in learning organizations since customer demands keep changing. Additionally, changes in the provision of healthcare demand new approaches that are fulfilled by infrastructure changes and new approaches to providing health care. Measuring growth at the hospital is not a straightforward endeavor since it operates as a single system consisting of 18 different hospitals. Relying on the two main indicators of growth aforementioned, it was apparent that the hospital was in the growth phase. The leadership provided a clear vision that was anchored on the hospital’s principles and a strong drive to provide better services. The objectives and goals at the departments then completed the framework for organizational growth. Improvements in equipment used in the diagnosis and in the operating room were the most notable infrastructure changes. The number of specialist staff also increase to the change management policies that were adopted. The result of the new and improvement skilled staff was manifested through the improved outcomes. Considering the fact that the hospital provided learning opportunities for students, the quality and level of education offered at the hospital also improved. 

Improvement in processes as a result of the new director’s philosophical approach to leadership. He was responsible for a change in attitudes at the departmental level. He identified the need to motivate the workers and provide an environment that would enhance their output. Again, he placed emphasis on teamwork where team leaders were tasked with ensuring coordination and the achievement of set goals. The result of the change in processes was a motivated workforce that was willing to put their best effort to improve patient outcomes. The reputation of the hospital grew as more professional desired to work under the hospital. Teamwork encouraged the sharing of duties and exchange of ideas. Interprofessional teams at the hospital drawn from various sections of the hospital helped to relieve the workload by distributing duties. Consequently, accidents and complaints greatly reduced. The management was able to leverage attitude change to introduce new ideas and systems. The positive attitude eased the processing of embracing the new ideas leading to a short adjustment period. 

Patient Outcomes 

The vision of the hospital is to provide top of the range of care to patients and achieve outcomes that are reflective of the hospital staff dedication to patient care. The two main indicators of improvements in patient outcomes are the observable standardized evidence and improvements in the approach to healthcare (Burson & Moran, 2018). Optimized care at the hospital was evidenced by proactive measures as opposed reactive approaches. Proactive measures include processes that are meant to prevent undesirable outcomes and foreplanning for events. For instance, there was always a team on standby in the operating room to attend to emergencies or any other eventualities that might arise. Self-management is another indicator of optimized care. The hospital's management encouraged interprofessional teams to thrive in the hospitals, consisting of a team leader and team members. The teams easily make decisions concerning their activities hence enhance the self-management aspect. Evidence-based guidelines are critical to the type of care that patients receive. Health care at the hospital is based on this aspect to ensure that patients receive the best care and medical errors are eliminated. These guidelines are a blueprint that every employee at the organization strictly adheres to at all times. 

Improvements in outcomes are also attributed to the management decided to invest plenty of resources to the development of an electronic system of keeping patient records. Elimination of the previously ineffective system paved the way for a more modernized system that eased access and retrieval of the records. The result of the transformation was better tracking of patient conditions which ultimately leads to better outcomes. The resources for patient care are a determinant of the outcomes. These include the human resources and the equipment used at the hospital. A continuous process of infrastructure improvement was adopted which ensured that processes and systems were up-to-date. Coupled with the employment of competent professionals to handle the patients, it was likely that this was a step in the right direction. The director and hospital administrators embarked creating a culture of quality. Processes within the organization that was deemed below standard were analyzed and measures for improvement spelled out. By so doing, it becomes possible to create a hospital system that boasts of quality and uniformity in the delivery of services. 

Improved Reputation 

Reputation constitutes the way organizational systems and processes interact with stakeholders and the public in general. Reputation is critical to the way patients view the processes within the organization and their perception of how the care is accorded to them. Reputation also extends to the family members of the patients interact with the staff at the hospital and their attitude of the quality of services. Organizational change creates uncertainties that leaders have to handle ethically (Sharif & Scandura, 2014). Ethical leadership in the face of these uncertain situations is necessary for creating an excellent reputation among employees that then influences employee attitudes. Unethical leadership trickles down to employees and is then reflected in the manner of service delivery. Patients and families who feel dissatisfied with the handling of matters at the organization develop mistrust and suspicion. The director set out to act as the benchmark for all things ethical about the organization. He also encouraged departmental heads to portray high levels of honesty through open communication and rewarding of staff for their efforts. Ultimately, the practice created trust between the employees and was reflected in the handling of patients resulting in an excellent reputation for the hospital. 

Measuring Change Effort 

Change management strategies outline the need to adapt to a constantly changing environment to sustain organizational success. Change is common in both the external and internal environment. Change in the internal environment includes the way employees communicate and view their work environment, relationships between the employee and the management and the effect that change has on the patients. The external environment is especially critical due to technological adjustments, customer attitudes, and competition. Various crucial aspects in the change effort determine the success of the whole organization in the change process. Measuring change effort at the department and organization deserves close focus on these aspects. 

