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Organizational Change Part I

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Organization Change Plan Part I

Crystal Robinson

HCS/587

Organizational Change Introduction

Every organization or company will experience change on a large scale at some point in time. Change occurs everyday in personal lives and in businesses, like the time of day changing or the way task are completed are not exactly done the same each time. In a business or organization it is important for the staff to understand the need for the change. Understanding the need for the change is not just for the betterment of the organization but also for the employee to understand the importance of their role in change for the business or organization. Providing better access and resources to health care in Maryland State Correctional Institutions has become a major focus for management. There is a huge lack of services and resources especially in the pretrial division of Maryland State Correctional Institutions. The concern is not just inmate or patient satisfaction but a concern for the safety and health of those responsible for detaining these inmates. This paper will examine the need in Maryland State Correctional Institutions for a change in inmate access to healthcare and healthcare resources especially in the pretrial division. It will also identify factors that will influence changing inmate access to healthcare and summarize those factors that can prepare the organization to this change. A theoretical model that is relative to changing inmate access to healthcare and resources will be identified as well as internal and external resources to assist the change will be explained.
Need for changing inmate access to health care in a Pretrial division Currently in the State of Maryland individuals in the control and custody of the Department of Corrections receive health care services through the “Office of Treatment Services” (DPSCS.org, 2013). The focus for these health care services are not on medical health issues but on mental health problems and substance abuse issues. While substance abuse and mental health issues plague the State of Maryland residents (Ricky Foxwell (personal communication, September 26, 2013), many inmates come into the correctional facilities with pre-existing health care issues like hypertension and diabetes that usually go undetected in the pretrial division. Inmates in Maryland State Correctional facilities do not receive a thorough medical evaluation until they are sentenced and housed in a prison environment for the duration of their stay or until transferred. They do not receive a full range of services in pretrial other than mental health and drug abuse screenings. Offenders or detainees can spend anywhere from one day up to two years in pretrial detention before they are sentenced (DSPCS.org., 2013). This can be strenuous to an inmate with a pre-existing condition living in a pretrial detention facility for two years. The pretrial detention facility in Maryland State employees two nurses, one doctor who specialized in mental healthcare, six case management specialist ranging from supervisory to trainee levels. These employees are not equipped to thorough address medical problems of inmates should they arise. If an inmate needs medical treatment in pretrial detention they are escorted and transferred to local hospitals. This produces a need for additional manpower, possible escape attempts, unpredicted overtime cost, and a slew of other issues. According to California Healthcare Access (2004), “Inmates are frequently in poor health, and diseases such as tuberculosis, AIDS and hepatitis can spread easily” (p. 656). In 2008, Pretrial Detention and Services experienced, what can be described as an epidemic, of employees and inmates suffering from staph infections (Ricky Foxwell (personal communication, September 26, 2013), that was founded to have been initiated from a inmate on work detail. These are some reasons why changing inmate access to healthcare in a pretrial division is necessary.
Organizational and individual barriers to changing inmate access to healthcare One relevant organizational barrier to changing inmate access to health care is the lack of skilled and licensed medical professionals available to pretrial detention services. The salaries for medical professionals are not even close to parity to private sector. All positions regardless of importance is budgeted according to availability. A Nurse's starting salary in the State of Maryland is around $39,000 a year regardless of past experience, and working in a correctional institution is not appealing to many in the field. Maryland correctional facilities have similar issues to prisons in Britain “The prison health system is failing to attract sufficient numbers of new staff `due to appalling working conditions', according to a report by the British Medical Association” (British Journal of Nursing, 2001). Not only are the building conditions deplorable but many medical professionals do not want to risk their safety taking care of inmates. Also remember that medical professionals outside of Case Management Specialist do not have access or prior knowledge of why these offenders are in custody. Some are murders, rapist, and burglars awaiting trial and sentencing. This is a safety issue in itself. Individual barriers are lack of medical training for staff, fear for their safety, employee dissatisfaction and unrealistic changes like huge increases in salaries, or just not understanding the need for the change and how it could affect them as employees.
