Factors influencing change management in a selected hospital in Saudi Arabia

Brand, Catharina Gertruida Maria (2013-03)

Thesis (MCurr)--Stellenbosch University, 2013.

Thesis

ENGLISH ABSTRACT: Saudi Arabia has experienced a number of changes due to revolutionary new findings and technologies, discoveries and new research in the health care arena, which has proven and contradicted a new approach to health care delivery. Demands by patients who have become more educated, the emergence of new or modern disease profiles which demand a new way of approach and a quickening in the pace of change, hurled unfamiliar and often demanding and challenging conditions at management One such change, as addressed in this study, is the change from a paper-based patient record system to a computer based patient information system to which all healthcare professionals in the multidisciplinary team had access to. However, not all change is welcomed, accepted or viewed as necessary by those who have to carry out or use new technologies. Change is harsh, and part of the problem is identifying factors that influence change initiatives. This study addresses the perceptions of nursing personnel of the process of change from a paper-based to a computer based (Quadramed) patient record system. The study design used a quantitative and descriptive approach in which a structured, self-designed questionnaire was used to obtain data from 117 professional nurses at a selected healthcare facility in the Eastern province of the Kingdom of Saudi Arabia. The theoretical framework used for this study was the Model for Change Management as designed by the Prosci Institute for Research, also referred to as the ADKAR Model of Change Management (Awareness, Desire, Knowledge, Ability and Reinforcement). The major findings of this study revealed that 97.44% of the respondents were non-Saudi individuals, and were mainly from the Philippines (69.24%), with (95.65% being female with an average age of 37-42 years. Most (47%) were in possession of specialty qualifications in medical, surgical nursing and experience between 8-10 years, of which 2-3 years had been in Saudi Arabia. In regard to 61.3% of the respondents it was found that they had no prior knowledge of computerised patient records. The nurse managers played a vital role in providing the most information and support to adjust to the system. With reference to the aspect of patient safety, positive feedback about the QCPR was provided by the majority of respondents. Most of the respondents experienced change positively, and 70% indicated that being involved played a major role in their positive attitude. Recommendations include that reasons for change should be more clearly communicated, suggestions for change should be valued more by managers and rumours and uncertainties about change should be addressed as and when appropriate.

AFRIKAANSE OPSOMMING: Saoedi-Arabië het 'n aantal veranderinge ondervind as gevolg van revolusionêre nuwe bevindings en tegnologie, ontdekkings en nuwe navorsing in die gesondheidsorg arena, wat 'n nuwe benadering tot die lewering van gesondheidsorg bewys en weerspreek. Eise deur pasiënte wat meer geletterd is, en nuwe en moderne siekte profiele eis 'n nuwe benadering tot verandering. Die versnelling in die tempo van verandering is dikwels onbekend, veeleisend en uitdagende vir die bestuur van gesondheidsinstellings. Een so 'n verandering, soos dit in hierdie studie aangespreek word, is die verandering van 'n papier-gebaseerde na 'n rekenaar-gebaseerde pasiënt inligting stelsel wat aan alle lede van die multidissiplinêre gesondheidsorg span toegang verleen. Nogtans word nie alle verandering verwelkom, aanvaar of as nodig beskou deur diegene wat die dienste uitvoer of die nuwe tegnologie moet gebruik nie. Verandering is gekompliseerde proses, en deel van die probleem is die identifisering van faktore wat 'n invloed op die veranderings inisiatiewe het. Hierdie studie fokus op die persepsies van die verpleegpersoneel tydens die proses van verandering van 'n papier-gebaseerde tot 'n rekenaar gebaseerde (Quadramed) pasiënt rekord stelsel. Die studie-ontwerp gebruik 'n kwantitatiewe, beskrywende benadering wat 'n gestruktureerde, self-ontwerpte vraelys gebruik om data te verkry van 117 professionele verpleegsters by 'n geselekteerde gesondheidsorg fasiliteit in die Oostelike Provinsie van die Koninkryk van Saoedi-Arabië. Die teoretiese raamwerk wat gebruik word vir hierdie studie was die model vir veranderingsbestuur soos ontwerp deur die Prosci Instituut vir Navorsing, waarna ook verwys word as die “ADKAR Model of Change Management” (Awareness, Desire, Knowledge, Ability and Reinforcement). Die belangrikste bevindings van hierdie studie het aan die lig gebring dat 97,44% van die respondente was nie-Saoedi-individue nie, en was hoofsaaklik van die Filippyne (69,24%), met (95,65%) vroue met 'n gemiddelde ouderdom van 37-42 jaar. Die meeste (47%) was in besit van gespesialiseerde kwalifikasies in mediese, chirurgiese verpleeging. Die meeste van die respondente het tussen 8-10 jaar ervaring in verpleegkunde gehad, waarvan 2-3 jaar in Saoedi-Arabië was. Met betrekking tot 61,3% van die respondente dit is gevind dat hulle geen vorige kennis van die gerekenariseerde pasiënt rekords gehad het nie. Die saal bestuurder het 'n belangrike rol gespeel in die verskaffing van die meeste inligting en ondersteuning om aan te pas tot die nuwe stelsel. Met verwysing na die aspek van die veiligheid van pasiënte, is positiewe terugvoer oor die QCPR voorsien deur die meerderheid van die respondente. Die meeste van die respondente het ook die verandering positief ervaar, en 70% het aangedui dat hul betrokkenheid 'n belangrike rol gespeel het in hul positiewe gesindheid. Aanbevelings sluit in dat die redes vir verandering duidelik gekommunikeer behoort te word, voorstelle vir verandering moet erkenning kry deur bestuurders en gerugte en onsekerhede oor verandering moet aangespreek word soos en wanneer toepaslik.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/80141
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