Parkway Nursing Care Board Of Director Information Technology Essay

5226 words (21 pages) Essay

1st Jan 1970 Information Technology Reference this

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Following the organization developing, any company will face a lot of or some issues even crisis. If they expect achieving more benefit, continue developing business, keep good reputation of organization. They will change current management. In Parkway Nursing Care, it also appeared some problems. The consulter done research and analyzed the Parkway Nursing Care’s situation of organization. As a consultant, I report solutions intent of practice barriers for board of director, help organization changes and ways to overcome related resistances as well as a stress management plan aimed at developing a conductive environment for Parkway to pursue its long-term growth objectives. Well-known, organization depends on capable leadership to guide them from unsuitable management to successful management. Then leadership strategy is becoming significant. Nevertheless in possession of successful leadership strategies plan is not only element of enterprise. When you implement this plan, the leadership also should require preparing many certain and uncertain future. However, how to alter old way as well as go about creating new strategy for your organization which will becoming long term effort accompany by the organization.

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Survey Results

According to last month information form result which from human resource department. The table chart showed information about situation of Parkway Nursing Care between 2000 and 2009. This information form touched six parts, and data on employee injuries, incidents, absences and turnover show the main issues of Parkway Nursing Care. This survey results indicate that many problems have developed while the organization was focusing on achieving its growth and profit objectives. Four aspects problems appear in the staffing problem, physical demands problem, documentation problem and filling the beds problem.

At all events, these problems increasing will influence enterprise development. We can not ignore any little things. Because American meteorologist Lorenz via renowned Butterfly Effect told us Chaos Theory that any small things can make big change. Parkway Nursing Care’s vision is improving profit meanwhile cut down cost. The aboard of director hope company will expansion business, they must confirm make any decision is right. Then the management level in charge of regulator, they must understand board of director’s commands after that pass on the information to subordinators. They also must have high-efficiency communication skills. The common employees they should have serious implement skills. That company can running on normal track. But today’s Parkway Nursing Care has lot of issue. As consultant, I state Parkway Nursing Care need revolutionary change. Board of director should think new vision which is appropriate today’s company.

Richard Lynch (2006:p351) states in his chapter:

‘Vision is a challenging and imaginative picture of the future role and objectives of an organization, significantly going beyond its current environment and competitive position.’

In the management level, they are both implementer and supervisor. They should have capabilities to influence people in complex circumstances.

Richard Lynch (2006:p355) declared:

‘Leadership is the art or process of influencing people so that they will strive willingly and enthusiastically towards the achievement of the organization’s purpose.’

In basic level, the organization likes the employee who can understand task and obey the company structure. Staff is company’s foundation stone especially service organization. In Parkway Nursing Care, before staffs obey to company, we must help them recognize the form of enterprise, address their difficulties and guide them finish the work.

Problems Identification

Parkway Nursing Care used AI process to collected information from employees then created change message. We use these information to analysis the practical issues. Through survey and research, the author discovered that have four main problems need to solute. There are: 1. Staffing problems 2. Documentation problems 3. Physical demands problems 4. Sales problems.

Staffing Problems

This chapter has explored the staffing issues surrounding on Parkway Nursing Care work place. As baby boom generation becoming senior citizens, they need more and more care. In contrast, Parkway Nursing Care’s staffs are becoming less and less. Service is becoming worse and worse.

¼Š Which affairs showed problems? Where place occur? What kind of impact brought?

From enterprise circumstance it has staffs short of careful training. Some nurses can not make correct report medical issue or concerns; some of them do not have skills or knowledge for move, restrain and transfer patients. These will make patients suffer a serious fall or injuries. Another issue is nowadays Parkway Nursing Case lack of enough experienced staffs. People who are coming need to waiting for long time to see a doctor. This set off a lot of complain. In the understaffing stress, when the new one came in, company did not perform sufficient background check. If nursing care hires the incorrect employees, they will bring mistakes very serious consequences. This also is shift senior leader who is working in Parkway Nursing Care 15 years said staffing levels drop down.

¼Š How to change this state? Why organization requires changing?

Consultant’s opinion, the hospital should organize high quality recruitment, hire new staff and give them correct training of foundation immediately.

Stephen P. Robbins & Timothy A. Judge (2010:p269) declared that ‘no company today is in a particularly stable environment. Even traditionally stable industries such as energy and utilities have witnessed and will continue to experience-turbulent change.’

¼Š Why company should do it right away?

From short view, that methods illustrate good aspect are reduce complains from customer waiting, increase the efficiency of work, decrease the mistake rate, and shrink staffs work stress. Nevertheless, bad aspect is will makes the company cost rise. If from long view, the methods show good way are the company gains more patients coming that should increase the profit. Company has reserve staffs. Staff is limited but the patient in unlimited. It just copes with Parkway Nursing Care vision.

3.2 Documentation Problems

In this chapter will argue documentation problems. Following the high technology society the government hopes to achieve the electronic report from any company. This will be convenient to saving and check information.

¼Š Why e-documentation is important in enterprise? What kind of benefit for company and employees?

In rapid develop of the time, E-solution becoming more and more important for enterprise. It is including e-documentation. E-documentation company to paperwork, it can keep the document longer than paperwork. It is easy to collect information for company, and convenient for share information with company. Any body can check the information timely. Avoid randomly change records. This is called open-source in company. E-documentation for staffs, it decline work stress and enhance. Record information is faster than handwork. Clearly transmission work content for shift position.

¼Š In Parkway Nursing Care what should we do? Which department should use new system?