Urgency in Organizational Processes 

Maintaining a status quo can be detrimental to the organization’s future prospects. Status quo can as well prove expensive to maintain especially in situations where customers and other stakeholders are demanding change. A sense of urgency is evident in the departmental approach to issues as well as in the top level management at the hospital. The leadership at these two levels created urgency by creating a compelling need for employees to embrace continuous change within the organizations. The departmental chief in the operating room implemented systems that embraced technology at the core of patient care. This included process improvement to reflect a modernized operating room. The urgency adopted by the departmental chief facilitated the management to avail funds to purchase equipment and hire qualified professionals for the job. As such, the successful transformation of the OR was easily facilitated by creating a sense of urgency. 

Similarly, the newly appointed manager identified the need to create change and favorably compete in an environment where reforms were fast taking place. Policy makers in healthcare were advocating for reforms to improve the type of care that patients received. The director was tasked with the responsibility of convincing stakeholders to adopt the changes if they were to remain relevant in the provision of healthcare. Discussions on how the change would be affected were carried out and key areas for stakeholder contribution pinpointed. By managing to get all stakeholders on board in relation to creating a sense of urgency, the director easily implemented his ideas about change management for the benefit of the hospital. 

A Review of the Current Strategy 

Change management is spearheaded by an organizational strategy which outlines the key aspects of the change process and then provides a framework for effecting the changes. Thus, reviewing the current strategy of the organization provides an insightful analysis of how change is taking place and the probability for success. The departmental strategy lays emphasis on goals and a plan for growth. Each member of the department is accorded tasks according to their expertise and abilities. These tasks provide the measurable goals that determine measure the efforts of the employee. Employees are also encouraged to take on new tasks to increase their skills and abilities. In line with the goal setting strategy, the exchange of ideas is encouraged through the team setup. Staff working in interdisciplinary teams combine their abilities and skills to create learning experiences. 

The same strategy is applied by the organization director. The director created a clear vision and mission for the organization. The vision was inspired by his desire to transform the organization into a leading center for health care delivery. Purposely, he shared the vision with departmental chiefs and convinced them to support its implementation. This form of strategy bears significant resemblance to the visionary leadership strategies of the directive, transformational, transactional and empowering investigated by Pearce, Wassenaar and Manz (2014). Under the aspect of the directive, the leader provided instructions and recommendations that were helpful in guiding the whole hospital towards a common goal. He also provided rewards in the form of incentives and compensation for spectacular effort and standout ambition. He then fostered commitment through his own character by availing himself at different sections of the hospital and engaging in the daily activities. He however often falls short on this aspect since staff deems that he is always searching for excuses to delegate duties and attend to other matters, either personal or relating to his position in the organizations. The influence of the director is seen through his ability to empower staff by creating opportunities for interaction. Certainly, the director’s strategy for the organization, though not perfectly executed, has the potential to result in growth. 

Communication 

Organizational leaders are tasked with the role of adopting communication channels that reflect the organization’s belief on the importance of communication and how it influences change effort within the organization. Change effort within the organization is measurable by the effectiveness of the communication between the management and the hospital staff as well. Change management at the hospital made communication effectiveness one of the priorities in transforming the hospital into the best care facility. Initially, the organization operated under a disjointed form of communication where the top management handed down instructions to the departments. Departmental heads similarly issued instruction to the employees without a clear method of receiving feedback. This autocratic system created a communication gap between the management and the hospital staff leading to workers dissatisfaction. Poor communication resulted in low employee morale and high staff turnover at the organization. In the operating room, due to the sensitivity of the cases handled, the administrator always ensured communication was precise and was done on time (Vermeir et al., 2015). 

Expectedly, the newly appointed hospital director identified the communication problem and sought to instill measures to improve communication in the organization. The director divided his communication strategy into two; the open door policy and the periodic departmental meetings. The open door policy mainly applied in the departments where leaders could easily be accessed by the staff either physically or through communication devices (Wallapha et al. 2015). As result, information moved much faster and employees easily sought for clarification on matters that were not clear. Decision making also improved as well as the confidence of the employees. Weekly departmental meetings enhance coordination within the whole hospital by permitting the exchange of ideas and creating a shared vision. Through these meeting, the departmental leaders familiarize with the goals of the organization and work together to fulfill them. Teamwork is also vital to the improvement of communication in the hospital. Teams in the OR consists of professionals from various disciplines who work together to achieve a common purpose. The team's leaders ensure coordination by ensuring every member makes a contribution. OR teams with well-coordinated activities reduce the number of surgical accidents and enhance the skills of the team members (Russ et al., 2013). In essence, communication improvements positively contribute to patient safety. 

Culture 

Organization culture defines the way employees, management interacts with each other and the way patients are handled at the hospital. Culture is defined by the underlying characteristics, shared values, beliefs and behavior that are unique to the hospital. (Toussaint & Berry, 2013). Culture influences the way of thinking of staff such that a negative culture produces a bad attitude and vice versa. It is imperative that the management cultivates a culture that places focus on patient care. Patient care is crucial in building the reputation of the hospital by building trust and improvement in hospital ranking. The management at the hospital advocates for patient-centered care at the organization. Patient-centered care strives to provide specific care to patients according to their individual needs. Patient-centered care is applicable in the OR by allowing the OR teams to fully assess the specific needs of their patients and devise care program based on these needs. By building a culture of placing precedence to patient care, new employees easily become acquitted and improvement in processes is also witnessed. 

