Harvard Case - Killing the Pager at ZSFG
"Killing the Pager at ZSFG" Harvard business case study is written by Michaela J Kerrissey, Masha Kuznetsova. It deals with the challenges in the field of General Management. The case study is 15 page(s) long and it was first published on : May 16, 2023
At Fern Fort University, we recommend ZSFG implement a phased approach to eliminating pagers, leveraging a combination of technology, organizational change, and stakeholder engagement. This strategy aims to improve communication efficiency, enhance patient care, and foster a more modern and technologically advanced work environment.
2. Background
This case study focuses on the San Francisco General Hospital (ZSFG), a large public hospital facing challenges with its outdated pager system. The pager system, despite being widely used, suffers from limitations in communication speed, accuracy, and integration with other systems. These shortcomings hinder efficient patient care and create frustration among staff. Dr. David Kim, a physician at ZSFG, champions the need for a more modern communication solution, facing resistance from some colleagues who are accustomed to the pager system.
The main protagonists are:
- Dr. David Kim: A forward-thinking physician advocating for a more efficient communication system.
- Dr. Susan Jones: A senior physician representing the perspective of those who are comfortable with the existing pager system.
- ZSFG Management: The hospital administration responsible for making decisions about technology adoption and organizational change.
3. Analysis of the Case Study
Strategic Framework: This case study can be analyzed through the lens of Organizational Change Management and Technology Adoption frameworks.
Organizational Change Management:
- Resistance to Change: The case highlights the resistance to change among some staff, particularly those accustomed to the pager system. This resistance stems from comfort with the familiar, fear of the unknown, and potential disruptions to established workflows.
- Communication and Stakeholder Engagement: Effective communication is crucial to overcoming resistance and ensuring successful implementation. ZSFG needs to engage all stakeholders, including physicians, nurses, and administrative staff, in a transparent and collaborative manner.
- Leadership and Sponsorship: Strong leadership and sponsorship from key individuals, like Dr. Kim and hospital administrators, are essential to drive the change initiative and build trust among staff.
Technology Adoption:
- Needs Assessment: ZSFG must conduct a comprehensive needs assessment to understand the specific communication requirements of different departments and roles within the hospital. This assessment should consider factors like patient safety, emergency response, and interdepartmental communication.
- Technology Evaluation: A thorough evaluation of available communication technologies is necessary, considering factors like cost, reliability, ease of use, integration with existing systems, and security.
- Pilot Program: Implementing a pilot program in a specific department or unit allows ZSFG to test the new technology, gather feedback, and refine the implementation strategy before rolling it out hospital-wide.
SWOT Analysis:
- Strengths: ZSFG's commitment to patient care, its strong reputation, and its existing infrastructure can be leveraged to support the transition.
- Weaknesses: Resistance to change, outdated technology, and potential budget constraints are challenges that need to be addressed.
- Opportunities: Improved communication efficiency, enhanced patient safety, and a more modern work environment are potential benefits of adopting a new communication system.
- Threats: Potential technical issues, cost overruns, and staff dissatisfaction are risks that need to be mitigated.
4. Recommendations
Phase 1: Pilot Program & Stakeholder Engagement (6 months)
- Select Pilot Department: Identify a department with a high volume of communication, such as the Emergency Department, to pilot the new communication system.
- Technology Selection: Conduct a thorough evaluation of available communication technologies, considering factors like cost, reliability, ease of use, integration with existing systems, and security.
- Pilot Program Implementation: Implement the chosen technology in the pilot department, providing comprehensive training and support to staff.
- Data Collection and Feedback: Collect data on communication efficiency, patient satisfaction, and staff feedback during the pilot phase.
- Stakeholder Engagement: Engage all stakeholders, including physicians, nurses, and administrative staff, in open forums and discussions to gather feedback, address concerns, and build consensus.
