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Xanda hospital overview

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Participants

A sample staff of 350 hundred employees from Xanda hospital would be randomly collected through the human resources files of the institution and these included staff from various sections of the hospital operations (e.g. physicians, nurses, biomedical specialists, laboratory specialist) from three different departments where the project is to be rolled out first.

Procedure

Given the complex and sensitive nature of the hospital environments, participants would need to be engaged at different times to avoid disruptions to the operations of the departments involved in the study. Therefore, some of the employees would be invited to a briefing at which the whole program of change is explained to help bring them on board as participants for a 10 minutes discussion, after which the survey questionnaires would be administered, taking approximately 40 minutes for all the assessment, until all the information is collected from all the departments involved. The information would then be analyzed using action research method. Having established the concerns, problems and challenges, the employees would then be engaged on the solutions and then change program using the discussed models to implement the change and the staff trained on how to utilize the technology. After completion of the final phase of the implemented change, a survey would be conducted to assess the progress made with the use of the new technology after three months and another one after six months.

Measures

The participants will be measured on different constructs that were instrumental to implementing the change process at Xanda hospital which included; Risks of change and self-efficacy job change, quality of service and psychological measures.

Psychological Measures

Readiness for organizational change: The ORC instrument consists of 18 scales grouped into four sets for measuring staff perceptions about the adequacy of program resources, counselor attributes, work climate, and motivation or pressures for program changes. The scales contain an average of six items apiece, each scored on a five-point Likert scale ranging from strongly disagree to strongly agree. On average, the ORC requires about 25 minutes to complete. Principal components analysis confirmed the scales’ factor structure, coefficient alpha reliabilities showed they have adequate levels of psychometric internal consistency, and their relationships with selected indicators of client and program functioning yield good predictive validities. The primary respondents to the ORC usually are the staff members in units that have direct service-related contact with clients. Selected components of the ORC are completed to meet distinct organizational purpose to achieve a common mission of assessing change. To provide adequate group representation as well as to preserve personal anonymity, subunits should include no fewer than three respondents level enables the organization to pinpoint the status and readiness to change of each of its separate functional components (Simpson & Dansereau, 2007; Lehman, Greener & Simpson, 2002).

Risks of change and Self-efficacy job change

Job insecurity. A 6-item 5-point (strongly disagree to strongly agree} scale (alpha=.65) measured job insecurity to assess the level of job insecurity by the employees because of the technological changes being introduced (Greenhalgh & Rosenhlatt. 1984).
Self-efficacy job change. Confidence in one’s ability to cope with job change, the transferability of job skills, and job prospects will be measured with a 5-item 5-point (strongly disagree to strongly agree) scale developed specifically for use at Xanda hospital (alpha= .80).

Quality of Service

Attention to quality improvement This measure was a 5-item, 5-point (poor to excellent to don’t know) scale based on the Hospital Corporation of America’s questionnaire (Hays, 1994) plus additional items examining staff perceptions of the hospital’s commitment to quality improvement (alpha=.88). For example, staff rated the emphasis placed on evidence to guide improvement of quality in care and services’.

Interviews and focus group discussions

Interviews and focus group discussions will also be conducted to gather more detailed information in additional to the measurements that will be taken through the survey questionnaires. The purpose of the interview would be to allow for one-to-one discussion with selected individuals in the hospital, while the purpose of focus group discussions would be to study especially the teams and their patterns of behavior in view of the changes being undertaken at hospital and departments as well as encourage interaction and discussion on the changes. This assessment will be especially relevant at group or team level analysis.

Results Analysis

Analysis of results was mainly through descriptive statistics. The results were analyzed using one-way repeated measures analysis of variance (ANOVA) as we wanted to understand if there were significant differences in the change intervention measured over the two different conditions prior to the intervention and after the intervention in the change process over a two months period. This is designed to check whether there is a difference before the change was implemented as well as after the change was implemented, which would be essential in assessing the change. The same constructs are measured before and after the change. these results will also be supplemented by the interviews and focus group discussion to understand the hospital environment considering the change.

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