Importance of Collaboration in Solving the Problem of Understaffing 

Work scheduling due to staff shortages is the most prevalent problem at the hospital. Staffing according to the needs at the hospital is crucial in ensuring that the patients receive highly commendable care. Additionally, adequate staffing prevents overworking of the caregivers which can result in high staff turnover rates and burnout. Complaints of some team members working for up to 14 hours in a day are common. Although the hospital offers incentives for the extra workers that the staff stays, the excessive workers hours significantly affect performance due to fatigue. Additionally, the chances for errors increase in such situations as the staff gets tired due to the long working hours. Collaboration in handling tasks at the OR and other sections of the hospital can alleviate the challenges related to the staff shortage. Collaboration in such settings involves coordinated activities with a common purpose or goal. (Maccoby, Norman & Margolies (2013) described collaboration in healthcare as a psychological process of the ideal future that the team had envisioned. Collaboration involves placing people in appropriate roles and motivating them to complete the tasks. Collaborative strategies applied to staff will ease the pressure on the hospital administrators and the staff in the delivery of care in situations of inadequate staff. 

Collaboration in Teamwork 

The OR in an academic teaching center requires the highest levels of efficiency owing to the number of personnel present, the equipment in use and the level of technology needed to achieve outcomes (McDowell, Diaz, Young & Urman, 2015). Further, sharing of knowledge is a continuous process hence maintaining consistency in the team working in the OR is critical. Staffing problems at the hospital can potentially compromise the level of efficiency in the OR. Leveraging the team settings in the OR can help in increasing efficiency and eliminating delays and errors related to understaffing. Typically, operating rooms consists of several people dawn from several disciplines including surgeons, anesthesiologists, operating room nurses and resident medical students. They form a team that comprehensively performs tasks to determine the outcomes of patients. In situations where there is limited staffing, the preparation process for operations experiences delays which affects the periods for the turnover. The time required for completion of procedures is also affected as more time is spent on tasks that would otherwise be effectively completed with the right number of people. Generally, efficiency is affected and patient outcomes are reduced. 

By applying collaborative strategies, the number of nurses preparing the OR for surgical procedures may remain the same but effective distribution of tasks will ensure they are completed within the expected time. Maccoby (2013) posited that placing people in their right roles facilitates efficiency due to their familiarization with the tasks that they handle. He went further to explain that this practice triggers the intrinsic motivation of the people and enhances efficiency. Various tasks in the OR are repetitive. In situations of understaffing, ensuring that these tasks are completed by one individual or a group of individuals every time enhances speed and efficiency while at the same time reducing the chances of errors. The procedure itself can also be completed on time if the teams are motivated through the provision of a conducive work environment by the management. The director should plan the schedule such the requisite number of people are always present to complete the required activities. 

Team collaboration extends to other parts of the organization. West and Lyubovnikova (2013) in their study of intricacies of teamwork in health care acknowledge the benefits of team collaboration which include reduced medical errors, better outcomes for workers, increased patient safety and better job satisfaction. Various departments at the hospital also consist of teams that perform duties in close coordination. Coordination applied to the organization, in general, will enhance effectiveness by ensuring that the teams complete their duties before the deadline. This frees up more time to attend to tasks that may be pending. 

Collaborative Strategies in Management 

Collaboration in healthcare is not limited to teams, the strategies can be applied in management with significant outcomes. The management at the hospital displays strategic management practices that might assist in enhancing overall collaboration at the organization. Interdepartmental collaboration is common in the healthcare through its capability in facilitating processing that might otherwise take a longer time to complete in its absence. The strategy is mostly applied where issues or problem are too complex such that they cannot be solved by one department. Understaffing qualifies as such an issue since it affects all areas of the organization. The initial step involves conceptualization of the issues and how it affects processes that flow between the departments. Once the processes have been pinpointed, the process of analyzing them in detain begins. This analysis provides an in-depth understanding of their importance to the hospital and how solving these problems will create improvement. These are the processes that are slowed down due to lack of personnel to undertake them on time. 

Secondly, the processes are linked to their respective departments and areas of disconnect found. For instance, the supply of equipment from the procurement department to the OR is affected if the task of requesting is delayed. Once the area of disconnect is found, partnerships are formed between these departments to secure these areas and avoid delays. This step is achieved through a strategic plan that is unique to the area of disjoint. The strategic plan outlines how the issue of understaffing causes delays and problems in coordination between the departments and formulates methods of restoring coordination. Once the strategic plan is in place, close ties between the different departments are established that enable coordination. Under this plan, departments that are fully staffed or excessive caregivers can provide extra members with the requisite expertise to the other departments. Interdepartmental collaboration ensures that human resources are efficiently utilized in the organization while ideas are exchanged to enhance organizational growth. 

