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Metabolic Health Monitoring Change Management

Table of Contents

Introduction. 3

Background. 3

Change Management Model 5

Model Selected. 5

Advantages. 5

Limitations. 5

Implementation Plan for Metabolic Health Monitoring. 6

Phase 1: Sense of Urgency. 6

Phase 2: Guiding Coalition. 6

Phase 3: Vision Formulation. 7

Phase 4: communicating the vision. 7

Phase 5: Team Empowerment to work towards the vision. 7

Step 6: Track Quick Wins. 8

Phase 7: Building on the Change. 8

Phase 8: Change Institutionalization. 8

Change Management leadership Style. 9

Management VS Leadership. 9

Leadership Styles. 10

Most Appropriate Style. 11

Leadership Challenges. 11

References. 15

Metabolic Health Monitoring Change Management

Introduction

Change is an inevitable process and in healthcare settings, innovative approaches to problems are required to achieve desired outcomes. Patients suffering from mental illness are often immobile and may also be affected by administered drugs. The implication is that their metabolic rate is slowed leading to lifestyle diseases such as obesity, cardiovascular disease, diabetes, and other health complications. Therefore, there is a need to carefully monitor their metabolic rates to inform the appropriate methods that can be applied to correct decline fast and effectively to achieve positive patient outcomes (Michael & MacDonald, 2020). This paper reviews the change management model that can be adopted to ensure the metabolic health monitoring of mentally ill patients in a healthcare setting is affected sustainably. The report also examines various leadership styles and points out the most optimal style that can be adapted to effect the change process. In this section, the budget constraints, staffing and skills, and resistance challenges leaders face while implementing the change process are also evaluated concerning metabolic health monitoring.

Background

Severe mental illnesses include major depressive disorder, bipolar disorder, and schizophrenia. People suffering from the condition are prone to physical healthcare disparities and exposure to poor physical health leading to a shorter life expectancy than the other members of the population. Also, due to exposure to sedatives and other psychotropic and antipsychotic drugs that are used to control their reactions, mentally ill patients live an inactive life. Therefore, they are at an increased risk of suffering dyslipidemia, metabolic syndrome, obesity, and cardiovascular diseases (Michael & MacDonald, 2020). Notably, most causes of mortality and cardiovascular risk among mentally ill patients can be corrected if they are identified and monitored by healthcare providers. Mentally ill patients also lack adequate healthcare attendance especially when it comes to metabolic monitoring hence these risks go unnoticed. Poor cardio-metabolic health monitoring would pose as a step in the right direction towards the achievement of healthcare equity and make early interventions to manage the risks. According to Happell et al. (2016), there is a 30% less likelihood of monitoring lipid, blood glucose, and weight levels among mentally ill patients than those suffering other diseases. The study also points out that liver and renal functions are rarely monitored among mental health patients with only 36% of consumer forms containing the metabolic health data (Happell et al., 2016). This points out the extent to which the metabolic health of the mentally ill patients is underprioritized despite the risk it poses to health.

The greatest enabler of change according to Akinbode & Shuhumi (2018), is information technology. The availability of electronic health records and electronic monitoring devices ease the burden of tracking metabolic health performance. The other enabler is the existence of metabolic monitoring within other departments in the hospital. Although the mental health department is short of the procedure, there are other departments where metabolic monitoring is mandatory. Therefore, the facility can use the departments as an information base and copy some of the procedures used in these departments and use them to monitor patient metabolism hence reducing the implementation period. However, the change faces a financial barrier because of the need to incur an extra expense in providing the tools, equipment, and expertise needed to monitor the condition. The other barrier is in the selection of a suitable change management model and leadership style that can aid the successful project implementation. Acceptance of the change among workers is also a challenge as some may harbor contrary opinions and negative attitudes towards the change process.

Change Management Model

Model Selected

The common models of change include Lewin’s Three-Step model, Kottler’s 8-step plan, Nadler’s system model, McKinsey's 7-S change management model, and the ADKAR model. These models are used to structure a change management project and develop an effective plan ahead of the implementation. The change will be implemented using Kottler’s 8 step model. Although the model is not popular in managing nursing change projects, it was selected because it is a step-by-step methodology that is easy and emphasizes change preparation and acceptance (Carman et al., 2019). Besides, the transition from one step to the next is smooth and easily achieved.