Parkway Nursing Care has to use e-documentation (software) to record nurses work agenda and answer government requirement. Company needs to purchase facilities for built electronic system. For example, computers, database, server, computer lab. Invite expert to training staffs. However before the nurses always use paperwork to record and transmit work agenda. Hand writing already is their habit. Now let them change the way is difficult especially elder employees. They resist changing.

¼Š Why Parkway Nursing Care requires break old record way to new electronic system? When will Parkway Nursing Care do?

In short-term view, Parkway Nursing Care changes to use new way record needs to spent many financial resource and human resource. In addition, this implement can set more employees’ resistance on fire. Yet, in long-term view, the company answers the governments require will gain more smoothly development. Management easy to control subordinates work performance. Make sure correctness of information. The staffs obtain new skills also help them increasing employment competitiveness. Software record should be less work time than hand writing, and easy to know the critical. Solute documentation problems, company will be transformational change. It will influence every body who work in Parkway Nursing Care. As well as prepare facilities and training staffs should use long period. Parkway Nursing Care complete this process on government gives time will be fine.

3.3 Physical Demands Problems

In this chapter will discuss physical demands problems. From the collect information, some employees’ suggestion work time can be flexibility.

¼Š Which affairs showed physical demands problems? What is influence for Parkway Nursing Care?

Every worker has their family, some time they want to deal with emergency responsibility. Like some workers belong to single family, they need to take care of their children and elder parents. When the high demanding work make them can not leave position, they maybe produce some mistakes. Sometimes under the long strength work they are easy suffer from illness or produce some incidents or injuries. For the company, it will improve absent rate or turnover rate. The other reason is long time work makes them battle-weary. When the worker got home they even do not want to do anything for family or themselves. They cannot balance the job and life in long period work.

¼Š How to make change in here?

In my opinion, company should re-organize the time table. Make the time table flexible. Every worker gets the rational utilization. Carry out the work by turn system, rest by turn system. Add some intelligent machines to reduce nurse’s physical labor. Offer some welfare for staffs in work place. As built some massage room, coffee room, gym, sauna room, even built a nursery for single family staff.

¼Š Should we resolve these problem at once? Why should we do it?

Depending on Parkway nursing Care vision, these problems can not affect profit directly. So I suggest slow processing. When we address problems in short-term view, built reset room or purchase machines will let cost up grade. But long term, staffs’ problems get solute. They can pay more attention to serve to customers and pay more attention to work position. Cut down accident rate. Even they free relax can join some training in free time by themselves. These can improve their professional skills for job; make customers more comfortable and satisfied in the hospital. Profit will get increasing.

3.4 Sales Problems

More beds need more patients. Now Parkway Nursing Care has very good development. Because baby boom generation already growth senior person.

¼Š Is it a Parkway Nursing Care problem of lack of patient in nowadays? Should we continue accept a lot of patients in?

Parkway Nursing Care always had outstanding patient care. Under increasing government scrutiny, the nursing home industry investigate built branch. They prepared more beds for more patients. But understaffing and not enough medical appliances can not serve to more patients better. So, short view Parkway Nursing Care is not short of patients and organization can just retard find widespread patient.

¼Š What time Parkway Nursing Care can turn up widespread patient get in? Why Parkway Nursing Care had better slow down receiving?

About sales problem, in my point of view, organization should put it in the end. Following the company vision, Parkway Nursing Care should accept more customers. But please think about organization’s current situation. That would offer customer better service. Short period view, it rejects more money coming in. Capital is stopped. However long period view, we can gain good reputation and faith from customers.

4 Change Management Strategies

Parkway Nursing Care has four main issues remain to be change. Any company doing comprehensive change programs, they have to face resistance from both employee and enterprise.

4.1 Forms of Resistance

Parkway Nursing Care internal changes combine to scientific research. First resistances come from organization. There are:

1) Improve cost

2) Alter structure

3) Redesign vision

4) Technology puzzle.

The other resistances come from employees. There are:

1) Lack of job security

2) Peer pressure

3) Climate of mistrust

4) Unknown fear.

4.2 Resistance in Parkway

In Parkway Nursing Care, resistances of organization:

1) When company buy medical facilities, built relax room, prepare computer system will use a lot of the budget. The board of director has operational targets pressure. They worried cost will not becoming profit or will use very long period. Also accounting department in charge of company financial, they also have stress for pay high budget.

2) Increase of the staffs with the increase of the customers, organization should build a new stracuture. Add number of middle level managers. In the level’s people must be implementer and supervisor. High level should distribute powers

3) Company’s old vision is high profit, low cost, but now this is not fit Parkway. The board of director has to think new vision make employees follow. They also have stress for worried whether this new vision can be used forever.

4) Company will be computerization. Managers’ worried subordinates reject, high technology equipment will spent a lot of cost and themselves also do not challenge their job ‘comfort zone’.

In Parkway Nursing Care, resistance of employees:

As staffs lack of job security. When organization recruit new staff, they will resist, worried about new staff will instead of his position. They never or negative to teach new staff job skills.

When Parkway Nursing Care let them asked them use software to record job information, they also has reluctant attitude. Because they don’t believe they can easy control this knowledge, they worried peer will better than them.

The employees did not understand why company wants to change. That change will modify their job habit, gave them trouble. They think company only think about benefit of enterprise never think about them.

While they did not know any organization strategies that alternation suddenly drop. They fear organization will have some problem. Maybe they will lose job in the near future.

