Research Report on Process and Change Management in Hospitals

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Table of Contents
1. Part One: Business Process Reengineering Challenges: Implications for Change Management 2
1.1. Change management and Business process reengineering 2
1.2. Literature Review 2
2. Part two: 5
2.1. Value chain for the organization 5
2.2. Organization diagrams 7
2.3. Process map 9
2.4. KPI’s for the process 11
2.5. Process simplification methodology 12
2.6. Expected changes in the process KPI 13
3. Conclusion 13
4. References 14

Part One: Business Process Reengineering Challenges: Implications for Change Management
Change management and Business process reengineering
Change management refers to the process of redeveloping and restructuring the resources that are used in the organization and the operations that are performed on the basis of these resources. It is a very critical element in ensuring the success of a company in the global market. Due to the technological advancement and large number of new strategies adopted in the management field, there are many changes that are constantly been made in the organizations in order to sustain themselves in the global market. In order to develop a niche for themselves in the market, inculcating change at the right time and at the right place in the right quantity is very important (Grover, 1999).
Business process reengineering is a concept that is based on the change management process where there is a significant change adopted in the designing, structuring and working of a business. It is carried out with the purpose of increasing the productivity and reducing the wastage of resources in the various functions performed throughout the organization. Business process reengineering is the need of the day as there are constant innovations and new strategies developed by different companies across the globe to sustain themselves in the global market. It requires a critical evaluation of the process carried out and then developing the potential factors that can contribute in the improvement of operations through increasing the productivity across the operations. The different researches on the subject of Business process reengineering and change management has been discussed in the below section (Grover, 1999).
Literature Review
There are different researches developed on the concept of change management in business processes. The scholars have identified different parameters of the change management process that have a significant impact on the development of business for organizations. There are three theories identified by Peter Trkman, a management research scholar and these three theories include contingency, dynamic capability and the technology that fits the tasks. There should be a synchronization between the environment in which a business is carried out and the process that is followed for carrying the business. After establishing the balance between them, the scope of change has been inculcated in the business. There are critical success factors that are identified through the change management process and they have to be handled with care while developing business restructuring for any business process in an organization (Trkman, 2010).
In one such research, the authors have developed a relationship between the business reengineering and the change management process. It involves consideration of four types of change and they are in process, structure, culture and power allocation. There has to be an integrated system developed for considering all he four changes in an organization. It has been stated that a holistic approach is required for inculcating organizational change across the different processes that are carried out in the business (Cao, et al., 2001). It states that Business process reengineering has to be done such that it helps in enforcing change management across different dimensions that are important for the success of a business.
The management of business processes has been discussed by many research scholars pertaining to the management field. In one such article, the authors have tried to identify the six core elements of business process management (BPM) that would help is determining the base for the development of the BPM. These six elements are strategic alignment, governance, methods, information technology, people, and culture. The structure of the BPM has been developed by them and different BPM initiatives have been developed across different business in the world. It has been concluded by them these elements are required to ensure that the BPM has been implemented successfully and that it would be sustainable in the global market (Rosemann & Vom Brocke, 2015).
Developing a proper framework is very important for managing the change across the organizations. There are various steps that have to be followed and tasks to be performed before incorporating any kind of change in the management of a business as it is very significant and has a huge impact on the working of the organization. The framework that is required for implementing changes in the management of an organization consists of understanding the needs of the customers, evaluating the current strategies used and products or services provide, identify the element where there is a scope of improvement in the business. The change management process has to be maintained feasibly to ensure sustainable growth in the market.
There is a significant impact of Business process reengineering on the performance of a firm. This has been achieved in terms of employee productivity, return of investment, return on equity and return on assets in the business. There is a stable cross-functional execution of changes that are to be enforced in the company. The business process reengineering that have a narrow and focused approach are more likely to improve the performance of a business or an organization (Ozcelik, 2013). The performance of the firm is interdependent on various changes that are incorporated through the functioning of the management in different businesses.
While adapting the process of business reengineering on the healthcare organizations, it can be observed that it has been emerging since the last few years with a large number of changes introduced in the management of different functions and operations carried in the hospitals. It has been observed that the main purpose of Business process reengineering is to imbibe transformations in organizations so as to provide more customer focused and economic services to the customers (Elkhuizen, et al., 2006). It involves developing the process after evaluation and obtaining better solutions for the same elements.
Thus, the relationship between the business process reengineering and change management process is inevitable. Developing new and innovative systems in the working of hospitals or healthcare industry can help in developing their businesses.