Interaction with Patients 

Collaboration between nursing caregivers and patients is not far-fetched. The idea of collaboration between caregivers and patients differs slightly with the observed conversation within teams in health care. Collaboration between caregivers and patients will ease the delivery of care and help in solving the problem of understaffing at the hospital. Just like poor collaboration practice between physicians and nurses is known to adversely affect levels of satisfaction, poor interaction between nursing caregiver and patients will also affect patient outcomes (Tang, Chan, Zhou & Liaw, 2013). When put into perspective, the quality of services offered by caregivers depends on the level of job satisfaction and the conduciveness of the work environment. A hostile environment is demotivating to the caregivers and affects their output. Patients play a huge role in determining the type of environment that caregivers work. Through their interaction with patients, nursing caregivers are either motivated to provide excellent services to becoming detached from the needs of their patients. The hospital management emphasis on the need for patient-centered care in providing services at the hospital. This form of care is only possible if the patient is able to freely interact with the caregiver and cooperate in diagnosis and treatment. Cooperation between the caregiver and the patient enable faster delivery of services thus easing the challenges related to understaffing. Fewer caregivers are able to attend to a greater number of patients if they fell motivated and the interaction is without incident. On the contrary, a hostile environment created by the patients increases the challenges that the staff face while delivering care hence more time will be spent in completing tasks. Additionally, family support for the patients also allows the nurses to easily recognize the needs of the patient thus attend to them on time. 

Version 3 

Plan for Inter-professional Collaboration 

The benefits of collaboration in healthcare underline the need for excellent strategies in coordinating activities and tasks in the OR. The benefits of collaboration in healthcare include improvement in outcomes through the prevention of medical errors, prevention of adverse drug reaction and reduction in morbidity and mortality rate (Bosch & Mansell, 2015). The benefits to staff at the hospital include reduced workload and an increase in job satisfaction rates. Typically, operating rooms consists of several people dawn from several disciplines including surgeons, anesthesiologists, operating room nurses and resident medical students. They form a team that comprehensively performs tasks to determine the outcomes of patients. Each of the professionals in the OR perform specific tasks or are within the OR for a specific purpose hence their presence should not be undermined. The efficiency in the OR can be kept at the highest level if the roles are understood and carried out diligently. As posited by Maccoby (2013), identifying the right people to perform specific tasks is critical for the success of any collaborative strategy. Hence, the inclusion of professionals with different skillsets OR activities improves outcomes. 

Development of a plan for interprofessional collaboration is necessary for mapping out the areas that each team member will concentrate on making the collaboration successful. Additionally, the plan integrates various aspects of teamwork into the collaboration to ensure proper coordination of activities. Typically, conflicts arise within collaborative teams. The chances for conflict in interprofessional teams increases due to the members being drawn from various disciplines. The existence of a plan makes it easier to solve these conflicts and enhance collaboration. Since the focus at the hospital is to provide patient-centered care, the plan acts as a blueprint for the achievement of this mission while the team also works to ensure the vision of the facility is accomplished. Planning for interprofessional collaboration involves the identification of people to include in interprofessional teams, outlining the purpose and the goals for the team, ensuring integration and mutual understanding while working towards achievement of the goals and evaluation of the team performance through objectives and goals. 

Constitution of the Teams 

The director and the administrator are responsible for ensuring the constitution of the interprofessional teams in the OR meets the requirements. Implying that the people working in the OR must have the necessary skill set, experience and motivation to provide the highest quality of care. Given that every team member completes different tasks, team constitution helps in ensuring every member is appreciated in their capacity. The imperative for rightful team constitution also extends to staffing requirements. ORs are usually busy at the facility hence the need for efficiency in observing timelines for completion of tasks. This includes the time taken in preparing the operating room for procedures and the times for turnovers. With the right people in place, such tasks can be completed on time and the efficiency enhanced in the OR. Various people have different tasks in the OR. For instance, the OR nurse is responsible for patient care before, during and after the surgery is done. The nurse provides education and is responsible for the needs of the patient at every step. The anesthesiologist is responsible for medical management of the patient’s vital organs such as heart rate, breathing, blood pressure etc. The number of people present during procedures is also a determinant of outcomes. A high number of people present increases the risk for surgical site infection (Sadrizadeh, Tammelin, Ekolind & Holmberg, 2014). Striking a balance between the number of people necessary for the effective completion of procedures and the staff composition that will ensure patient safety is a necessity. Importantly, the staff in the OR should be well constituted for close coordination to be effective. 

Purpose and Goals 

Critical in the plan for interprofessional collaboration in the OR are clear, precise and specific goals. The goals define what the teams intend to achieve within a given period with the available resources. The purpose, on the other hand, is the guideline for the team to work in meeting the mission of the hospital. Having a clear purpose in the OR that all the staff work within the limits of the described purpose. For instance, the purpose in the OR may be stated as emphasizing on the provision of patient-centered care through the surgery. Consequently, all activities in the room will be designed to ensure patient safety and desirable outcomes due to the surgery. Patient safety standards include protection of the patient against injuries, infection, and provision of patient education. Risk factors for infection during surgical procedures must be fully understood for purposes of enhancing patient safety. Medical errors during procedures also undermine the efficiency of operation in the OR. Collaborative strategies effectively reduce the chances of making errors. Having interprofessional teams that share the same purpose in the operating room creates opportunities for providing efficient care. 