Advantages

Kottler’s model has numerous advantages. One of the advantages is that it lays special emphasis on the preparation and enactment of change acceptability instead of the actual process the change goes through (Lv & Zhang, 2017). The model also places importance on employee acceptability and involvement in the overall process as a determining factor of change management (Pollack & Pollack, 2015). Besides, easy step-by-step phases are followed which offer clear guidance and description of the whole change process which makes the implementation relatively easy (Carman et al., 2019).

Limitations

Kottler’s 8-step model also has limitations. Firstly, the model assumes that change is a linear progression that can be implemented in a step-wise manner (Rajan & Ganesan, 2017). However, change is a fluid process that can take any dimension. Being a phased process, every step must be implemented in order. The implication is that negative impacts are highly likely to emerge if any of the eight steps are skipped.

Implementation Plan for Metabolic Health Monitoring

Kottler’s model follows 8 steps in the implementation of change (Lv & Zhang, 2017). The model will be used in the planning and implementation of metabolic health monitoring for mental health patients in facilities of care following the phases.

Phase 1: Sense of Urgency

The importance of metabolic health monitoring is a growing concern among patients with mental health due to their lifestyle (Michael & MacDonald, 2020). The recognition of this problem raises a sense of urgency to implement the change (Carman et al., 2019). The administration should commence by ensuring staff perceives the sentinel events that cause poor health outcomes among these patients when their metabolic performance is not monitored. Consideration of the health risk the patients are exposed to due to lack of metabolic monitoring, the unit is motivated to carry out the change. To ensure nurses in the mental health unit are familiar with the concern, they are provided with articles that describe how metabolic health monitoring for mental health patients enhance their health outcomes and make it possible for patients, the nurses, and their families to ease the burden of care.

Phase 2: Guiding Coalition

The guiding coalition comprises a team of leaders that will carry the responsibility of persuading others towards change adoption (Lv & Zhang, 2017). For the metabolic health monitoring change implementation, the team members can include a unit clinical advisor, administrative clinical supervisor, resource nurses, nurse educator, nursing manager, and senior attending nurses who are committed to upholding metabolic health monitoring to act as the guides through the implementation process. The director should educate the guiding coalition on Kottler’s 8-step model of change management. Leaders should also review the literature on initiatives that can be implemented to monitor metabolic health among mental health patients. The leaders can then form a cohesive team with a clear understanding of the model and the metabolic health monitoring initiatives to create a vision for the project.

Phase 3: Vision Formulation

This step entails the creation of the vision that will facilitate the development of health monitoring initiatives and steer the change process (Carman et al., 2019). For this project, the vision is to improve the outcomes of mental health patients through the inclusion of metabolic health monitoring in their treatment plan. The expected outcomes are the prevention of adverse effects and improved satisfaction in receiving and providing care to mentally ill patients.

Phase 4: communicating the vision

A message reflecting the formulated vision is shared with the project execution team (Pollack & Pollack, 2015). The articles that describe the benefits of metabolic health monitoring among mental health patients and the Kottler’s model change implementation literature is availed and distributed across all mental health staff. Education sessions and weekly meetings also include communication about the vision and the steps to be adopted to ensure it is met.

Phase 5: Team Empowerment to work towards the vision

In this phase, the team is instigated to buy in the change, process from each other (Lv & Zhang, 2017). Members should be given room to understand the vision and autonomously act by developing tools that put the metabolic health monitoring agenda on the ground. A uniform change may not work effectively depending on the situation and the patient's condition. Therefore, staff can develop systems that outline the situation, the appropriate intervention, and a plan that works for the local facility. Barriers to change adoption should be resolved with countermeasures to guide workers towards the vision

Step 6: Track Quick Wins

Envisioning and starting changes is easy but their sustenance is daunting. This phase challenges teams to aim for clear and visible achievements (Carman et al., 2019). Identifying the small wins such as a slight improvement in metabolic rate after a week’s monitoring should be recorded. Another small win is the realization that involved workers keep a uniform track of the monitoring process successfully.