Internal and external factors that might influence inmate access to healthcare When the Pretrial division experienced more than twenty (20) employees and a undisclosed number of inmates with staph infections that was the biggest influence to changing the access that inmates have to medical healthcare. Another factor that can influence inmate access to healthcare is not having adequate equipment and materials to track and treat inmates health care issues (Science Letter, 2004). In the Pretrial division unless an employee has been issued a State cellular phone, they cannot enter the premises with a phone. Also, computer and internet usage is limited and blocked, making some medical resources nearly impossible to access without books. Perusing through a book to find the right medication for inmates can be time consuming and with the lack of modern medical technology it can stall coordination and communication across the healthcare system (Science Letter, 2004).
Identify the theoretical model that relates to your proposed change In an article titled “It's just a phase we're going through: A review and synthesis of OD phase analysis (1985)” the authors have encompassed what they describe as the seven essential steps or phases in a theoretical change model into four basis steps that is needed for successful organizational change. This analysis was based on assessing Lewin's, Hertzberg's, Lippits, and other change models and what each one lacks and what each one has (Bullock & Batten, 1985). It is the newest theoretical change model and consist of four change phases; exploration, that includes needs awareness; search; and contracting (Bullock & Batten, 1985). Exploration is identifying the need for the change and the expectations of what the change can accomplish (Bullock & Batten, 1985). Planning is inclusive of diagnosis; design; and decision. Planning should define what exactly needs to be done. Create a plan and move right into phase three, the Action Phase. Action phase is the implementation and evaluation phase. When action occurs the developed plan is being used and assessed by management and users along the way. During the action phase smaller changes for accuracy can and should be made. Integration is the final phase of the Four Phase Change Model and the organizational change has been defined, developed, implemented and assessed, and now ready for finalization (Bullock & Batten, 1985). Using this new four phase change model will open the door for management/employee communication and eliminate a misunderstanding for the need of the change because the employees that are involved in the change will have continuous information.
Internal and external resources available to support your change initiative Resources in changing inmate access to health care can come from many avenues internally and externally. Management can document that hiring medical professionals at the salaries available creates hard to fill positions and request additional funding to hire adequate staff. Another resource would be questionnaires and survey for inmates and current staff to complete to access needs and gain more ideas. Open the door for current staff to be re-educated to obtain licensing and other opportunities for advancement. Partnerships and collaborations can be made with community colleges and medical institutions for training purposes. Current students needing teaching time or volunteer hours can become interns at the correctional facility to increase skilled professional existence. Another external resources that can double as part of the action phase is to collaborate with community medical facilities for free medical treatment for inmates in pretrial who after an assessment demonstrates the need for medical treatment not available to them through the correctional facility.
Conclusion
There are many reasons that inmates need access to healthcare services that have been outlined in this paper. Utilizing the Four Phase Change Model will assist in employees and management understanding the need for the change in inmate access to health care, will improve staff moral by maker the work environment safer. Providing better access and resources to health care in Maryland State Correctional Institutions will improve on the treatment received from inmates to staff and improve on treatments offered to detainees.

References

Bullock, R. J., & Batten, D. (1985). It's just a phase we're going through: A review and synthesis of OD phase analysis. Group & Organization Studies (Pre-1986), 10(4), 383. Retrieved from http://search.proquest.com/docview/232429284?accountid=458.
Healthcare access; California state prisons should mirror federal prison healthcare, senators say. (2004). Science Letter, , 656. Retrieved from http://search.proquest.com/docview/209275988?accountid=458.
Inmate services. (1993 – 2013). Maryland Department of Public Safety and Correctional Services. Retrieved from http://dpscs.maryland.gov/aboutdpscs/index.shtml.
Prison healthcare system is in 'appalling' condition. (2001). British Journal of Nursing, 10(8), 488. Retrieved from http://search.proquest.com/docview/199471185?accountid=458.

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