Goal setting is part of the integration process for interprofessional collaboration in the OR. Goals are the specific targets that staff in the OR aim to achieve within a given period. The departmental director is responsible for coming up with clear and purposeful goals that he then shares with the other staff. Getting all the staff in the OR to support the goals is the initial step in ensuring their attainment. For instance, the director may set goals for the improvement of patient outcomes. It impossible for a single professional to work towards the achievement of such a goal. As such, all the staff comes into consensus on the techniques that they will apply to improve outcomes for patients that pass through the operating rooms. As they work towards the achievement of the goal, the staff are able to build strong working relationships that are an embodiment of interprofessional collaboration. 

Moreover, a holistic approach to the patient care highlights contributes to the collaboration strategies. Holistic approaches involve the concentration on the overall healing of the patient as opposed to just the diagnosis and treatment of specific areas of diseases. The first step in the holistic process of healing is the identification of key areas of weaknesses that might hinder the desired outcomes of the treatment process. This is dining by the OR nurse who provides counseling and education to the patient. Resultantly, the patient goes into the OR with deep knowledge of the situation. The team responsible for the surgery is also fully aware of the patient's needs and strives to fulfill them. After surgery, the patient then undergoes counseling to enhance the healing process. Various tasks performed by different professionals in providing holistic care demand coordination in the team set up. Thus, team members learn to work together for the good of the patient. 

Integration and Mutual Understanding 

Interprofessional teams in the OR, just like any other teams in health care, require integration for the coordination of activities and elimination of setbacks inherent in team settings. Integrative practices in team settings build on the interpersonal skills of the team members. The ability of the team members to effectively communicate. An environment with effective communication practices becomes devoid of confusion, conflict and other negative effects of poor communication. Interprofessional communication as a part of the skills that people learn and almost perfect while working in a collaborative environment. Attaining competence in the OR demands effective communication practices in the form of active listening, assertiveness, keenness when speaking to patients and timeliness. Communication gaps are closed with the application of these best communication practices. Integration and mutual understanding rely on empowerment of team members on their roles and importance to the team. Traditional healthcare practices in the OR granted the surgeon complete autonomy in making decisions on the treatment of the patients. However, with improvement and health care reforms, other professionals are able to make positive contributions to the care process which effectively improves patient safety. As the team members become empowered, they are more willing to make contributions that contribute to patient outcomes. 

Mutual respect within the team enhances team mentality. Various professionals practicing in the same setting presents the challenge of others viewing themselves as more important. This form of mentality is detrimental to team effort since it results in arguments and conflicts. Overcoming this mentality is crucial in creating cohesive interprofessional teams with a high success rate. The management thus creates an environment of mutual respect and understanding such that the role of each team member is respected and appreciated. Sources of conflict are easily identified in such situations and handled. Mutual respect cements the team mentality in the operating room by boosting the confidence of different people within this setting. In essence, a plan for interprofessional collaboration becomes effective if the team members are willing to ensure its success. Appreciation for the efforts of all team members is critical to the integration process. Successful integration of interprofessional collaboration in the OR will be evident through the improvement in both patient and worker outcomes. 

Evaluation 

Evaluation of the integration process for interprofessional collaboration in OR provides an avenue for measuring the successes of various aspects of the process and determining the weak points that will then be strengthened. An assessment of the influence of the team leader in the OR will indicate the level of integration. Fully integrated interprofessional collaborative teams in health care have established team leadership that is responsible for coordinating activities within the team. The quality of leadership is apparent in the manner in which the team conducts its activities. Characteristic with well-integrated interprofessional collaborative teams is the clear establishment of roles for the team members (Shrader, Kern, Zoller & Blue, 2013). Each team member fully understands their role and undertakes the activities related to their roles with due diligence. The evaluation plan will assess this critical aspect to establish the role are adhered to for the success of the integration process in the OR. The process of sharing information within the department is also an indicator of the success of the integration process. Effective communication processes facilitate easier and faster transfer of information which adds efficiency to OR processes. Presence of protocols for sharing information is important in such a setting. Breakage of such protocols results in errors and inefficiency in care delivery. Interprofessional teams share a focus on the issues affecting patients (Shrader, Kern, Zoller & Blue, 2013). Since the facility is focused on providing patient-centered care, teams need to lay emphasis on the specific needs of patients in the OR. A fully integrated system for collaboration defines a method for ensuring patient receive only the best care available. Furthermore, an empowered OR room is vital to the excellence of the care delivered. An empowered staff is seen through the grasp of their roles and the urgency to improve on these roles. Hence, the evaluation process is vital in creating continuous improvement in the OR in relation to interprofessional collaboration. 