Phase 7: Building on the Change

Any progressive changes must be reinforced and maintained to keep the focus on the overall project vision (Rajan & Ganesan, 2017). For instance, the practical steps in tracking the metabolic health of patients should be reinforced to foster a desire for improvement and motivation to achieve more.

Phase 8: Change Institutionalization

This step entails establishing the change into a cultural shift that normalizes the vision (Lv & Zhang, 2017). Metabolic health monitoring becomes a normal process for mentally ill patients in health facilities through buy-in from most workers. The new culture will improve the tracking and development of initiatives to deal with metabolic health disorders among mentally ill patients.

Change Management leadership Style

Management VS Leadership

Management and leadership are often mistaken to be the same while they are strikingly different. The first difference between the two is that management entails planning while leadership focuses on motivation/inspiration (Liphadzi, Aigbavboa, & Thwala, 2017). Managers focus on goal setting, measurement, and achievement through control of situations within or beyond their objectives. Leaders, on the other hand, focus on engaging workers to convert the vision into reality. They strive to examine the appropriate initiatives they can undertake to activate employees and enhance the performance of teams. While managers strive to be heroes, leaders work to culture all around them into heroes. Management is about giving directives while leadership is about asking questions to chart a common path. Management is responsible for developing strategies that will enable the organization to achieve its vision. Leadership, on the other hand, is about the implementation of these strategies to channel the organization towards successful goal fulfillment (Liphadzi, Aigbavboa, & Thwala, 2017).

The differences are important in the Metabolic Health Monitoring change initiative because they help determine what is expected of all participants. The management team is responsible for charting the appropriate methods through which the change can be implemented which is the major role of Kottler’s 8-step change management process. The leadership on the other hand works hand-in-hand with subordinate staff members to implement the planned model and evaluate its performance in improving mental health patients’ outcomes (Liphadzi, Aigbavboa, & Thwala, 2017).

Leadership Styles

5 common leadership styles can be applied in the implementation of mental health monitoring change management. These include transactional, transformational, laissez-faire, autocratic, and democratic leadership styles (Elsan Mansaray, 2019). In the democratic leadership style, the input of all members is required in decision making. The leader makes the final decision but all employees have an equal stake in the direction of the project.

Autocratic leadership style, on the other hand, requires the leader to solely make decisions in project directions without consulting (Elsan Mansaray, 2019). The decisions are then communicated to other workers who are expected to follow them in adherence to the stipulated place and time.

Laissez-Faire leadership occurs when the leader lets employees make all decisions autonomously. Although there is an overall leader, the authority rests fully on the employee responsible for the given tasks. Leaders under this style trust their workers in terms of skill and judgment while they focus on steering the organization (Akinbode & Shuhumi, 2018).

Transformational leadership, on the other hand, dwells on constant improvement of the company depending on new developments or situations (Elsan Mansaray, 2019). Although employees have a distinct set of tasks and goals, they are constantly pushed beyond their comfort zones to do a little extra in delivering them.

Transactional leadership style is when employees receive rewards for their performance, in this case, people receive bonuses for good performance as well as punishment for failure. Transactional leaders provide employees with an incentive plan to motivate their performance in assigned duties consistent with the goals of the company (Holten & Brenner, 2015).

Most Appropriate Style

Transformation leadership is the most appropriate leadership style in the implementation of the metabolic health monitoring initiative for mentally ill patients. Leadership is centered on the achievement of a collective purpose (Elsan Mansaray, 2019). Undergoing a change process safely is akin to the project’s success and also the competitive position of an organization afterward. Leadership involvement also heightens organizational commitment, productivity, and job satisfaction among nursing and other health workers. Leadership is therefore closely linked to the relationship between the follower and the leader (Holten & Brenner, 2015). In transformation leadership leaders and followers engage in a collective pursuit of the vision and goals they jointly uphold. Although their purpose in the change process may kick off as related but divergent, leaders keep engaging the followers to ensure they are infused. Transformational leadership is also inspiring and elevating which makes workers increase their activeness and cultural self-leadership skills to manage individual performances. Among these benefits, transformational leadership has a positive effect on both the leader and followers which makes it the most appropriate in the challenging mental health setting (Elsan Mansaray, 2019).