4.3 Conquering the Resistances

If organization exists resistance, overcome it is necessary. From top management they must ensure the determined of strategies. Then we have strong support form top management. â- Company organize training for staffs and through effective communication with staffs to reduce resistance. â- Leadership build emotional commitment with employees. Guide them correct understand organization’s culture. â- Managers allocate source to any staff fairly. Make them easy the accept change. â- Managers establish role model in group. This person will easy to effect to staffs. â- Managers use force to threat. This way is not a good way if you have long time to wait change. But if change is very immediately and the staff very disobey, this way can use.

5. Implementation

5.1 Creating a Leadership Strategy.

Review the business strategy.

Identify the drivers of the strategy.

Assess current leadership situation and compare to the desired future.

Members of baby boom generation become senior citizens. Nursing care sector’s marketing share turn into bigger and bigger. Parkway Nursing Care attracts foreign investment from nursing home industry. It needs more branch of nursing care to accept more customers. The final realize profit growth. But now it is facing many barriers for profit growth. We must create new leadership strategy for Parkway Nursing Care.

Sheri Cyprus states that:

‘Strategic leadership basically means using strategy in the management of workers. The main strategy usually employed in a strategic style of leadership is to motivate workers to take the initiative to improve their productive input into the company. Strategy involves thinking and planning. Leadership inspires others to take the appropriate action. Strategic leadership is a management model that trains and encourages employees to best prepare the company for the future.’

Judging by Lewin’s Three-step change model, organization alternation should via unfreezing step then join to changing step finally get to refreezing step. This circle shows a successful change in organization. Then how can we implement change combine to leadership strategy? On the Essentials of Organizational Behavior book (2010:p274) declared that: Kotter’s Eight-Step Plan for Implementing Change. This method change can match the Lewin’s Three-step change model.

Kotter’s Eight-Step Plan for Implementing Change combines to Parkway Nursing Care:

Step 1: Increase urgency

This step is very important in whole change steps. Before you star organizational change, you should prepare enough, otherwise will bring barriers for after change steps. The leadership needs to tell employees what problems in enterprise and what things will happen in organization by honestly. Let’s everybody who working in Parkway Nursing Care understand organization will change urgent. Meanwhile, the management needs to identify potential threats, thinking what will be happen in the future. Give the chance for staffs let them talking and thinking reason. Asking the support from up-management and different department. During this step period, try to find the opportunity which one can use.

Step 2: Built a coalition

In this step leadership needs to do your best persuade people change is necessary, find the support form right people, right power and built a new leader team call coalition. From inside or outside of Parkway Nursing Care find the people who have real leader talent. Some staffs have higher degrees working in Parkway Nursing Care. They suffer to no chance to be promoted. Long-time, they will transfer another enterprise. Use inside people becoming leader, they can understand organization clearly than outside, organization also can control the turnover. Use outside people making leader, they have more experience and knowledge compare with own-staff.

Step 3: Create new vision

Parkway Nursing Care’s old vision is improve profit and cut down cost. Now it is not suiting today’s situation. Organization should create a new vision which is clear, simple and easy to remember. That vision’s conception can let everyone know what they should do and what is organization need. Organize meeting around management. Tale new and future company goal, collect ideas and summery these become vision.

Step 4: Communicate the vision

After created vision, you should communicate vision in every day and use it every day. When you solve the problems and make the decision according the vision. Let it becoming your habit.

Above four steps just responded Lewin’s three-step change’s Unfreezing period in organization.

Step 5: Empower actions by removing obstacles

In this step, you should continue check barriers or people’s resistance. Empower people who can help you implement change by vision. Identify your leaders, your structure, and system whether in vision. Use survey or questionnaire to get the feedback from your employees. Then check everyone’s attitude of change, which resist the change. Know his weakness for change, and reason, help him going right way.

Step 6: Plan for short-term wins

Parkway Nursing Care change plan should be very long and target should be very big. If management just set up final goal program, before get it you will unconfident by critical and negative. Leadership can first use easy and cheap program let the staff see the success. Like training skill of nurses program, redesign time schedule’s successful give employees’ motivation and believe this change is correct. Continue to thinking your final target’s weakness and avoid it.

Step 7: Small adjust in change

Follow step 6, management do not think every simple, short-term get success then the final target must be success.

Kotter argues that:

‘Many change projects fail because victory is declared too early. Real change runs deep. Quick wins are only the beginning of what needs to be done to achieve long-term change.’

Leaders should analysis and summarize the experience about advance and weakness of successful small goals. After that, think about the long-term goals and adjust it. Such as whether everybody should join software training and use it daily or depend on different hierarchy.

From step five to step seven’s method just match Lewin’s three-step change model’s changing period in organization.

Step 8: Reinforce the changes

This step is the last step of implement change. Organization needs to consolidate organization’s change and let change is Parkway Nursing Care’s core task. Management persists in every small or short-term change will have good reward. Make sure leadership strategy step by step manage parkway Nursing Care to final target.

This one most suitable match Lewin’s three-step change model’s refreezing period.

5.2 Recommended Leadership Style

Before consulter recommendation, and summarize Parkway Nursing Care’s resistances in different situations. Firstly, when organization address staffing problems, recruit new non-experience nurses, the senior nursing will resist to training them skills or knowledge. Because they worried new staff have one day will conquer their position. Secondly, when organization deals with physical demands problems; purchase some high technology’s machine for help nursing reduce the injuries, the people who have strong physical will resist the action. For they fear machines will instead of them. Thirdly, when organization solves the documentation problems, use electronic system to record information, the elder staffs will resist. Because they already familiar with the old way to record and worried the computer skill is worse than new staffs. Fourthly, when organization handle filling beds problems, organization should make sale task slow down on the basis of today’s Parkway Nursing Care situation. Market and sale staffs will resist. Due to them will cut down the reward and be occupied with nothing.