Phase 2: Hospital-Wide Rollout & Continuous Improvement (12 months)
- Rollout Plan: Based on the pilot program results, develop a comprehensive rollout plan for the entire hospital, considering factors like staff training, system integration, and communication strategy.
- Training and Support: Provide comprehensive training and ongoing support to all staff using the new communication system.
- System Integration: Ensure seamless integration of the new communication system with existing systems, such as electronic medical records and patient monitoring systems.
- Continuous Improvement: Establish a process for ongoing monitoring and evaluation of the new communication system, gathering feedback from staff and patients to identify areas for improvement.
Phase 3: Long-Term Sustainability (Ongoing)
- Technology Upgrades: Develop a plan for regular technology upgrades to ensure the communication system remains current and effective.
- Staff Training and Development: Provide ongoing training and development opportunities for staff to stay up-to-date on the latest communication technologies and best practices.
- Communication Strategy: Develop a clear communication strategy for disseminating information about the new communication system and addressing any concerns or issues that arise.
5. Basis of Recommendations
These recommendations are based on the following considerations:
- Core Competencies and Mission: ZSFG's mission is to provide high-quality healthcare to its community. Adopting a modern communication system aligns with this mission by improving patient care and communication efficiency.
- External Customers and Internal Clients: The new communication system benefits both patients and staff by facilitating faster and more accurate communication, leading to improved patient care and a more efficient work environment.
- Competitors: Other hospitals are increasingly adopting modern communication technologies to enhance patient care and improve operational efficiency. ZSFG needs to stay competitive in order to attract and retain top talent.
- Attractiveness: The benefits of the new communication system, including improved patient care, increased efficiency, and a more modern work environment, outweigh the costs of implementation.
6. Conclusion
By implementing a phased approach to eliminating pagers, ZSFG can achieve significant improvements in communication efficiency, enhance patient care, and foster a more modern and technologically advanced work environment. This strategy requires strong leadership, effective communication, and a commitment to continuous improvement.
7. Discussion
Alternatives:
- Maintaining the Status Quo: This option would maintain the existing pager system, but would continue to suffer from the limitations of outdated technology.
- Immediate Hospital-Wide Rollout: This option would involve a faster implementation timeline but could lead to greater resistance and challenges in system integration.
Risks and Key Assumptions:
- Resistance to Change: The success of the implementation depends on overcoming resistance to change among staff.
- Technology Integration: Seamless integration of the new communication system with existing systems is crucial for success.
- Budget Constraints: The project needs to be carefully budgeted and managed to ensure financial sustainability.
8. Next Steps
Timeline:
- Month 1-3: Needs assessment, technology evaluation, and selection of pilot department.
- Month 4-6: Pilot program implementation, data collection, and stakeholder engagement.
- Month 7-12: Rollout plan development, training, system integration, and continuous improvement.
- Month 13 onwards: Long-term sustainability, technology upgrades, and staff development.
Key Milestones:
- Successful completion of the pilot program: This milestone will demonstrate the feasibility and effectiveness of the new communication system.
- Hospital-wide rollout of the new system: This milestone will mark the transition to a more modern and efficient communication environment.
- Continuous improvement and feedback: This ongoing process will ensure that the new communication system remains effective and meets the evolving needs of ZSFG.
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Case Description
This case is about organizational change and technology. It follows the efforts of one physician as they try to move their department past using the pager, a device that persisted in American medicine despite having long been outdated by superior communication technology. The case reveals the complex organizational factors that have made this persistence possible, such as differing interdepartmental priorities, the perceived benefits of simple technology, and the potential drawbacks of applying typical continuous improvement approaches to technology change. Ultimately the physician in the case is not able to rid their department of the pager, despite pursuing a thorough continuous improvement effort and piloting a viable alternative; the case ends with the physician having an opportunity to try again and asks students to assess whether doing so is wise. The case can be used in class to help students apply the general concepts of organizational change to the particular context of technology, discuss the forces of stasis and change in medicine, and to familiarize students with the uses and limits of continuous improvement methods.
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