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The demand for quality services as well as improved acquisition and sharing of information, knowledge and skills have increased the need for transformational changes that promote as well as create learning organizations. In line with this, different organizations have instituted transformational changes as a way of adapting to the new way of providing health care services as well as transforming their organizations into learning organization. In this respect, there are different issues that affect the transformational change among them the partnership building efforts. This research paper will look at two organizations that have managed to institute transformational changes to create learning organizations. These healthcare organizations are Veterans Healthcare Administration (VHA) and Cincinnati Children's Hospital Medical Center.
Research Findings and Discussion
Issues that Led to the Change or the Need for Change
Firstly, the quality was one of the driving forces behind the need for change in these organizations. It is important to understand that from the mid 20th century to the 21st century, different technological advancement have enabled healthcare organizations to raise the quality of their service to patients. However, whereas technology remains among the greatest contributing factors to these changes, there is also a need for human capital to change their perspectives towards the way services are delivered. As such, these organizations were forced to implement transformational changes that would transform human resource, who were expected to delivered high quality services to patients.
Apart from the need to deliver high quality services, the 21st century requires health care organizations to change. In other words, time demands organizations to change (Karash, 2011). Firstly, the existing competition as well as the need for improved knowledge has increased the need for transforming these institutions into learning healthcare organizations. This requires continuous learning as well as sharing of vital knowledge concerning healthcare work as well as patients' issues.
Various Stakeholders Involved in the Change
There are various stakeholders that were involved in the transformational change of these healthcare organizations. To begin with, the Veteran Healthcare Administration had numerous stakeholders who influenced the way this organization was run. To begin with, the Congress was one of the primary stakeholders of the VHA. In reference to Abramson & Lawrence (2001), Congress, a primary stakeholder, has long wanted to see the agency provide veteran constituents with more accessible and cost-effective health care services, though its individual members have also been wary of any changes that might have negative impact on VHA facilities in their own districts (p.150). Other VHA stakeholders include VHA affiliated medical schools; veterans service organizations as well as different unions that represent the workforce of VHA with an aim of protecting the jobs of employees within the agency (p.150).
On the other hand, Cincinnati Children's Hospital Medical Center had various stakeholders who supported its programs. These include schools, local governments, neighborhood civic associations, libraries, churches and recreation centers (Cincinnati Children's Hospital Medical Center, 2011). This healthcare facility collaborates with these stakeholders by providing presentations as well as arranging and developing lectures in their neighborhoods for libraries and schools. More importantly, these programs and initiatives cover issues that are related to festivals and fairs, child health, etc. It is also important to mention that Cincinnati Children's Hospital Medical Center also partners with Institute for Patient- and Family-Centered Care for this organization's seminars and training programs.
Time Frame Involved in the Change Process
The transformational change that occurred within these organizations occurred within a particular period of time. To begin with the VHA has taken nearly 20 years to implement the transformational changes with its organization. In reference to U.S. Department of Veterans Affairs (2009), 'the most significant organizational transformation VHA has undertaken since the 1990'. This is as a result of intensiveness of implementing different issues and factors that require one to be thorough when implementing them. To begin with, the introduction of transformational changes that would transform the organization into a learning organization.
For Cincinnati Children's Hospital Medical Center's case, the transformational changes that have occurred began in 1998. In this respect, the organization was working toward implementing its mission of being the leader in enhancing child healthcare. As such, the organization partnered with Institute for Patient- and Family-Centered Care that provided the training as well as seminar service to the organization. The purpose of doing this was to enhance the care experience for families as well as patients. As such, the transformational change in this organization has taken approximately 12 years.
Financial Resources Allocated for the Change
The success of any change requires a lot of investments to be made. These include time, effort and commitment. In addition to this, financial resources are also required to enhance the implementation of a particular change program. It is important to understand that these finances are supposed to help VHA to be transformed into a 21st century organization. In this respect, it is project that the VHA was requesting US$125 million for 2011 (Zeiss, 2011). Statistics indicate that this was up 10% more than 2010's budget as well as almost 20% more than 2009.
As mentioned earlier, financial resources play a vital in ensuring that transformational change is achieved in any organization. In this respect, Cincinnati Children's Hospital Medical Center has invested heavily in its transformational change program. With this in mind, it is important to mention that Cincinnati Children's Hospital Medical Center received a total sum of US$1.9 million from the Robert W. Johnson Foundation as a grant to participate in Pursuing Perfection: Raising the Bar for Health-Care Performance (Institute for Patient and Family Centered Care, 2011). The participation in the seminars and trainings offered under this program has acted as an important avenue towards achieving transformational changes in this organization.
Issues that Surfaced during the Change Process
The Veterans Healthcare Administration faced challenges from different stakeholders who had differing points of interest. As a result, the course to be taken by the leadership of the organization towards change was challenged by the differences in opinions of the stakeholder. Another challenge that was faced by the organization during the implementation of transformational change policies and structures emanated from the VHA's upper-level management. According to Cummings & Worley (2009), the VHA's senior leadership team's ability to stay the course was tested by upper-hand managers (188).
There are different issues that surfaced during the change process. To begin with, it was realized that the organization cannot work alone in implementing the desired change. In line with this, since 1998, the organization has been working with the community to develop appropriate strategies and programs to enhance its relationship with different communities. Furthermore, the organization also includes members of the community on its change initiatives. In fact, one can argue that most of the programs or rather initiative that are run by Cincinnati Children's Hospital Medical Center are run by members of the community.
Outcomes of the Change
The implementation of the transformational changes in Veterans Healthcare Administration has seen different outcomes. To begin with, there has been a transformation with a cultural change within the VHA (U.S. Department of Veterans Affairs, 2009). In this respect, the relationship between employees as well as between employees and patient had changed tremendously. On the other hand, VHA had enhanced its efficiency. In addition to this, the past management system approached the issue of patient care from a physician's perspective. However, this has since changed and healthcare is patient-oriented. Observations on the environment of VHA revealed that the organizational environment was characterized with a friendly atmosphere.
There are different issues that emerge as outcome of change in Cincinnati Children's Hospital Medical Center. To begin with, this healthcare organization has been able to form the Family Advisory Council that has helped to improve the delivery o services in this organization. The Family Advisory Council has been able to create National Seminar, Inpatient Parent Handbook, Media Task Force, Surgical Waiting Room Renovation, Newborn Intensive Care Unit, Parking Committee, Billing Task Force that have enhanced the delivery of services in this organization. Furthermore, the transformational changes have seen the formation of The Family Advisory Council Award of Excellence in Family-Centered Care, Hispanic Advisory Committee, Family Resource Center, Patient and Family-Centered Rounds as well as Chronic Condition Clinical Portals.
Institutional Lessons Learned from the Change Process
The first lesson that can be learned is that change takes time. It is obvious that VHA had made tremendous changes within its system. However, the cost of this change was approximately 20 years of hard work and persistence. In addition, flexibility is an important aspect of change that must also be embraced when implementing any form of change. For instance, when there was resistance from the upper-level manager regarding the accountability system, the change implementation team was quick to accept the fact that their complaints were supposed to be addressed.
In addition, acquiring knowledge and skills is a very important part towards implementing the necessary organizational changes. Furthermore, the cooperation that exists between the stakeholders and the organization also contribute to the success in implementing change, a factor that must be encouraged among the organizations. Just to emphasize, persistent, hard work as well as commitment play a significant role in enacting different changes in a particular organization.