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Overcome these resistance let the change smoothly. I recommend from five types of leadership (charismatic leadership, participative leadership, situational leadership, transactional leadership, transformational leadership) chose the most qualified one or more leaders to influence employees. In Parkway Nursing Care situation, charismatic style’s leader and situational style’s leader will have more influential for organization change. Rationale is the leader who have charismatic trait can encourage people follow he do the significant and massive organization change. He has natural abilities can easily attract, appeal and effect people follow. Situational style’s leader, who can accord organization actual condition adopt different leadership method. The leader know the performance of staffs’ ability and confidence, can use directing, coaching supporting and delegating method in different condition. Even one people in different period will adopt different method. Parkway Nursing Care needs to find the candidates filling leader position through test and interview. Find the candidates whose character including extroversion, conscientiousness, openness and emotional intelligence traits.

5.3 Leader Behaviors of Home Directors

Home directors’ responsibility is establishing organization vision, select the person to fill management position, measure and allocate resource, negotiate with government, design change plan, empower the supervisors, check feedback form supervisors and redesign unsuitable plan.

In Parkway Nursing Care the home directors firstly should confirm the new organization vision, select the person to filling management position from inside or outside, rational allocation of resources, negotiate with government for asking long time to prepare use electronic system report, design the main change plan, reasonable to release power to supervisors, check feedback from supervisors regularly and make the redesign for unsuitable future plan.

5.4 Leader Behaviors of Supervisors

Supervisors’ responsibility is one hundred per cent understand board of directors, convey information clearly from higher to lower level, regulate subordinates complete work, organize meeting, help staffs solve the problems, address resistance, training the staffs, and report work issues and result to management.

In Parkway Nursing Care the supervisors should communicate organization vision to every staff, implement change plans of four main issues, launch the meeting to check staffs performance and communicate with them, when the staff have difficulty help and guide them rightly, solve resistance from staffs, training the skills, knowledge and experience to employees, and give work progress to home directors.

6. Job Stress in Parkway

Stephen P. & Timothy A. states:

‘stress is a dynamic condition in which an individual is confronted with an opportunity, demand, or resource related to what the individual desires and for which the outcome is perceived to be both uncertain and important.’

6.1 Sources of Stress

Work stress due to your job responsibility. Every body has his stress. In Parkway Nursing Care, work stresses come from three factors. There are environmental factors, organizational factors and personal factors.

Environmental factors reflect on:

Not enough nurses can serve with patients. Every nurse’s daily job makes them exhausted.

Inflexible job schedule makes them free like prison.

High rate injuries makes them anxious also the patients stress

Can not balance between job and family

Organization change give them stress

Study new skills give the senior staff stress

Government require will give home directors stress

Organizational factors seen on:

Cost will growth up during change

Employees absences rate rise bring the stress

Allocate resource

Personal factors appear in:

Single family can not take care the child

Change plan make them becoming worse than peer staff or new staff

Machines will instead of their job

6.2 Actions Required

Consulter suggests from Parkway Nursing Care use under ways to reduce stress.

First, board of directors’ stress comes from their responsibility. Complete organizational targets and select right management is their main things. Decline board of directors’ stress we can invite consult agents from outside help them. Inside, they should properly empower to management to do.

Second, supervisors’ stresses come from communication, allocate resource fairly, control the subordinates, and fulfill the task. Reduce this level people’s pressure, we can organize weekly meeting, communicate with subordinates, ask them submit the report, and after the class have dinner with group staffs.

Third, nurses’ stresses come from time management, physical, task. Address this tress we can redesign the timetable, make the shift position system, finish the task on time, built a massage room or yoga room for staff’s tired body, and set up their enthusiasm for work.

6.3 Stress Management Plan

Stress has two ways, one is bad. It makes people sad and hurt people’s health. Other way is good, but must be a bit of stress. It can give the people motive power. Stephen P. & Timothy A states that not all stress is dysfunctional. How can we management stress? We can use catharsis, consultation and lead three ways. We through sing a song, do the exercise, or yell to catharsis then decline the stress. Talk to family members, friends or consultant to get console and mental balance. Let the leader help your adjust job task, redesign the job target. Foster more interest habit. That all are good ways to manage stresses. Consulter suggests you study how to exploit and utilize stress.

7. Conclusion

The consulter discovers Parkway Nursing Care has staffing, documentation, physical demands and fills beds problems. Through analysis we give the solution to address these issues depending on Parkway Nursing Care reality situation. Organizational change will accompany Parkway Nursing Care long time in future. From short term, these solutions not all can bring the benefit immediately and directly. Like training staffs, purchase facilities, built relax room and make the sale task slow down are all will increase the cost. Influence organization’s economic. Nevertheless, long term change will bring more patients, customer satisfactions, improve work effective, and make the profit up. If you do not solve these problems or let the change plan dead, short term it can keep enterprise’s economic, realize profit growth. But long term, you will see the bad effect. Enterprise will go in bad worry cycle. More patients and staffs complain, poor facilities let you lost faith, improve turnover rate. Finally drop down the profit. By the way, I just give the one model of change plan, if this way fail, Parkway Nursing Care can chose the other model of change plan to address four main problems. If solve staffing problems fail, we can shift staff in another position, should have one position suit him. Or recruit experienced staff from other nursing care. If physical demands problems can not successful, the Parkway Nursing Care can use weekend or public holiday organize employees travel. If documentation problems can not go to the end, organization can hire special person record the information for every department. If Parkway Nursing Care can not persuade sales slow down, organization can cut down their task, or give them some holiday with salary every month or every quarter.

