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Managing organizational change

Answer 1 Kotter’s 8 step model – Implementation of Fortis operating system
Create urgency- potential threats, opportunities,

Fortis required the operating system to take care the routine which includes the local area needs and
making the bookkeeping activities. It is analyzed by the Shivinder that patients' health care is crucial and
for that appointments are required on time as he had faced the issue of delaying appointment, misplaced
reports, shifting from one department to another, issues related to bills and poor responses in emergency
situations. They got the opportunity to attract customers from all around the world. The adequate public
investment provided the opportunity for growth. Standardization was required in the Fortis hospitals
which are located in different areas of India. In order to build a meaningful network with high quality and
standardized operating procedures of the hospitals. It is required for the various patients facing non-
clinical processes which were impacting the patient's satisfaction and predictability and efficiency. It was
essential to implement the operation system in Fortis for making the process easy and competitive
advantage as the other players was growing in health care. It was required for giving the proper care to
the patients.

Form a powerful coalition

The top team is involved in the implementation of the Fortis operating system Team for working together.
The steering committee was included in the implementation process were Shivender and Daljit, the Chief
operating officers of the Fortis, head of the Medical Operations Group, head of finance, human resources
and Vaidya from McKinsey. The consultant required the involvement of stakeholders for effectively
understanding the situations. Daljit coordinated with the McKinsey in the process of implementation. Full
time and strong internal teams were required for the change in the organization. The steering committee
has provided the six high-performing and high-potential individuals for taking the initiative full time in
the process of the project. Along with the Ashish and Vaidya, six staff members were involved from the
different functional areas and for the purpose of screening, 30 high potential staff members were included
who are from last 5 years with fortis. It was implemented for building the next generation of leaders in the
Fortis system. For the effective team, the well-defined standards operating procedure were followed for
the key patient-related processes and including the driving services excellences. Effective management
was required for providing services like pharmacy, food and beverages and housekeeping. The criteria
were selected with the help of FOS for the departments.

Developing a vision and strategy

The vision of the Fortis was to create the world-class integrated health care delivery system in India and
also entailing the finest medical skills combined with compassionate health care. The mission of Fortis to
provide excellence in service delivery. It was developed by the management for ensuring to provide
uniformity, high quality of services, efficient and predictable services to patients. The objective was to
make the journey of patients informed and pain-free and for recognizing the state of vulnerability. It is
implemented for the optimum utilization of resources like OPD’S, inpatient beds, OTs, ICUs,
admissions/discharge processes. The strategy was to build leaders for tomorrow and the growth of the
organization. It was analyzed that the issues were occurring the outside of clinical domains like delay in
reports, patient crowding, OT scheduling, and unsmooth step-downs from ICU to regular wards. DMAIC
methodology training was given to staff members and for implementing the change. A powerpoint
presentation was given for the scorecard metrics. The vision was to embed the best practices in the
operational efficiency to yield bottom line impacts. It was essential for facilitating performance
management and standardizing the metrics, tools, and templates.

Communicating the Vision

After analyzing the vision and strategy, it was important to get the clinicians on board the project. It was
necessary to convey the vision clearly to clinical as well as non-clinical areas for supporting the work in
the hospital. The interview was conducted by Vaidya to understand the pain points. It is analyzed by the
Daljit, in order to obtain buy-in from stakeholders for the implementation and the stakeholders included
are the clinicians, nurses, medical staff and administrators and it was challenging to deal with the routine
activities. Powerful communication is required for forwarding the catalyzing the change. Extensive
communication is required by the staff at all levels for making them understand the benefits of the
change. The FOS was implemented at the different locations for providing te initiative with high
visibility. In order to communicate the process, the meeting was conducted with core team and head of
departments for analyzing the needs and benefits of the change. For the core team, boot camp was
managed at the offsite location which also included the department heads like pathology, Radiology,
outpatient, emergency and OT. A steering committee was involved in the boot camp for sending a clear
signal to the top management for the involvement and commitment. The strategic expectations and
approaches help in strengthing the ownerships and commitments for the change in management and
systems.

Removing obstacles

It is necessary for the organization to remove the obstacles and ensuring the structure and processes to be
aligned perfectly with the vision of the organization. The team of Fortis operating systems includes the
various processes for analyzing and removing the obstacles are processes in department, patient flow
processes and performance management system by reviewing the scorecard and review process.the
obstacles were analyzed in the discharge process and improvement ideas are required. With the help of
DMAIC, employees and staff were actively participating in the process documentation exercises. For the
resources and tasks re-allocation, the FOS scorecard was framed. In the scorecard, 12 assets were
considered for functioning. In order to measure and reviewing the performance, and for that the steering
committee has set the overall direction and getting the results of the program and monitoring the progress.
The challenge which they faced in implementing the FOS is to ensure the consolidation of changes and
the sustenance of gains for achieving, there will be drop in the energizing the presence of the top
management and external consultants. It will take a huge time to complete the whole process.