Analysis of Diversity in the Organization 

Workforce diversity in healthcare is critical in the delivery of equitable care to all members of the society. Most societies in the world today are diversified, necessitating the understanding of how social and cultural aspects of the population affects health and health care outcomes. Williams et al. (2014) summarized the benefits of a diversified workforce in healthcare as improvement in access to quality healthcare by all populations, contribution to health equity and elimination of disparities in the provision of health care. Typically, social classes in society influence access to quality healthcare. The rich in society have access to better health care and have better outcomes as compared to the less privileged. Equity in healthcare benefits the whole population since the poor gain access to healthcare which would otherwise be impossible if healthcare was not diversified. Interesting, studies show that healthcare professionals from minority groups or from backgrounds that are socioeconomically challenged are likely to work in rural areas or places where minority groups reside (Bacigalupe & Askari, 2013). Hence, diversity enhances access to quality healthcare for these groups. An analysis of the healthcare diversity in the hospital will base on the themes of effective communication, cultural response, equality in the delivery of health services and standards for equity established at the hospital. 

Effective Communication among Diverse Groups 

Communication is critical for the execution of quality health care to populations from diverse ethnic, social and cultural backgrounds. Cultural competence is vital to gain an in-depth understanding of the patient's needs. Communication strategies at the facility incorporate cultural understanding by directing physicians and caregivers to assess the cultural background of the patient while handling the patient right from the diagnosis stage to the point when the patient is released from the care of the nurses. The hospital policy incorporates concepts of field communication and communication training for serving minority groups. Training equips staff with the skills to handle patients from different backgrounds through communication strategies that enhance the quality of services delivered (Seeleman, Essink-Bot, Stronks, & Ingleby, 2015). Emphasis on patient-centered care and family-centered care is also based on proper communication. Caregivers have excellent interpersonal skills that enable them to easily relate to the patients and their family in order to fully understand their needs and effectively respond to areas of concern. Additionally, cultural competence in communication informs decisions on the type of questions that the physician or the nurse asks. In situations where there is a language barrier or cultural mismatch between the culture of the patients and the caregiver's knowledge, the hospital policy requires that the caregivers refer the patient to a well-suited member of staff. As such, the patient receives care according to their expectations and needs. 

Cultural Response 

Cultural responsiveness framework acts as the guideline for the hospital staff to attend to patients from different cultures. The frameworks include initiatives that are in place within the hospital policy to cater for the needs of people from different cultures. Cultural responsiveness includes the methods in place that ensure staff is conscious about the cultures of different patients and how they affect healthcare delivery at the facility. The director encourages the application of the hospital developed framework which approves the investigation of the patient's background before and throughout the process of care delivery. Management support for cultural responsiveness is crucial for the reputation of the hospital since individuals from a different culture, especially minority groups, feel at ease in the organization. Furthermore, cultural responsiveness is adhered to while hiring and training physicians and caregivers at the hospital. A diversified workforce at the hospital encourages the exchange of ideas which increases the cultural competence of other staff at the hospital. 

Equality in Delivery of Services 

Equality in offering health care services is at the center of the hospital’s beliefs on the providing unbiased care to everyone. Care delivery should not be biased to incorporate issues such as social class, race or religion. Health care reforms are focused on creating an equal health care system where patients are treated according to their needs as opposed to their ability to cater to these needs. The hospital is committed to the implementation of the changes in the health sector. Equality in the delivery of services asserts the needs for healthcare institutions to consider everyone in their activities, creation of policies and constituting their staff. The management acknowledges that the hospital operates in a diversified environment where healthcare needs vary (Seeleman, Essink-Bot, Stronks, & Ingleby, 2015). Providing homogenous care services to patients without consideration for these differences is a proof of incompetence and will adversely affect outcomes. Consequently, the staff is trained to offer services while conscious of these differences. These are not to imply that the type of care offered will differ but the caregivers will acknowledge the existence of these differences. Equality is also evident in the hiring of staff at the hospital. Background checks on potential employees ensure that the hospital management is aware of the professional’s history before hiring. Such checks ensure that professionals with a history of racisms or any other ills that might compromise the delivery of services are avoided. Advocacy for equality contributes to the image of the hospital by eliminating incidences or accusations of inequitable delivery of healthcare services. Since the hospital maintains a vision to become one of the best in the country, the policy is a step in the right direction. 

Equity Standards 

Equity standards provide a yardstick for organizations to assess their assessment on their adherence to several aspects of diversity and equality in the delivery of services (Seeleman, Essink-Bot, Stronks, & Ingleby, 2015). The standards are also a guide on how organizations can avoid derailment from the core requirements of equality in healthcare delivery. Equity standards as a measure of diversity provide an in-depth understanding of what diversity entails in healthcare and how the organization can keep track of the various aspects of diversity in its daily activities. An assessment of the hospitals care delivery services based on the aspects of the equity standards proves that the hospital is performing relatively good on the matters of diversity. Since organizational change advocates for adjustment to meet the health needs of the current populations, the diversity rating at the hospital is an indicator of the management’s resolve maintain relevance. However, improvements are also possible to keep attain excellence in the diversifying the workforce and attending the needs of minority groups. One of the suggested changes is language diversification where the hospital can hire translators to facilitate effective communication with patients from minority groups. Language barriers can potentially compromise the quality of care offered at the facility when caregivers miss crucial information that will enhance care. Another technique for improving care to minority groups is by offering extensive and continuous training to staff. The staff continuously improve on their abilities to provide care to patients at the same rate as the population becomes diversified. 