Following the organization developing, any company will face a lot of or some issues even crisis. If they expect achieving more benefit, continue developing business, keep good reputation of organization. They will change current management. In Parkway Nursing Care, it also appeared some problems. The consulter done research and analyzed the Parkway Nursing Care’s situation of organization. As a consultant, I report solutions intent of practice barriers for board of director, help organization changes and ways to overcome related resistances as well as a stress management plan aimed at developing a conductive environment for Parkway to pursue its long-term growth objectives. Well-known, organization depends on capable leadership to guide them from unsuitable management to successful management. Then leadership strategy is becoming significant. Nevertheless in possession of successful leadership strategies plan is not only element of enterprise. When you implement this plan, the leadership also should require preparing many certain and uncertain future. However, how to alter old way as well as go about creating new strategy for your organization which will becoming long term effort accompany by the organization.

Survey Results

According to last month information form result which from human resource department. The table chart showed information about situation of Parkway Nursing Care between 2000 and 2009. This information form touched six parts, and data on employee injuries, incidents, absences and turnover show the main issues of Parkway Nursing Care. This survey results indicate that many problems have developed while the organization was focusing on achieving its growth and profit objectives. Four aspects problems appear in the staffing problem, physical demands problem, documentation problem and filling the beds problem.

At all events, these problems increasing will influence enterprise development. We can not ignore any little things. Because American meteorologist Lorenz via renowned Butterfly Effect told us Chaos Theory that any small things can make big change. Parkway Nursing Care’s vision is improving profit meanwhile cut down cost. The aboard of director hope company will expansion business, they must confirm make any decision is right. Then the management level in charge of regulator, they must understand board of director’s commands after that pass on the information to subordinators. They also must have high-efficiency communication skills. The common employees they should have serious implement skills. That company can running on normal track. But today’s Parkway Nursing Care has lot of issue. As consultant, I state Parkway Nursing Care need revolutionary change. Board of director should think new vision which is appropriate today’s company.

Richard Lynch (2006:p351) states in his chapter:

‘Vision is a challenging and imaginative picture of the future role and objectives of an organization, significantly going beyond its current environment and competitive position.’

In the management level, they are both implementer and supervisor. They should have capabilities to influence people in complex circumstances.

Richard Lynch (2006:p355) declared:

‘Leadership is the art or process of influencing people so that they will strive willingly and enthusiastically towards the achievement of the organization’s purpose.’

In basic level, the organization likes the employee who can understand task and obey the company structure. Staff is company’s foundation stone especially service organization. In Parkway Nursing Care, before staffs obey to company, we must help them recognize the form of enterprise, address their difficulties and guide them finish the work.

Problems Identification

Parkway Nursing Care used AI process to collected information from employees then created change message. We use these information to analysis the practical issues. Through survey and research, the author discovered that have four main problems need to solute. There are: 1. Staffing problems 2. Documentation problems 3. Physical demands problems 4. Sales problems.

Staffing Problems

This chapter has explored the staffing issues surrounding on Parkway Nursing Care work place. As baby boom generation becoming senior citizens, they need more and more care. In contrast, Parkway Nursing Care’s staffs are becoming less and less. Service is becoming worse and worse.

¼Š Which affairs showed problems? Where place occur? What kind of impact brought?

From enterprise circumstance it has staffs short of careful training. Some nurses can not make correct report medical issue or concerns; some of them do not have skills or knowledge for move, restrain and transfer patients. These will make patients suffer a serious fall or injuries. Another issue is nowadays Parkway Nursing Case lack of enough experienced staffs. People who are coming need to waiting for long time to see a doctor. This set off a lot of complain. In the understaffing stress, when the new one came in, company did not perform sufficient background check. If nursing care hires the incorrect employees, they will bring mistakes very serious consequences. This also is shift senior leader who is working in Parkway Nursing Care 15 years said staffing levels drop down.

¼Š How to change this state? Why organization requires changing?

Consultant’s opinion, the hospital should organize high quality recruitment, hire new staff and give them correct training of foundation immediately.

Stephen P. Robbins & Timothy A. Judge (2010:p269) declared that ‘no company today is in a particularly stable environment. Even traditionally stable industries such as energy and utilities have witnessed and will continue to experience-turbulent change.’

¼Š Why company should do it right away?

From short view, that methods illustrate good aspect are reduce complains from customer waiting, increase the efficiency of work, decrease the mistake rate, and shrink staffs work stress. Nevertheless, bad aspect is will makes the company cost rise. If from long view, the methods show good way are the company gains more patients coming that should increase the profit. Company has reserve staffs. Staff is limited but the patient in unlimited. It just copes with Parkway Nursing Care vision.

3.2 Documentation Problems

In this chapter will argue documentation problems. Following the high technology society the government hopes to achieve the electronic report from any company. This will be convenient to saving and check information.

¼Š Why e-documentation is important in enterprise? What kind of benefit for company and employees?

In rapid develop of the time, E-solution becoming more and more important for enterprise. It is including e-documentation. E-documentation company to paperwork, it can keep the document longer than paperwork. It is easy to collect information for company, and convenient for share information with company. Any body can check the information timely. Avoid randomly change records. This is called open-source in company. E-documentation for staffs, it decline work stress and enhance. Record information is faster than handwork. Clearly transmission work content for shift position.

¼Š In Parkway Nursing Care what should we do? Which department should use new system?