Leadership Challenges

Budget is a common constrain in projects and the metabolic monitoring initiative is no exception. Leaders are likely to face budgetary shortcomings regarding the purchase and maintenance of the equipment (Tappen et al., 2017). They also face challenges in acquiring and paying sufficient staff members with the skills required to implement the change.

Staffing level is also a challenge that leaders face while implementing change processes (Tappen et al., 2017). In metabolic health, monitoring requires a closely tracked process where a nursing practitioner must be present with the patient at regular intervals to record values (Michael & MacDonald, 2020). Besides, patients require the help of a caregiver to engage in activities that can increase their metabolic rates. This may require assigning at most two patients to a caregiver which is not possible due to under-staffing of healthcare facilities and lack of proficient personnel. Additionally, the use of electronic trancing devices requires IT support which may not be readily available in the hospital setting or is engaged in other support and cannot be present full time.

Naturally, people are accustomed to current circumstances and the security it accords hence they develop resistance to change. Due to the great comfort derived from the status quo, growth is inhibited and often becomes a psychological problem (Tappen et al., 2017). In the mental healthcare facilities, patients are usually maintained in their most potent state due to the violent scenes when free from sedates. The implication is that their metabolic rates are low leading to lifestyle diseases and other complications such as cardiovascular complications (Michael & MacDonald, 2020). The introduction of metabolic monitoring systems implies that both patients and caregivers have to go out of their way to keep track of patient metabolic rates and develop strategies to nurture optimal values through initiatives such as physical exercise, regular massage, and other methods that can improve their metabolism. Leaders must support staff, offer training, and assure them that the change is a positive initiative that will transform mental health care in the future.

Conclusion

In conclusion, the initiatives towards metabolic health monitoring help in the identification of physical problems mental health consumers face. Globally, the physical health of mentally ill patients is underprioritized. The metabolic monitoring forms among patients with mental illnesses are not filled up to maximize the potential benefits their contents can offer in developing a suitable individualized treatment plan. Consequently, the treatments or interventions to deal with metabolic issues are eliminated from the care plan which raises concern, especially under their sedated state. Therefore, healthcare facilities attending to mental health patients should make metabolic health monitoring a mandatory procedure to ensure patients access interdisciplinary treatment to boost their outcomes. Metabolic health assessments include biomedical measurements, routine monitoring, and referral for requisite interventions depending on the patient’s condition.

The process of implementing change is a challenge to all organizations, even in healthcare where initiatives are geared towards saving lives and improving the patient’s quality of life through comprehensive healthcare services. Therefore, ensuring metabolic health monitoring is carried out routinely must be implemented using a suitable methodology or model. In this case, Kottler’s 8-step model offers easy to follow steps through which the change can be implemented successfully and effectively such that all staff members feel part of the process. Besides, management of the model is planned to ensure adequate information on the importance of metabolic health monitoring is acquired, procedures are learned and workers develop a positive attitude towards its initiation and long-term vision fulfillment.

Implementing change also requires proper leadership. Leadership differs from management in that instead of focusing on planning and formulating strategies to guide the organization, leadership focuses on motivating and guiding staff on the best ways they can implement the proposed change. Various leadership styles can be adopted to facilitate metabolic health monitoring. However, transformational leadership is the most optimal because it nurtures all individuals into possible leaders which makes adoption of the change process easier, smoother, and more interesting. However, this does not mean that there are no barriers to overcome. Leaders face financial constraints that limit the capacity and extent to which the change can be implemented. The implication is that there are fewer staff members, less electronic monitoring devices, and other items that need to be acquired to make the change process a success. Also, they face acceptance barriers where some or all employees can decide to oppose the change for various reasons.