Applying Change Management to Physical TherapyEssay

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Quality Care and Change Management Within Physical Therapy

According to the European Association for Quality Assurance in Higher Education, "policies and processes are the main pillars of a coherent institutional quality assurance system" and this as true in education as it is in physical therapy (SEG, 2015, p. 12). Likewise, the European Region World Confederation for Physical Therapy has stated that "Quality Assurance (QA) covers both internal and external systems and was developed to move towards greater internationalization" (2015). Internationalization as the World Confederation notes is important because it provides a universal standard of training and care that allows patients to have direct access to quality care no matter where they are. Conformity to a standardized level of quality care in physical therapy is an exercise that can heighten and facilitate optimal treatment in physical therapy facilities. Thus, the World Confederation for Physical Therapy has recommended a change management system that fosters the ability to meet the needs of "a global community of physical therapists, where everyone feels connected" (WCPT, 2016, p. 22). This type of connectivity demands a new system of orientation and integration among localized physical therapy facilities as they strive to become part of an international collegiate wherein direct access can be sustained and quality assurance maintained across borders, via connectivity, sharing of information, and support networks. This paper will discuss a change management system that can help localized physical therapy facilities to integrate themselves into the stated aim of the World Confederation for Physical Therapy (WCPT) as stated at its 2016 Conference in Limassol.

The specific change management targeted identified herein is the integration of our facility with that of the WCPT facilities looking to align themselves in terms of data and directional courses for the better establishment of a supportive network of physical therapists.

The rationale for the need for a global community of physical therapists is located in the issues stressed by physical therapists in response to the WCPT's survey: it is based on the concept that 1) a "community has global influence and brings about changes to health policy and practice," 2) that a community of this nature can promote physical therapy values more efficiently and effectively, 3) that a community can more readily share knowledge and advancements within the industry, and 4) that a community can command more respect within the health care industry (WCPT, 2016).

Enhancing Quality

As England's Care Quality Commission (CQC, 2014)) own use of an "intelligent monitoring" system has enabled the Commission to provide more accurate data on quality of care within the health care industry, the aim of the WCPT's call for quality assurance on a global scale via the integration of physical therapy facilities in a global community emphasizes the need for sustaining the same level of quality care intelligent monitoring that the CQC utilizes. Thus the goal in our facility is to effect a system that is oriented towards integrating our procedures and databases with those of the rest of the community in the WCPT.

Thus the change that is intended to be implemented in this project is for a more unified structure of standardized care among physical therapists as they provide more data, knowledge and information among one another through a process of integration and networking that facilitates the objectives of the community.

Key Theoretical Knowledge

The relevant literature on this particular change management system include McGregor (2004) who notes that change management is synonymous with quality management and that "quality and change are similar concepts because they both imply movement and are not finite states," (p. 3). It is also located in the concept of "spirit of mission" identified by Samaan and Verenuil (2009) in their study of the emergency response to Hurricane Katrina: they showed that a unified and coherent "spirit of mission" within an organization is essential to formulating an effective response strategy -- and this concept translates equally well to the fostering of a community of physical therapists working to overcome obstacles within their field and provide optimum levels of quality care to patients. Supporting this change management system will be literature that defines the necessary leadership qualities for producing effective outcomes, such as Luthans (1988), whose study on successful vs. effective leadership highlights specific leadership characteristics that are essential in a change management system implementation; Mayer and Salovey (2001), who underscore the importance of developing Emotional Intelligence among leaders and care givers; and Cavazotte, Moreno and Hickmann (2012) who emphasize the role of leadership, personality, and EI in the role of transformational leadership which can be used to facilitate the change management process.

Management Processes

Key government drivers throughout this process are the role of globalized society as reflected in various governmental projects, such as EU integration, trade deals like that Trans-Atlantic Trade and Investment Partnership (TTIP) and Trans-Pacific Partnership agreements being discussed by various nations around the world, and the concept of corporate solidarity as a means of providing effective control and care. These are designed to provide better security for workers, stability for the economy, and support for integrated jobs -- and these too serve as drivers for a greater global community of physical therapists (Office of the United States Trade Representative, 2015). As Porter and Lee (2013) observe, care providers must move "toward a patient-centered system organized around what patients need" with "patient outcomes" being the standard objective of practitioners. This is not only the opinion of health care experts but also what is interpreted from analysis of statistical evidence presented by the WCPT, which shows that there is too much disparity among communities in terms of the ratio of physical therapists to populations: "The 2011 returns have revealed that estimates of the ratio of physical therapists to populations range from a high of one to 354 people in Finland, to a low of one to 530,375 in Malawi" (WCPT, 2014). Clearly this indicates that without better coordination among the global physical therapy community, localized communities will continue to suffer from a lack of proper care and provision from physical therapists. Key management processes that will be utilized in order to meet these drivers are the concepts of leadership styles discussed below (Transformational, Servant, Democratic).

Existing policies in terms of integration among physical therapy providers are lacking in a change management plan that can implement the needed communication and sharing so as to solidify the community and enable it to grow and respond to the variations that undermine the collective need provide for all areas. This need is addressed in the following pages.

Relevant areas for quality enhancement in service provision are evident in the WCPT's statistical analysis of physical therapists to population ratios among its member nations, which shows that there is a need for more physical therapists to contribute to developing parts of the world where the ratio is lower than in developed parts of the world. Quality enhancement via communication methods among member groups and facilities can allow therapists to engage with one another and achieve effective results in supporting communities that are in need.

The basis for the implementation of this proposed change management system is the concept of integrative mechanics among operators as stipulated by Victor and Franckeiss (2002) who state that "organizational change is a complex activity that requires structure and process to be effective" (p. 35). For proper integration among physical therapists within the WCPT, a stated objective needs to be clearly defined with a guide for how to achieve the objective, measure success, and implement modifications post-review.

The first step that is necessary is to define the current state of the physical therapy community and the problems that need to be addressed through the change management system. The second step is to define the future state -- i.e., the state of the industry that the change is meant to effect. The third step is identify the key implementers, that is, the necessary roles of participants from managers to staff at local facilities to their function within the larger community in terms of sharing communication, data, information, and knowledge. The fourth step is review the implementation process, make adjustments accordingly so that the process is in line with goals, and reward participants for meeting objectives; incentivizing participants is a way to accelerate and reinforce strategic aims (Kissack, Callahan, 2010; Rogers et al., 2015; Liden et al., 2014). The fifth stage is to use model metrics to serve as a comparison of progress and where it should be in the overall initiative. Victor and Franckeiss (2002) it as the 5 D's: "Direct, Describe, Define, Deliver and Develop" (p. 37). This is essentially the strategy to be employed by the WCPT and the localized member physical therapist facilities as they streamline their integrative approach to working together in order to fill the gaps in service in specific regions and to boost their overall strategy of providing optimum level quality care to patients.

Management and leadership concepts that are essential to the success of this operation include Transformational Leadership, Servant Leadership, and… [END OF PREVIEW]

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