Parkway Nursing Care has to use e-documentation (software) to record nurses work agenda and answer government requirement. Company needs to purchase facilities for built electronic system. For example, computers, database, server, computer lab. Invite expert to training staffs. However before the nurses always use paperwork to record and transmit work agenda. Hand writing already is their habit. Now let them change the way is difficult especially elder employees. They resist changing.

¼Š Why Parkway Nursing Care requires break old record way to new electronic system? When will Parkway Nursing Care do?

In short-term view, Parkway Nursing Care changes to use new way record needs to spent many financial resource and human resource. In addition, this implement can set more employees’ resistance on fire. Yet, in long-term view, the company answers the governments require will gain more smoothly development. Management easy to control subordinates work performance. Make sure correctness of information. The staffs obtain new skills also help them increasing employment competitiveness. Software record should be less work time than hand writing, and easy to know the critical. Solute documentation problems, company will be transformational change. It will influence every body who work in Parkway Nursing Care. As well as prepare facilities and training staffs should use long period. Parkway Nursing Care complete this process on government gives time will be fine.

3.3 Physical Demands Problems

In this chapter will discuss physical demands problems. From the collect information, some employees’ suggestion work time can be flexibility.

¼Š Which affairs showed physical demands problems? What is influence for Parkway Nursing Care?

Every worker has their family, some time they want to deal with emergency responsibility. Like some workers belong to single family, they need to take care of their children and elder parents. When the high demanding work make them can not leave position, they maybe produce some mistakes. Sometimes under the long strength work they are easy suffer from illness or produce some incidents or injuries. For the company, it will improve absent rate or turnover rate. The other reason is long time work makes them battle-weary. When the worker got home they even do not want to do anything for family or themselves. They cannot balance the job and life in long period work.

¼Š How to make change in here?

In my opinion, company should re-organize the time table. Make the time table flexible. Every worker gets the rational utilization. Carry out the work by turn system, rest by turn system. Add some intelligent machines to reduce nurse’s physical labor. Offer some welfare for staffs in work place. As built some massage room, coffee room, gym, sauna room, even built a nursery for single family staff.

¼Š Should we resolve these problem at once? Why should we do it?

Depending on Parkway nursing Care vision, these problems can not affect profit directly. So I suggest slow processing. When we address problems in short-term view, built reset room or purchase machines will let cost up grade. But long term, staffs’ problems get solute. They can pay more attention to serve to customers and pay more attention to work position. Cut down accident rate. Even they free relax can join some training in free time by themselves. These can improve their professional skills for job; make customers more comfortable and satisfied in the hospital. Profit will get increasing.

3.4 Sales Problems

More beds need more patients. Now Parkway Nursing Care has very good development. Because baby boom generation already growth senior person.

¼Š Is it a Parkway Nursing Care problem of lack of patient in nowadays? Should we continue accept a lot of patients in?

Parkway Nursing Care always had outstanding patient care. Under increasing government scrutiny, the nursing home industry investigate built branch. They prepared more beds for more patients. But understaffing and not enough medical appliances can not serve to more patients better. So, short view Parkway Nursing Care is not short of patients and organization can just retard find widespread patient.

¼Š What time Parkway Nursing Care can turn up widespread patient get in? Why Parkway Nursing Care had better slow down receiving?

About sales problem, in my point of view, organization should put it in the end. Following the company vision, Parkway Nursing Care should accept more customers. But please think about organization’s current situation. That would offer customer better service. Short period view, it rejects more money coming in. Capital is stopped. However long period view, we can gain good reputation and faith from customers.

4 Change Management Strategies

Parkway Nursing Care has four main issues remain to be change. Any company doing comprehensive change programs, they have to face resistance from both employee and enterprise.

4.1 Forms of Resistance

Parkway Nursing Care internal changes combine to scientific research. First resistances come from organization. There are:

1) Improve cost

2) Alter structure

3) Redesign vision

4) Technology puzzle.

The other resistances come from employees. There are:

1) Lack of job security

2) Peer pressure

3) Climate of mistrust

4) Unknown fear.

4.2 Resistance in Parkway

In Parkway Nursing Care, resistances of organization:

1) When company buy medical facilities, built relax room, prepare computer system will use a lot of the budget. The board of director has operational targets pressure. They worried cost will not becoming profit or will use very long period. Also accounting department in charge of company financial, they also have stress for pay high budget.

2) Increase of the staffs with the increase of the customers, organization should build a new stracuture. Add number of middle level managers. In the level’s people must be implementer and supervisor. High level should distribute powers

3) Company’s old vision is high profit, low cost, but now this is not fit Parkway. The board of director has to think new vision make employees follow. They also have stress for worried whether this new vision can be used forever.

4) Company will be computerization. Managers’ worried subordinates reject, high technology equipment will spent a lot of cost and themselves also do not challenge their job ‘comfort zone’.

In Parkway Nursing Care, resistance of employees:

As staffs lack of job security. When organization recruit new staff, they will resist, worried about new staff will instead of his position. They never or negative to teach new staff job skills.

When Parkway Nursing Care let them asked them use software to record job information, they also has reluctant attitude. Because they don’t believe they can easy control this knowledge, they worried peer will better than them.

The employees did not understand why company wants to change. That change will modify their job habit, gave them trouble. They think company only think about benefit of enterprise never think about them.

While they did not know any organization strategies that alternation suddenly drop. They fear organization will have some problem. Maybe they will lose job in the near future.