Create short term wins

The management decided to implement the change firstly in one hospital in Mohali for analyzing the
situation. The plan was to enroll in next two hospitals after some time and then in remaining hospitals.
They had made the plan to keep two core team members to stay in Mohali for institutionalizing and for
initiating the change in other hospitals the other core team members were sent to different locations. The
obstacle was to implement the system in small locations and whether it will be accepted.

Consolidating gaps

In order to negate or minimize the impact of a gap, McKinsey played a crucial role by fulfilling the need
of internal team and preparing them for facing the challenges which may arise in the process. For the gap
DMAIC was implemented for FOS which includes defining, measuring, analyzing, improving and
controlling the system. The purpose was to establish the case for improving by understanding the things
with the help of improving by analyzing and benchmarking. It requires identifying specific areas for
improving primary and secondary information. in the step of analyzing the selecting of issue and
generating the ideas for improvements are required for problem-solving. For controlling and embedding
the process the tools are required to ensuring sustainability.

Anchoring change in the corporate culture

For the success of FOS, the initiatives are taken for grabbing the opportunities. FOS has become an
integral part of the organizational culture. It helps in ensuring the support of the business functions and
provided the benefits for the patient's health care and providing the information on time. Change is
considered as the continuous improvement methodology for the benefits of the organization.
The online facilities are provided to the patients and staff which helped in making the process easy as the
greenfield and acquisition and in the management contracts. Support from the management is provided
for implementing the FOS in the remaining hospitals at different locations. The leaders of the company
are identified for making the effective use of the system in future. The change is supported by the
management for implementing the FOS and making the required changes in taking care of the patients. In
the small town hospitals, it will be effective for providing quality by kick start the process. Challenges
will be faced by the organization in future in the operating system which will require the update in the
version of the system. The changes will be seen in the process of the organization. The availability of
beds will be increased with the implementation of the system by admitting the patients on the day of
operation and tests are conducted in the OPD. It is necessary to maintain the excitement in maintaining
the initiative and resulting for better environment with the implementation of FOS.

Answer 2. Change initiative

McKinsey & Company was hired as the consultant for the development of FOS. It was effective for the
Fortis hospital as they make the operating systems for Reliable, repeatable and Replicable. They had
played a significant role in changing the system in Fortis. It was effective for the Fortis as the process was
implemented at one location for analyzing and understanding the process. They had played a crucial role
in facilitating the change in providing the services as the test bench was adopted for implementing the
FOS. McKinsey provided support to the organization. FOS by McKinsey helped the organization in
providing the comfort level by providing basic rights as compared to the other competitor hospitals. The
consultant has adopted the strategy to make the business effective and gathered the information from the
departments for effectively implementing the FOS in hospitals. The process of the organization was re-
engineered which helped the organization in effectively implementing the FOS. The feedback was also
gathered by the team for making the required changes according to the needs of the business and
management. The aim was to provide the improved values and they effectively removed the bottlenecks.
They helped in creating the manuals for the different departments. They had set the benchmark for setting
the parameter. They had implemented the FOS bu understanding the background and facilitated the
finding of solutions. Full time was given to the organization and also involved the single-window
approach and gathering the information of the patients.

The system provides counter personnel with all the technical support needed to resolve any queries a
patient may have. The patient can even know the waiting time of the facility before registration. The
critical analysis of the resources was included for creating high-end patients and without charging the
patients and their requirements. The had justified the costs in implementing the change. FOS has provided
various benefits to the organization by giving the various benefits and facing the issues which may arise
in future. They had influenced the senior physicians for making them experts and providing the intended
training to the staff and clinicians for understanding the change and retaining the employee. FOS helped
in providing the facilities to the various department and intensive training was helpful for the core team
for understanding the process and change which are required by the organization. The workflows were
included by the team for providing the health care system and involved the people for consistently
reviewing and measuring the performance of the organization. It was an effective decision. The initiative
taken by consultant was effective for measuring and reviewing the performance of the organization. It
helps the organization in making decisions related to different business functions. It helped in making the
process easy by limiting the back-end support at the first location. The steering committee has gained the
knowledge and information from the consultant regarding the event. For the high-potential, it is analyzed
that the high performance and potential are required for scheduling and disparate of the organization.

It was realized by the team of McKinsey that the change is required and they effectively provided the
team for the internal change and team was provided at the different location of the hospitals. The process
helped the organization in providing the effective services to the people. The effective team was provided
for effectively implementing the change in the organization.