Selene James
This section of the project will focus on expounding and justifying the various interventions which will be supported by literature on the same. The RFP response entailed developing interventions to the tasks that would be fulfilled in the project. This section will substantiate these responses by giving a psychological view on the matter and addressing how the DHMC will benefit from these tasks. Furthermore, the objective will be to expound on the responses in a manner that relates to how health care providers in California should interact with people with disability. It also gives a psychological view on how people with disabilities should be treated and how best to adopt the recommendations into the DHMC project. This will be expounded on each task in the order of how they were presented in the earlier document. This section will also give substantiation of the recommendations in relation to how different literature and theories in psychology function. Historical, current and proposed information will also be synthesized into these recommendations to make it demonstrate the face of I-O Psychology in the field of health care provision. The substantiation will also be directly related to how a psychologist would discuss with the RFP client in an informal setting to justify each recommendation.
Training Needs Analysis and Training Guide Development
The first and subsequent tasks will entail forming a group that would develop a road map to the development of educational and training resources for healthcare providers dealing with persons with disability in California. A study conducted by McNeal, Carrothers and Premo (2002) which surveyed 2000 health providers in California revealed that 68 per cent of the respondents indicated that they did not receive any training in medical school on issues of physical disability. Therefore, there is a need to train health care providers on how to deal with different kinds of disabilities such as mental, physical and emotional disabilities. I/O psychologists will evaluate the training needs and create a training program with the help of health care experts. There are different kinds of specialists who would be resourceful in ensuring that the right development materials are identified. Disability experts would be required because they know how to deal with disabled people. It is their area of specialization and they can easily identify the materials required for the enhancement of service provision. It is important to evaluate cognitive factors in order to understand how individuals learn by having feedback. I/O Psychologists come in because they have an in-depth understanding cognitive behaviour of different people and what influences those behaviours. This is based on the cognitive-behavioural theory which plays a central role in changing behaviour. Thoughts or cognition of a client influence their behaviour and consequently how they change their behaviour. For example, negative beliefs or thoughts may make it almost impossible to create positive behavioural change in a client. A psychologist can assess and determine the behaviour and reaction of the health care providers, workers in the health care systems and their attitude towards people of disability. Cognitive strategies will then be used to change their faulty thinking and irrationality towards persons with disability. The interventions can only be successful if healthcare providers have a positive attitude which will create positive outcomes. Training needs analysis will be important in helping the team of experts identify educational material that would train these people on how to deliver quality services to disabled people. Psychologists would also come in handy in ensuring that the experts make the right decisions concerning health care employee attitudes. Social learning will also be incorporated in the training process. The most effective training technique is through observation and modelling behaviour, emotional reaction and attitudes of others. Employees who will act as role model will be identified basing on their cognitive ability. The will receive additional training on how to guide others after the formal training process. An empirical study conducted by Bandura (1973) on aggression revealed that human beings learn aggressive behaviour through observation learning. Bandura argued that people who saw filmed role models engage in aggressive behaviour are more likely to be aggressive. Similarly, creating positive role models among health care providers who are knowledgeable, kind and helpful to persons with disability will encourage other health care providers to be friendly and helpful to persons with disability through imitation. The importance of having a workforce that is positive in order to ensure success of the interventions proposed cannot be overemphasised. Formal training will also be used to enhance the knowledge and skills of employees on the proposed system. Both a class set up and practical set ups will be used. Brum (2007) argues that there is a relationship between training and employee turnover and employee commitment. Therefore, there is a need to evaluate the impact of the training on employees. This will be achieved through assessing the current level of expertise and job attitudes of the group of employees in Californian health care institution before and after training.
DHMC also needs I/O Psychologists because they act as the link between the health care institution employees and the other experts. I/O Psychologists will be tasked with informing those experts the desires and job attitudes of the employees in most Californian health care organizations. This information will then be used in the identification, development and training of employees as well as identifying the most suitable material to be used. The material to be developed and those to be retained in the new health care system for use by disabled persons should be comprehensible to health care employees. This will help improve their morale hence; their job attitudes will also change for the positive. Employees have to be motivated to work with the new health care program so that they can effectively help disabled clients who visit these centres. The best way to know what the employees’ desire is through hiring I/O Psychologists who will give an accurate analysis of how employees want the system to be and what motivates them.
