Initiate and explain change management methodologies appropriate to improving healthcare outcomes.

Order Description
Please find attached Subject description Health systems worldwide are facing increasing pressure to improve their efficiency and effectiveness while delivering safe, high quality and patient-centred care. Most countries accept that existing models of health care delivery are not sustainable for future decades, resulting in modern health services engaging in large system changes. Health service managers, planners and clinicians require competencies in understanding systems in the health services, implementing and leading change, and project management. This subject assists students to develop knowledge and skills in understanding and adapting health systems to achieve efficiency and effectiveness. The subject initially examines a range of change theories that can be applied to the healthcare environment as well as relevant leadership theories within the context of change. Finally the subject focuses on national health reform and a range of service improvement approaches and tools such as lean thinking, six sigma, clinical services and system redesign, clinical process mapping and patient flow analysis. A number of recent initiatives are presented that explain how to implement change at national, corporate, statewide and health care organisation levels.

Assessment task 3: Case study responses
Intent: This assessment item focuses on the ability to synthesise all the content delivered in this subject and apply it to two case studies.
It is important to be able to review real scenarios and provide guidance as to what the leadership and
change issues are and which strategies would be useful to implement. This assessment item will
reveal to the student how much they have learned about leadership and change, and provide them
with the confidence that they can apply these concepts in a hypothetical situation.
Objective(s): This assessment task addresses subject learning objective(s):
A, B and C

A. Critically appraise relevant strategies to implement individual or organisational change in the healthcare environment based on validated theories and models;
B. Consider factors that act as a stimulus for change, resistance to change and successful change in health care;
C. Propose fundamental leadership skills necessary to implement organisational change and act as a change agent;

This assessment task contributes to the development of graduate attribute(s):
1.1, 1.2 and 1.3

Critique, interpret and synthesise data and research findings to develop safe, effective and evidence-based solutions to healthcare challenges. (1.1)
Propose relevant problem solving and human factors theories to the analysis of common issues inherent in the management and evaluation of healthcare services . (1.2)
Initiate and explain change management methodologies appropriate to improving healthcare outcomes. (1.3)

Type: Examination

Weight: 30%
Task: 1. Read both case studies that focus on recent or
potential change or health service reform.
2. Provide answers to the questions presented in the examination during Day 3.
Length: 60 minute extended response examination

Criteria: 25% Analyses and reframes the major issues inherent in each of the case studies demonstrating a depth of knowledge of leadership and change management
25% Considers likely challenges in each of the case studies demonstrating a depth of knowledge
about leadership and change management
50% Recommends appropriate and focused strategies based on relevant theoretical frameworks to
address the major issues in each of the case studies

Assessment Item 3 ? Case Studies
You have been appointed as the Director of Clinical Services at a large (600 bed) metropolitan hospital ? Ambrose Health. You are younger than the previous incumbent, being only 30 years of age and better qualified, having just completed a Master of Health Service Management and enrolled in a doctoral program. Most of your experience has been in smaller hospitals outside the metropolitan area. The executive management team made it clear to you at interview that they were interested in effecting change throughout the Clinical Services Division, which is why they were seeking an external appointment to the position. In particular, they were seeking an individual who could establish a cohesive and productive working team.
Shortly after commencing in the position it becomes obvious that much of what is achieved is as a result of ?who you know?. There are many instances when the usual communication channels or procedures are not followed because of ?system failures? which have never been brought to anyone?s attention. When running short of stock medications, for example, many nurses contact the nursing unit manager of the medical ward as she has a ?contact? in the pharmacy, rather than working through appropriate channels to correct the problem. Patients in the Coronary Care Unit are routinely admitted directly to the unit rather than through the Admissions Office because it is a slow and tedious process.
When you ask why these problems have never been addressed formally, the reply is along the lines of ?It has always been this way. I am a very experienced health professional ? I know the system and how to get around it to get what I need to do the job properly. I see no reason to change things when I think the system is working well.?

Assessment Item 3 ? Case Studies
You are a community health worker who has recently been awarded a grant from the commonwealth department of health for three years to establish a drug education program in an inner city suburb which is a known gathering point for drug addicts. The goal is to decrease rates of HIV/AIDS and hepatitis but more importantly, to decrease rates of drug use and overdose. The project will be evaluated at the end of the grant to determine whether continued funding is warranted. As project director, you have the funding to choose and hire four additional employees and manage the program as you desire.
The average age of those likely to use the service is 15 years, and most live on the streets. This suburb is known to have a high crime rate. Police patrols are more frequent than in previous years but petty theft, burglaries, assaults and prostitution are common. High unemployment rates are a feature of this suburb.
The local community has just been advised that the project is to commence shortly. They are becoming increasingly ?agitated? about the effects that the introduction of such a program may have on their local area. While accepting that there is a high proportion of drug addicts frequenting the area at the moment, they are concerned that raising the awareness of this community as a ?safe haven? may encourage even more individuals to congregate in the area, particularly during the day. The state department of health has endeavoured to counter this argument by organising several open forums where the issues can be discussed and fears allayed. This seems to have encouraged open debate but diminished acceptance of the proposal.
There are three primary schools in close proximity to the proposed site and a private co- educational high school two blocks away. It is the parents of children attending this school who appear to be most vocal. Their objections have increased since two children were expelled for drug-related offences. The local churches have thus far not contributed to the debate nor ventured any opinion on the proposal. To date, they have not become involved in providing any type of ?social welfare? to those who call the streets ?home?.

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