Paper Synthesis 

Leadership in a healthcare organization is a multidimensional endeavor demanding focus on several aspects such as people leadership, focus on exchange, keeping track of systems and how they affect care and development of strategies to assist in adapting to change and creating continuous improvement. Organizational leaders in current health care organizations have the responsibility of transforming these facilities into learning organizations. Learning organization are characterized by the ability to adapt to the changing environment and have systems in place that facilitate these changes. These organizations are ideal for the transformations that occur in various industries since their ability to adapt ensures that they always stay ahead of competitors. In transforming the hospital into a learning organization, various leadership qualities are required. These include strategic, transformational, and transactional leadership. A strategic leaders place himself or herself at the center of activities within the organization and make observations from an insider’s point of view before developing techniques to implement change. Transactional leadership, on the other hand, relies on different forms of incentives to motivate people to perform tasks. Transformational leaders develop clear vision and goals and convince others to work towards the achievement of these goals. 

Certainly, these forms of leadership have the ability to transform the hospital into a learning organization and also motivate growth. In such healthcare settings, a strategic leader is involved in tasks and identifies the challenges that employees face hence is in a better position to come up with solutions for these issues. Transactional leadership exploits human nature to feel motivated by activities that fulfill their needs. Transactional leadership relies on the idea that without the right form of incentive, morale goes down and the output is reduced. Typically, caregivers are likely offered excellent services if they are motivated by the promise of good pay. Good working conditions such as excellent relationships with the management are also triggers for good performance. Identifying the type of leadership that suits the situation is critical to the whole process of organization change. Not a single leadership style is superior to the other, but discerning the most appropriate style is paramount. 

While providing leadership in organizations, leaders are faced with situations that resist change. Maintaining a status quo seems more enticing to some individuals or the systems become rigid and repulse change ( Drupsteen & Hasle, 2014) . Resistance to change undermines leadership efforts, especially in healthcare settings. Hence, leaders must develop strategies to instill change in organizations even in the face of resistance. Organizations with a culture for change become manageable when change presents itself. Such organizations have either achieved the status of learning organizations or are in the process of becoming learning organizations. Communicating the change efforts also eases tensions before the real onset of change. Humans inherently fear change due to the uncertainties it brings. Preparing them psychologically before the onset of the change reduces the shock involved. Additionally, creating systems within the organization that are flexible enough to accommodate change is another longterm effort of preparing for change. 

Surprisingly, change effort in organizations mostly has positive effects despite the barriers that change agents experience. The tangible and intangible effects of change are the main motivators for healthcare organizations to invest effort and resources in creating change. The effect of the change at the hospital was tremendous as the new director immediately began implementing his leadership philosophy in the hospital processes. His philosophy well-suited to the needs at the hospital for purposes of maintaining parity with healthcare reforms. The hospital also needed growth in the form of infrastructure and facilities. The director successfully managed to transform the attitudes of mid-level hospital managers and get them to support his ideas. The form of dynamism in hospital processes is also commendable since it assisted in creating a workforce that is resilient enough deal with issues that arise in service delivery (Lee, Weiner, Harrison & Belden, 2013). The new director's philosophy successfully transformed the hospital into a learning organization. 

In as much as the philosophy successfully steered the hospital to new organizational status, the true value of the change effort could not be determined without an in-depth assessment of the key areas within the organizations. These are the areas that are indicative of how the change effort impacts on the organization, either positively or negatively. They include an evaluation of the strategies within the organization and the viability of these strategies. Change in organization culture to a new and sustainable model is also indicative of the positives of the change effort. The goals of the hospital were aligned to the core [purpose of providing patient-centered care. Undeniably, the goals were driven by a direct purpose to make the hospital a desirable place for receiving health care services. As such, the strategic approach to the whole process of organizational change was successful (Pearce, Wassenaar & Manz, 2014). 

Despite the strides made in implementing change in the hospital, the problem of understanding still persisted ( Drupsteen & Hasle, 2014) . Staffing problems at the hospital are likely to undermine the various positives achieved through the organizational change efforts. Solving the staffing issues requires a multidimensional effort where teamwork and collaboration are embraced while the hospital changes face becoming a desirable place for health care professionals to work. Effective leadership will be at the core of these changes by developing policies and strategies that will enable the hospital to retain its staff and attract others. Interdisciplinary teams, not only in the OR but the organization as a whole need to maintain the highest levels of cohesion. When every employee is appreciated, the conditions become conducive for working. 

Evidently, the OR is the embodiment of interprofessional collaboration at the hospital. The OR is constituted of professionals from different disciplines with each member of these themes playing a critical role in the success of activities in the OR. Maintaining the highest level of efficiency in the OR is a necessity owing to the sensitivity of cases handled. Emphasis on teamwork in the OR also plays to the advantage of the healthcare professionals involved since it instills practices that are beneficial to outcomes of patients. Thus, a plan for interprofessional development should be centered on the activities in the OR before the practices are borrowed by other departments at the hospital. Additionally, acknowledging the existence of diversification in the society is crucial for the development of practices within the hospital that caters for patients from different cultural, social and economic background ( Drupsteen & Hasle, 2014) . Cultural awareness in the provision of care contribution to the hospital’s reputation. Ana diversity extends to the workforce at the hospital since a culturally diverse workforce becomes more inclusive thus contributing to the quality of care that patients receive. 