4.3 Conquering the Resistances

If organization exists resistance, overcome it is necessary. From top management they must ensure the determined of strategies. Then we have strong support form top management. â- Company organize training for staffs and through effective communication with staffs to reduce resistance. â- Leadership build emotional commitment with employees. Guide them correct understand organization’s culture. â- Managers allocate source to any staff fairly. Make them easy the accept change. â- Managers establish role model in group. This person will easy to effect to staffs. â- Managers use force to threat. This way is not a good way if you have long time to wait change. But if change is very immediately and the staff very disobey, this way can use.

5. Implementation

5.1 Creating a Leadership Strategy.

Review the business strategy.

Identify the drivers of the strategy.

Assess current leadership situation and compare to the desired future.

Members of baby boom generation become senior citizens. Nursing care sector’s marketing share turn into bigger and bigger. Parkway Nursing Care attracts foreign investment from nursing home industry. It needs more branch of nursing care to accept more customers. The final realize profit growth. But now it is facing many barriers for profit growth. We must create new leadership strategy for Parkway Nursing Care.

Sheri Cyprus states that:

‘Strategic leadership basically means using strategy in the management of workers. The main strategy usually employed in a strategic style of leadership is to motivate workers to take the initiative to improve their productive input into the company. Strategy involves thinking and planning. Leadership inspires others to take the appropriate action. Strategic leadership is a management model that trains and encourages employees to best prepare the company for the future.’

Judging by Lewin’s Three-step change model, organization alternation should via unfreezing step then join to changing step finally get to refreezing step. This circle shows a successful change in organization. Then how can we implement change combine to leadership strategy? On the Essentials of Organizational Behavior book (2010:p274) declared that: Kotter’s Eight-Step Plan for Implementing Change. This method change can match the Lewin’s Three-step change model.

Kotter’s Eight-Step Plan for Implementing Change combines to Parkway Nursing Care:

Step 1: Increase urgency

This step is very important in whole change steps. Before you star organizational change, you should prepare enough, otherwise will bring barriers for after change steps. The leadership needs to tell employees what problems in enterprise and what things will happen in organization by honestly. Let’s everybody who working in Parkway Nursing Care understand organization will change urgent. Meanwhile, the management needs to identify potential threats, thinking what will be happen in the future. Give the chance for staffs let them talking and thinking reason. Asking the support from up-management and different department. During this step period, try to find the opportunity which one can use.

Step 2: Built a coalition

In this step leadership needs to do your best persuade people change is necessary, find the support form right people, right power and built a new leader team call coalition. From inside or outside of Parkway Nursing Care find the people who have real leader talent. Some staffs have higher degrees working in Parkway Nursing Care. They suffer to no chance to be promoted. Long-time, they will transfer another enterprise. Use inside people becoming leader, they can understand organization clearly than outside, organization also can control the turnover. Use outside people making leader, they have more experience and knowledge compare with own-staff.

Step 3: Create new vision

Parkway Nursing Care’s old vision is improve profit and cut down cost. Now it is not suiting today’s situation. Organization should create a new vision which is clear, simple and easy to remember. That vision’s conception can let everyone know what they should do and what is organization need. Organize meeting around management. Tale new and future company goal, collect ideas and summery these become vision.

Step 4: Communicate the vision

After created vision, you should communicate vision in every day and use it every day. When you solve the problems and make the decision according the vision. Let it becoming your habit.

Above four steps just responded Lewin’s three-step change’s Unfreezing period in organization.

Step 5: Empower actions by removing obstacles

In this step, you should continue check barriers or people’s resistance. Empower people who can help you implement change by vision. Identify your leaders, your structure, and system whether in vision. Use survey or questionnaire to get the feedback from your employees. Then check everyone’s attitude of change, which resist the change. Know his weakness for change, and reason, help him going right way.

Step 6: Plan for short-term wins

Parkway Nursing Care change plan should be very long and target should be very big. If management just set up final goal program, before get it you will unconfident by critical and negative. Leadership can first use easy and cheap program let the staff see the success. Like training skill of nurses program, redesign time schedule’s successful give employees’ motivation and believe this change is correct. Continue to thinking your final target’s weakness and avoid it.

Step 7: Small adjust in change

Follow step 6, management do not think every simple, short-term get success then the final target must be success.

Kotter argues that:

‘Many change projects fail because victory is declared too early. Real change runs deep. Quick wins are only the beginning of what needs to be done to achieve long-term change.’

Leaders should analysis and summarize the experience about advance and weakness of successful small goals. After that, think about the long-term goals and adjust it. Such as whether everybody should join software training and use it daily or depend on different hierarchy.

From step five to step seven’s method just match Lewin’s three-step change model’s changing period in organization.

Step 8: Reinforce the changes

This step is the last step of implement change. Organization needs to consolidate organization’s change and let change is Parkway Nursing Care’s core task. Management persists in every small or short-term change will have good reward. Make sure leadership strategy step by step manage parkway Nursing Care to final target.

This one most suitable match Lewin’s three-step change model’s refreezing period.

5.2 Recommended Leadership Style

Before consulter recommendation, and summarize Parkway Nursing Care’s resistances in different situations. Firstly, when organization address staffing problems, recruit new non-experience nurses, the senior nursing will resist to training them skills or knowledge. Because they worried new staff have one day will conquer their position. Secondly, when organization deals with physical demands problems; purchase some high technology’s machine for help nursing reduce the injuries, the people who have strong physical will resist the action. For they fear machines will instead of them. Thirdly, when organization solves the documentation problems, use electronic system to record information, the elder staffs will resist. Because they already familiar with the old way to record and worried the computer skill is worse than new staffs. Fourthly, when organization handle filling beds problems, organization should make sale task slow down on the basis of today’s Parkway Nursing Care situation. Market and sale staffs will resist. Due to them will cut down the reward and be occupied with nothing.