Change Management and Employee Motivation
Change always has an impact on employee motivation. In any organization today, employees have a significant bearing on the success of the organization. Organizations have to appreciate that employees are not mere cogs in the industrial machinery; they are human beings with feelings and emotions. Therefore, it is important to understand what motivates them and their likely reaction to any changes in the organization. One of the earliest contributors to human relation motivation theories was Elton Mayo through the Hawthorne Experiments. Mayo (1927) revealed that sense of belonging, need for recognition and security were the most important determinants of workers’ morale. They ranked higher than physical work conditions. Effectiveness and attitudes are influenced by social demands both within and outside the organization. He also argued that change tends to disrupt an organization’s social organization. Employees tend to resist change because it creates risk of redundancy and unemployment. The RFP proposed a detailed training program to impart health care providers with skills to effectively work with the new system. This way, it will reduce resistance to change. The changes will also be introduced in phases to avoid disrupting the social set-up of the organization which may adversely affect employee motivation and productivity. The gradual implementation of the proposed system will be implemented through goals setting and an incentive scheme based on Locke’s Goal- Setting theory. Targets will be set for every employee and employees who reach their target will be awarded. After set goals have been attained, new goals are set. The process will continue until the system is fully operational and implemented within the given timeframe. Locke (1968) argued that behaviour is motivated. He also argued that motivation is a process that is goal-directed. Therefore, the theory argued that an individual who is given the right goals will be motivated to find the right skills and knowledge to achieve those goals. However, Locke argued that goal commitment, task complexity, ability, and feedback are necessary for goal attained. This RFP proposed an incentive scheme as a feedback mechanism.
Measuring Attitudes and Outcomes
I/O psychologists will be given a chance to interview employees and ask them how they feel about the current health care system when dealing with disabled people. They will then ask employees on what are their recommendations and what they would like to be changed in the system to improve service delivery and raise employee morale. Psychologists will be tasked with identifying the desires of employees of their employers. I-O Psychologists have the expertise of conducting interviews and administering surveys to obtain relevant information that is useful in analysing a given situation. Both closed ended questionnaires and open ended questionnaires will be used. Closed ended questions are questions with multiple choose. Closed ended questions are easier to analyse since similar responses can be lumped together. The proposer will use “yes” or “no” questions and questions that require ranking using the 5-point Likert scale. The 5-point Likert scale was invented by Rensis Likert in 1932 in order to measure psychological attitudes of human beings in a scientific manner. Likert (1932) argued that there is a need to develop a metric that can measure psychological attitude in order to make research in psychology objective and eliminate researcher’s bias in interpreting qualitative responses thus according it a more scientific feature. However, questions that require respondents, to give their opinion, recommendation or feelings, will be open ended. It must be appreciated that feelings and opinions are as diverse and many as the number of respondents. Therefore, open ended questions will be appropriate in some instances.
Updating the Health Care System
The second intervention regards updating the health care system to conform to the latest technology. The world is constantly evolving due to the technological progress around the world. The main objective of developing new technology is to ensure that it is easy to work out things than it was in the past. In fact, most of the technological discoveries in the recent past have been all about helping human beings store information and make work easy. In the health care system, data collection, storage and maintenance have been the main beneficiary of technological progress.
The DHMC is encouraged to adopt the newest technology in its quest to provide quality services for people with disabilities in California State because of several reasons. Latest technology is always developed as a customised version of the older technology. For example, the current health care system has a data base that stores patient information for all people in the same pool. This information is not differentiated based on the class of patients. It is assumed that the institution handles all patients equally hence; the information is not classified into the types of patient. This makes it difficult for one to identify patient information for patients with disabilities from the rest of the patients visiting these health care institutions. This limitation has been solved by most recent healthcare information systems.
Frequent updating of technological information to meet the needs of the disabled patients is the best option these institutions should select. This is because new technology is usually easier to handle. New technological devices are dynamic in that they are easy to operate by the health care system workers, only if they are given comprehensive training. A study conducted by Wright, Kacmar, McMahan and Jansen (2005) on the impact of IT on employee attitudes using 58 Fortune 500 companies revealed that introduction of a new IT platforms reduced employee attitudes. To mitigate the adverse effect, there is need to educate employees to remove misconceptions and misinformation about their new system. In addition, the system should incorporate the suggestions of employees so that they can feel they are part of the change. I/O Psychologists will analyse the views of health care workers on how the new technology affects them. The psychologists are also tasked with giving employees mental and emotional guidance in preparation for the technological changes in the health care systems. The psychologist meets the employees, talks to them about the benefits of technological change, how they will improve service delivery. This helps maintain a positive job attitude and raise the morale of employees in these health care institutions.