Conclusion 

Successful organizational change in healthcare borrows immensely from the business world. While leadership in health care may slightly vary from other areas, organizations inherently need to change to remain sustainable. Thus, change management strategies become applicable in the hospital. Change in the top level management introduced a philosophy that steered change at the hospital and contributed to growth. The hospital leadership also focused on providing patient-centered care to patients, hence improving outcomes. Employee affairs were also granted a deserved level of attention that was vital in improving care delivery. Emphasis on practices search as teamwork and interprofessional collaboration improved the care that patients received at the hospital. The hospital management identified the need for a providing care that is conscious of diversity in the population. The efforts of the organizational leadership were vital in creating positive change at the hospital. 

References 

Bacigalupe, G., & Askari, S. F. (2013). E-Health innovations, collaboration, and healthcare disparities: Developing criteria for culturally competent evaluation.  Families, Systems, & Health ,  31 (3), 248. 

Bosch, B., & Mansell, H. (2015). Interprofessional collaboration in health care: Lessons to be learned from competitive sports.  Canadian Pharmacists Journal/Revue des Pharmaciens du Canada ,  148 (4), 176-179. 

Burson, R., & Moran, K. J. (2018). Improving Patient Outcomes.  Home healthcare now ,  36 (2), 123. 

Drupsteen, L., & Hasle, P. (2014). Why do organizations not learn from incidents? Bottlenecks, causes and conditions for a failure to effectively learn.  Accident Analysis & Prevention ,  72 , 351-358. 

Lee, S. Y. D., Weiner, B. J., Harrison, M. I., & Belden, C. M. (2013). Organizational transformation: A systematic review of empirical research in health care and other industries.  Medical Care Research and Review ,  70 (2), 115-142. 

Maccoby, M., Norman, C. L., Norman, C. J., & Margolies, R. (2013).  Transforming health care leadership: A systems guide to improve patient care, decrease costs, and improve population health . John Wiley & Sons. 

McDowell, J. L., Diaz, J. H., Young, A. E., & Urman, R. D. (2015). Effective strategies in improving operating room case delays and cancellations at an academic medical center.  The Journal of medical practice management: MPM ,  30 (6), 24. 

Pearce, C. L., Wassenaar, C. L., & Manz, C. C. (2014). Is shared leadership the key to responsible leadership?  Academy of Management Perspectives ,  28 (3), 275-288. 

Russ, S., Rout, S., Sevdalis, N., Moorthy, K., Darzi, A., & Vincent, C. (2013). Do safety checklists improve teamwork and communication in the operating room? A systematic review.  Annals of surgery ,  258 (6), 856-871. 

Sadrizadeh, S., Tammelin, A., Ekolind, P., & Holmberg, S. (2014). Influence of staff number and internal constellation on surgical site infection in an operating room.  Particuology ,  13 , 42-51. 

Seeleman, C., Essink-Bot, M.-L., Stronks, K., & Ingleby, D. (2015). How should health service organizations respond to diversity? A content analysis of six approaches. BMC Health Services Research, 15 , 510. 

Sharif, M. M., & Scandura, T. A. (2014). Do perceptions of ethical conduct matter during organizational change? Ethical leadership and employee involvement.  Journal of Business Ethics ,  124 (2), 185-196. 

Shrader, S., Kern, D., Zoller, J., & Blue, A. (2013). Interprofessional teamwork skills as predictors of clinical outcomes in a simulated healthcare setting.  Journal of Allied Health ,  42 (1), 1E-6E. 

Tang, C. J., Chan, S. W., Zhou, W. T., & Liaw, S. Y. (2013). Collaboration between hospital physicians and nurses: an integrated literature review.  International nursing review ,  60 (3), 291-302. 

Toussaint, J. S., & Berry, L. L. (2013, January). The promise of Lean in health care. In  Mayo clinic proceedings  (Vol. 88, No. 1, pp. 74-82). Elsevier. 

West, M. A., & Lyubovnikova, J. (2013). Illusions of team working in health care.  Journal of health organization and management ,  27 (1), 134-142. 

Williams, S. D., Hansen, K., Smithey, M., Burnley, J., Koplitz, M., Koyama, K. ... & Bakos, A. (2014). Using social determinants of health to link health workforce diversity, care quality and access, and health disparities to achieve health equity in nursing.  Public Health Reports ,  129 (1_suppl2), 32-36. 

Vermeir, P., Vandijck, D., Degroote, S., Peleman, R., Verhaeghe, R., Mortier, E. ... & Vogelaers, D. (2015). Communication in healthcare: a narrative review of the literature and practical recommendations.  International journal of clinical practice ,  69 (11), 1257-1267.