Change management is a field that explains how to successfully transition through the change process, and it entails the tools, processes, skills, and principles that are applied in managing the human resource that is affected by the change for purposes of achieving the desired outcomes of the change initiative. In a world where healthcare is fast changing to meet the regulatory and policy requirements, EHR technology is quickly being integrated into health care in the best interest of providing safe, high-quality, and efficient patient care services. According to John Kotter, change management is a three-step model organized to help facilitate the challenges that are inherent in a change initiative such as the implementation of EHRs in healthcare (Health Information Technology Research Center, 2013). Phase one of Kotter’s model entails creating a climate for change. Phase two involves engaging and enabling the organization, while phase three deals with implementing and sustaining the changes.
The introduction of EHR in the CTU Health Care information systems department, will be based on Kotter’s model, which highlights the importance of having everyone in an organization understand the need to leave the current state, how the future state is better both for the practice and the patients, the necessary changes in the workflows, the technologies, new skills that are required, and the acquisition of the new skills and knowledge to guide the fitting of the technology into the everyday work life.
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In order to effectively introduce the EHR in the department, the change management team must create a vision for the future state, a vision that defines how the state of patients, staff, and management will be bettered. Input on developing the vision must be solicited from all stakeholders, which include the patients, physicians, nurses, other clinical staff, nonclinical staff, health system affiliates, and other affiliated practices (Health Information Technology Research Center, 2013).The vision must communicate the future state, goals, and priorities of the EHR implementation (Crosnick, 2012). It is important to note that EHR integration will change how the users who include the nurses, doctors, accountants, administrators and other medical practitioners handling the patients will work. The vision should show how the technology will help them work more efficiently and effectively (Reid, 2013). In order to achieve this, a guiding team is formed. A cohesive team is made up of members of staff that are supportive of the change to spearhead the implementation process. Creating a climate for change requires that a sense of urgency is established by highlighting the deficiency of the current state and how the future state improves the current state, hence the need for an immediate change.
This change process, like any other, will face resistance due to uncertainty, fear for loss of job, social positions and self-esteem, team pressure to resist change, and a believe that the proposed change does not serve the best interest of staff or that of the practice. To overcome this resistance, it is important to ensure that the staff is involved in all levels from planning, implementation, to the evaluation of all change initiatives as this involvement creates a sense of ownership in the whole process. Since the staff members are the experts in the current state, they are best suited in the assessment of policies, procedures, and workflows and as a result, they must be involved in implementing the changes. In addition, resistance can be minimized by involving the staff in carrying out pilot process changes. As a result, any recommendations and adjustments on the use of the technology to yield desired outcomes will come from the same staff (Health Information Technology Research Center, 2013). Training, re-education, and support programs are essential in ensuring an easy transition hence reducing resistance. Finally, encouraging, incentivizing, and rewarding innovative solutions and continuous quality improvement are strategies that can be used to foster staff involvement and support for the changes.
To achieve buy-in, the project administrators must empower others to participate in the process of achieving the future state. The practice staff and other users must be engaged throughout the system selection and implementation to ensure ownership of the project. Communication can be done through vendor demonstrations and videos, staff benchmarking visits, role-playing, and simulated question/answer communication.
Provision of ongoing training and support can be pursued to address low computer literacy levels, updates, and workflow efficiency among the staff. Feedback from practice staff is vital in informing training and updates on the system (Health Information Technology Research Center, 2013).
References
Crosnick, M. (2012, May 29). Change management is crucial for successful EHR implementations. Retrieved from https://www.healthworkscollective.com/change-management-crucial-successful-ehr-implementations/
Health Information Technology Research Center. (2013). Change management in EHR implementation. National Learning Consortium , 1-23. Retrieved from https://www.healthit.gov/sites/default/files/resources/changemanagementprimer_feb2014.pdf
Reid, C. (2013, July 23). Applying structured change management to EHR implementations. Retrieved from https://www.hitechanswers.net/change-management-to-ehr-implementations/
