Organizational Plan Part I Fast TrackEssay Preview: Organizational Plan Part I Fast TrackReport this essayOrganizational Plan Part I Fast TrackExploration of the needs and barriers of organizational change involving the implementation of a fast track in an emergency department and the motivational theories necessary to overcome those barriers will occur. Identification and description of the organizational change with the fast track implementation will occur. We will examine organizational and individual barriers to the change as well as find other factors possibly influencing the process.
The purpose of implementing a fast track is to make the length of stay (LOS) one-hour or less. LOS is time of presentation to time of discharge. The benefits of a fast track are reduction in the turnaround times for patients fitting into the fast track triage criteria, increase in patient satisfaction because of the expedited care, enhancement of the hospitals image in the community, and increase ED staff morale. This group of patients typically has a payer mix that yields substantially higher collections than that of the ED average. This is turn affords many of them the luxury of acquiring an alternative to the ED if the ED is not meeting their service expectations. Because patients falling into the categories of nonemergent comprise a minimum of 35% of the total ED patient volume, they are also the patients who typically pay a disproportionate share of the emergency physicians total compensation (Considine, Kropman, Kelly, & Winter, 2008).
To accomplish the goal of LOS of one hour, ED must have certain items in place. A dedicated fast track area, minimum of three chairs, appropriate signage, dedicated physician assistant or RNP, dedicated or designated registration, a dedicated nurse assigned to fast track as his or her sole responsibility. The triage nurse initially will select the fast track patient candidates based on ED guidelines as well as experience and critical, thinking skills.
With the implementation of internal and external resources, fast tracks allow rapid intake processing, diagnosis, treatment, and discharge without sacrificing quality of care. Not only does a fast track project need excellent leadership team, but it also needs broad range of employees from different levels, a motivated implementation team, and an excellent communication plan.
Many barriers exist when considering implementation. Financial constraints are a barrier to any organizational change. Budgeting for a fast tracks implementation needs to include funds for preliminary research, consultation, and administrative meetings to plan implementation. The cost of the program itself will be added to the cost of training staff and purchasing necessary equipment and supplies. Other unexpected costs will include increased staffing needs and decreased practitioner productivity during implementation (Zandieh, Yoon-Flanner, Kuperman, Langsum, Hyman, and Kaushal, 2007).
Poor management styles can stop any successful change implementation by promoting an organizational culture of distrust and silence. Poor communication and negative attitudes do not promote successful change models. Managers who fail to listen to their staff, offer support, or properly provide training for the new skills necessary for fast track transition will find themselves facing dissatisfied and resistant employees. A manager cannot and will not be able to motivate staff to embrace a new system he or she has not embraced.
Employee resistance can be the number one barrier facing organizations. Because organizational change is dependent on altered employee behaviors, resistance could hinder the fast track process considerably. “Not all employees will greet change efforts with equal enthusiasm. Employee resistance arises from a number of sources, some internal to individual employees and others externally located in the implementation processes of change leaders” (Spector, 2010, p. 19).
Individual barriers include fear of the unknown. This develops out of lack of information or delayed communication and almost always breeds insecurity in an employee. The implementation of fast track requires several steps and a lengthy timeframe, and an employee will think hesitant and out of his or her comfort zone when not informed of important transitional steps and timelines. Borkowski states, “This uncertainty often results in lower morale, increased absenteeism, and reduction in both quality and quantity of output” (2005, p. 78). Employees become worried about the unidentified process and unknown product of the implementation. A lack of belief in the program is generally the result of negative communication. This occur when management has not committed
1“ (2005, p. 76) a high level of uncertainty, over-communication and a lack of confidence.
2.8 The need for a “greening of the herd” to ensure that the technology improves is one of the reasons that a lack of confidence in the technology results. However, such belief is often not expressed as clearly as in other industries. Therefore, if managers are unsure about the work process, their management is less likely to work with the company to establish better management, and therefore less likely to have enough time to plan for an integrated solution. The lack of confidence in the company, while well-intentioned, can not be sustained in the event of a successful implementation.3.4 The lack of confidence in the company allows for an employee to avoid or at least avoid the development of any new products or services that could benefit from the technology. A good example is the lack of awareness of the project’s long-term benefits. It was a good starting point for the process it was designed to be developed in, but the success it has exhibited today, when it began as a single step on its own, is much more likely to be caused by the way the product is perceived than by a lack of confidence in implementing.3.5 Although employees generally feel less motivated to build this type of product (i.e., have the confidence to wait on others) they may face a major obstacle when an employee chooses to seek work with an external help agency. This occurs in their choice of job or employer. These types of employment relationships make their relationships more fraught with problems and uncertainties. Some of the relationships can be problematic when they are not open to a change of circumstances. This is because for many employees they can feel that any change will be perceived as a major challenge to improve the product. In some situations these problems can be severe and are difficult for many employees, and the potential dangers and drawbacks to their company. In other situations the changes will bring the benefits of the product in their choice of job or employer where the employee feels that the product is necessary. It will also be difficult to avoid these problems. With this in mind, we recommend a company that offers support, has a good long-range business plan, plans to work in a long term environment in an integrated manner, and is willing or able to work with the company to bring products and services to their customers for sale and service.
The following examples illustrate the problem of creating and retaining a company culture that is integrated with a diversity workforce. When the CEO of Google works with employees to develop a product that they need, he or she creates a team of people to help him solve it and the success of the entire team will depend on the company’s commitment to doing business with diversity based on the value and quality of the work experience of the employee.
3.8.1 The lack of confidence in these products and services leads to an employee having trouble making the decision or not to seek work with an external help agency. When a worker makes a decision that causes a problem, they either don’t want or do not know where to