Part two:
Value chain for the organization
Value chain can be referred to as the specific set of activities and tasks that are carried out in a company so as to improve the value of its products or services in the market. A general value chain consists of handling the firm infrastructure, Human Resource management, Technology and Procurement. All of these are the supporting activities and the primary activities are the inbound logistics, operations, outbound logistics, marketing logistics and services. These are the chain activities that are to be fulfilled while establishing a change management process in the business that involves transferring and storing the records and documents electronically.
The example of value chain analysis for a hospital has been provided in the figure below:

In this, the primary activities are also known as the core processes; whereas the supporting activities are known as support processes. Now while adapting it for the medical records and documents that are to be stored in the hospital we get the following chain value diagram. Handling the medical records begins with the preventing section of the hospitals. It is then carried through the diagnosing section and then it gradually passes through the intervening and treatment in the hospital. It involves the primary activities of knowledge development, informing the patients about their details, measurement of the patient’s records and assessment of the lab’s reports and patient tests that are carried in the medical labs (Haux, 2006).
The main problem that is faced during the activities carried in the value chain is the manual handling of records and documents of the patients. The UAE government has developed the Wareed concept in the healthcare industry that refers to a platform which stores information and records of the patients electronically and is also known as electronic healthcare system (HIS) (Al Ghufli, et al., 2015). Thus, it can be stated that core as well as the support processes require handling of data and information about the patients. It has to be precise and accurate and the earlier method of managing the medical records system manually was not able to provide the required efficiency. Hence, in order to make it accurate, systematic, easy to store and easy to retrieve, and at the same time ensure optimization of resources across the hospital, electronic medical records and documents management system has been recommended for the hospitals in UAE.
Organization diagrams
There are several processes that are carried in the organization and from the healthcare industry pint of view, these processes are critical and have severe effects on the people that are concerned with it. Management of the data, information, records and documents in the hospitals serves to be a very significant issue for the healthcare industry as it consumes a lot time, efforts, and resources and even after that, accuracy and preciseness is not obtained in it.
The processes that are carried in the hospitals have been categorized into 3 processes and they are:
• Management processes
• Core processes
• Support processes

In the core and the supply processes that are related to the management of data and information system in the hospitals, there are following function that are to be carried out for handling the patients and providing them with the required treatment.

In the above figure, the support and the core processes have been obtained for the hospitals in UAE. There is an extensive network developed that involves developing and storing the information through knowledge management, measurement of the patient’s details and assessment of the hospital information. The Wareed that has been developed by the UAE government serves to be a major contribution in the data handling system that has been adopted in the hospitals. It has a significant contribution in the organizational diagram that has been adopted in the public and private healthcare sector across UAE.
Process map
Process map refers to evaluating the different processes that are being performed in the organization, that is, hospitals in this case and then changing the process through business reengineering. It is very necessary to introduce different levels of evaluation in the system that is being adapted. Evaluating the technique or system developed involves considering the factors that would be contributing in the implementation of the system and obtaining its impact on the system or business or an organization. It is very important to evaluate the system before adopting it as it will help in understanding the defects or flaws that may be detected while adopting the system (Hempel, et al., 2015).

As show in the above figure, the process of evaluation, research and measurement are interlinked and the section that merges all three of them should be the optimum solution for the problem and it is shown with an arrow where the business reengineering or the change management process can be implemented. The main function of the process map is to obtain the right process where change management can be carried out. In this case, it is the handling of the medical record system in Al Zahra Medical Centre, in Dubai. The process diagram that has been followed in the hospital has been shown in the simple diagram below:

On a similar note, it is very critical to analyze the conditions before implementing any system in the organization as it requires a lot of research, analysis and in depth study of the parameters that are related to the healthcare organizations. Research can be carried out in the form of qualitative or quantitative method. Qualitative method requires proper understanding and thorough evaluation of the characteristics and attributes related to the topic. Qualitative factors include the level of ease and simplicity that can be achieved through the use of electronic medical records in the healthcare organization. It also involves considering the approach of the employees as well as the level of care and satisfaction that is felt by the patients.
On the other hand quantitative research includes developing results by reaching as many people as possible and developing strategies and plans on the basis of statistical evaluation of the responses that are obtained from the patients and other people. Hence, carrying a quantitative research would be more helpful as electronic medical records system involves maintenance of statistics in the form of data about the patients. That is why, it becomes very important to see the number of patients that are enrolled in the system and its flexibility to recollect and regenerate their smallest and minute data whenever they want to access it (Portela, et al., 2015). Carrying this kind of research before implementing a new system in the hospital helps in achieving success through the processes that are followed in it and it ensures high efficacy among the different functions that are performed in the hospital as shown through the process map.
KPI’s for the process
KPI refers to the key performance indicators that are developed in order to measure the value that is created by the business that is being carried out in the company. It involves various activities, processes and systems that are enforced and used in an organization. In the healthcare industry, the method and technique with which the hospitals handle the data and information of a patient is one of the most significant KPI indicating their performance from the global point of view. It can also be said that the main function of the research involves critical assessment of the electronic medical records system in the healthcare organization. Patient and employee satisfaction can be obtained through the KPI indicators and their characteristics are mentioned below (Lighter, 2011).
There are few KPI’s which are to be achieved in the working and several functions performed in the hospitals related to the management of records and information of the patients:

• Being scientifically accurate and precise throughout the management
• The developed change should be useful, important as well as relevant for the healthcare organization.
• The data management system can be easily interpreted and retrieved across the system.
• It should be reported consistently regarding the changes that are incorporated to improve the efficiency of the processes.
• Feasibility should be obtained during the processes that are performed in the hospitals.
Process simplification methodology
The main purpose of the processes that are used and implemented in the organization through inculcating the change management in the business reengineering is to simplify the methodology and obtain transparency throughout the system. It involves developing different processes across the system and evaluating them for obtaining higher values through performance in the organizations. It involves developing several procedures that are significant in developing and managing the data and records through the system in the Al Zahra. It has been shown through the ACE star model of transformation that has been developed for the change management process in the organizations (Stevens, 2004):
.

Expected changes in the process KPI
The main purpose of the change management and business reengineering process is to incorporate significant changes in the KPI through improving the processes that are being followed in the system. In the Al Zahra hospitals, the implementation of the electronic medical records or information system has brought several changes in the management that is followed in it. The expected changes that are observed in the KPI are as follows:
• Usage of evidence-based strategies and techniques through monitoring different processes and implementing them after evaluating.
• To ensure that the staff of the hospital is engaged in performing processes that is required for the success of the business through managing the success across the different departments.
• To encourage accomplishment through the efficiency of work done and achieved through the processes implemented in the organization.
• Bring all the healthcare organizations on a common platform that involves sharing of information and networking among the UAE hospitals.
• Obtaining high levels of accuracy and confidentiality in the storing, retrieving and sharing of the patient’s information through the medical records and other documents that are collected by the hospital from the patients.
Conclusion
Thus, it can be stated that the implementation of the electronic medical record and information management system in the healthcare organizations is very important. It has to be achieved through proper training and implementation of the new system in the Al Zahra and other hospitals in UAE. The change management process and the technique of business process reengineering has positive impact on the efficiency of the employees across the healthcare organization and it helps in developing a positive brand image for the hospital in the healthcare industry.

References
Al Ghufli, A., Al Tunaiji, K., Al Ali, S. & Samara, K., 2015. Integrating Knowledge into Health Care Systems: A Case Study Investigation on UAE Health Care..
Cao, G., Clarke, S. & Lehaney, B., 2001. A critique of BPR from a holistic perspective.. Business Process Management Journal, 7(4), pp. 332-339..
Elkhuizen, S. G., Limburg, M., Bakker, P. J. M. & Klazinga, N. S., 2006. Evidence-based re-engineering: re-engineering the evidence: A systematic review of the literature on business process redesign (BPR) in hospital care.. International Journal of Health Care Quality Assurance, 19(6), pp. 477-499..
Grover, V., 1999. From business reengineering to business process change management: a longitudinal study of trends and practices.. Engineering Management, IEEE Transactions on , 46(1), pp. 36-46..
Haux, R., 2006. Health information systems–past, present, future.. International journal of medical informatics, 75(3), pp. 268-281..
Hempel, S. et al., 2015. 2015Development of the Quality Improvement Minimum Quality Criteria Set (QI-MQCS): a tool for critical appraisal of quality improvement intervention publications.. BMJ Qual Saf bmjqs-.
Lighter, D. E., 2011. Advanced performance improvement in healthcare: principles and methods, MA: Jones and Bartlett.
Ozcelik, Y., 2013. Effects of Business Process Reengineering on Firm Performance: An Econometric Analysis. Business Process Management, pp. 99-110.
Portela, M. C. et al., 2015. How to study improvement interventions: a brief overview of possible study types.. BMJ Quality & Safety, 24(5),, pp. 325-336..
Rosemann, M. & Vom Brocke, J., 2015. The six core elements of business process management. In Handbook on. Business Process Management 1 (pp. 105-122). Springer Berlin Heidelberg., Volume 1, pp. 105-122.
Stevens, K. R., 2004. ACE Star Model of EBP: Knowledge Transformation. : , San Antonio, Texas: Texas: Academic Center for Evidence-based Practice.
Trkman, P., 2010. The critical success factors of business process management. International Journal of Information Management, 30(2), p. 125–134.

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March 9, 2018

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