Overcome these resistance let the change smoothly. I recommend from five types of leadership (charismatic leadership, participative leadership, situational leadership, transactional leadership, transformational leadership) chose the most qualified one or more leaders to influence employees. In Parkway Nursing Care situation, charismatic style’s leader and situational style’s leader will have more influential for organization change. Rationale is the leader who have charismatic trait can encourage people follow he do the significant and massive organization change. He has natural abilities can easily attract, appeal and effect people follow. Situational style’s leader, who can accord organization actual condition adopt different leadership method. The leader know the performance of staffs’ ability and confidence, can use directing, coaching supporting and delegating method in different condition. Even one people in different period will adopt different method. Parkway Nursing Care needs to find the candidates filling leader position through test and interview. Find the candidates whose character including extroversion, conscientiousness, openness and emotional intelligence traits.

5.3 Leader Behaviors of Home Directors

Home directors’ responsibility is establishing organization vision, select the person to fill management position, measure and allocate resource, negotiate with government, design change plan, empower the supervisors, check feedback form supervisors and redesign unsuitable plan.

In Parkway Nursing Care the home directors firstly should confirm the new organization vision, select the person to filling management position from inside or outside, rational allocation of resources, negotiate with government for asking long time to prepare use electronic system report, design the main change plan, reasonable to release power to supervisors, check feedback from supervisors regularly and make the redesign for unsuitable future plan.

5.4 Leader Behaviors of Supervisors

Supervisors’ responsibility is one hundred per cent understand board of directors, convey information clearly from higher to lower level, regulate subordinates complete work, organize meeting, help staffs solve the problems, address resistance, training the staffs, and report work issues and result to management.

In Parkway Nursing Care the supervisors should communicate organization vision to every staff, implement change plans of four main issues, launch the meeting to check staffs performance and communicate with them, when the staff have difficulty help and guide them rightly, solve resistance from staffs, training the skills, knowledge and experience to employees, and give work progress to home directors.

6. Job Stress in Parkway

Stephen P. & Timothy A. states:

‘stress is a dynamic condition in which an individual is confronted with an opportunity, demand, or resource related to what the individual desires and for which the outcome is perceived to be both uncertain and important.’

6.1 Sources of Stress

Work stress due to your job responsibility. Every body has his stress. In Parkway Nursing Care, work stresses come from three factors. There are environmental factors, organizational factors and personal factors.

Environmental factors reflect on:

Not enough nurses can serve with patients. Every nurse’s daily job makes them exhausted.

Inflexible job schedule makes them free like prison.

High rate injuries makes them anxious also the patients stress

Can not balance between job and family

Organization change give them stress

Study new skills give the senior staff stress

Government require will give home directors stress

Organizational factors seen on:

Cost will growth up during change

Employees absences rate rise bring the stress

Allocate resource

Personal factors appear in:

Single family can not take care the child

Change plan make them becoming worse than peer staff or new staff

Machines will instead of their job

6.2 Actions Required

Consulter suggests from Parkway Nursing Care use under ways to reduce stress.

First, board of directors’ stress comes from their responsibility. Complete organizational targets and select right management is their main things. Decline board of directors’ stress we can invite consult agents from outside help them. Inside, they should properly empower to management to do.

Second, supervisors’ stresses come from communication, allocate resource fairly, control the subordinates, and fulfill the task. Reduce this level people’s pressure, we can organize weekly meeting, communicate with subordinates, ask them submit the report, and after the class have dinner with group staffs.

Third, nurses’ stresses come from time management, physical, task. Address this tress we can redesign the timetable, make the shift position system, finish the task on time, built a massage room or yoga room for staff’s tired body, and set up their enthusiasm for work.

6.3 Stress Management Plan

Stress has two ways, one is bad. It makes people sad and hurt people’s health. Other way is good, but must be a bit of stress. It can give the people motive power. Stephen P. & Timothy A states that not all stress is dysfunctional. How can we management stress? We can use catharsis, consultation and lead three ways. We through sing a song, do the exercise, or yell to catharsis then decline the stress. Talk to family members, friends or consultant to get console and mental balance. Let the leader help your adjust job task, redesign the job target. Foster more interest habit. That all are good ways to manage stresses. Consulter suggests you study how to exploit and utilize stress.

7. Conclusion

The consulter discovers Parkway Nursing Care has staffing, documentation, physical demands and fills beds problems. Through analysis we give the solution to address these issues depending on Parkway Nursing Care reality situation. Organizational change will accompany Parkway Nursing Care long time in future. From short term, these solutions not all can bring the benefit immediately and directly. Like training staffs, purchase facilities, built relax room and make the sale task slow down are all will increase the cost. Influence organization’s economic. Nevertheless, long term change will bring more patients, customer satisfactions, improve work effective, and make the profit up. If you do not solve these problems or let the change plan dead, short term it can keep enterprise’s economic, realize profit growth. But long term, you will see the bad effect. Enterprise will go in bad worry cycle. More patients and staffs complain, poor facilities let you lost faith, improve turnover rate. Finally drop down the profit. By the way, I just give the one model of change plan, if this way fail, Parkway Nursing Care can chose the other model of change plan to address four main problems. If solve staffing problems fail, we can shift staff in another position, should have one position suit him. Or recruit experienced staff from other nursing care. If physical demands problems can not successful, the Parkway Nursing Care can use weekend or public holiday organize employees travel. If documentation problems can not go to the end, organization can hire special person record the information for every department. If Parkway Nursing Care can not persuade sales slow down, organization can cut down their task, or give them some holiday with salary every month or every quarter.

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