Frequent technological changes to adopt the newest technology available are also crucial in helping disabled patients learn. Patients with disabilities have found it difficult to navigate through the health care systems in the past because of the complications. A study conducted by Roupa et al (2010) revealed that the disabled and the elderly find it difficult to navigate through modern devices developed for them. Similar finding were made by Flecter et al (2002) who studied the use and ownership of hearing aids by the elderly in the U.K. The study revealed that 8 per cent had great difficulty in listening using hearing aid while 58 per cent failed an acoustic test. The researcher revealed that it was because they were using the device wrongly. Psychologists and other experts hired by the DHMC will provide the necessary training to clients so that they learn how to use the new technology that changes frequently with the discovery of new technology. The experts may be knowledgeable in terms of dealing with people with disabilities but they cannot analyse the behaviour of these people during the training process. Therefore, it is important to have I/O psychologists, who will offer their expertise in analysing the behaviour of disabled patients during the testing of new technology and training of this target group to use the new technology. It is the expertise of I/O psychologist that will be relied on when developing technology that suits people with disability. Psychologists will have sessions with various patients with different kinds of disabilities, listen to their thoughts and ideas on the current technology and the changes they would like to see in the health care sector. The recommendations of the psychologists will be used when developing the new technology.
Changing technology often is a risky approach when dealing with people with disability. Therefore, the experts involved in designing the new technology will be required to rely on the feedback gotten from psychologists. Psychologists will be the link between the stakeholders in the health care systems in California and the team of experts. Therefore, psychologists must be ready to give an accurate analysis of the disabled community, the employees in health care societies and the other stake holders in California. The DHMC should constitute a team of experts who will be ready to assess and determine the areas of the California health care system that require changes.
Provision of Unique Health Care Facilities to meet the Disabled Needs
There is a need to separate the disabled group of patients from the other patients in order to provide specialized health care facilities. This is a detailed process that requires comprehensive analysis of identifying the unique healthcare facilities required by disabled persons and how to separate them from other patients. In the initial RFP, this recommendation is a continuation for the long run to enhance the welfare of the disabled people in California. The separation of databases also includes creating a special unit in the Californian hospitals for disabled patients.
This exercise is important because currently the health care organizations have lumped patient information for both the disabled and the other normal patients. This makes it difficult for disabled persons to navigate through the system. Patients with normal ability often find it easy navigating through the system because they have the mental, physical or emotional capacity to handle the complications of the system. In California, the same system is expected to serve people with disability. Some of the employees in the health care system are overworked as they seek to serve both the normal and the disabled people.
Therefore, the separation of the health care system of the disabled from that of the normal patients has a lot of benefits. First, this is an opportunity for the DHMC to develop a system that s specifically meant for disabled patients only. Having such a system will enable the team of experts to customize the system so that it becomes easier for these patients than the current system. I/O Psychology is important in developing a system that is customised for disabled people. Only a team consisting of experienced I/O psychologists would be able to identify the components disability patient system. This is because they understand the various things that meet the needs of disabled people. For instance, disabled people need assistance when navigating through the health care system. The emotional, mental or physical disabilities make the disabled people slow in understanding how to navigate the system.
Developing a new system specifically for the disabled people in California will be crucial because it will mean that there are special employees to handle these people. Currently, the health care system is complicated in that doctors attend to both the normal and disabled patients at the same time. The new system would allow for the training of employees who will be specifically be there to assist the disabled. Giving full time attention to the disabled will reduce the work load that currently burdens these employees hence; it will increase their productivity. I-O Psychologists have the expertise of performing a training needs analysis, developing training programs and evaluating the success of those programs.
Creating a separate database for the storage of information on the disabled people is also important because it helps avoid confusion. The database can be simplified so that people with disabilities can have the chance to go through them. For example, there should be facilities such as braille, hearing aids, eye glasses and magnifying glasses and wheel chairs for people with disability to navigate through the system easily. Furthermore, the system should also cater for people with emotional disability by hiring psychologists who offer counselling and emotional help for such people. The separated system will also be easy to operate for employers who will have a less amount of data to deal with. Having a system that has specifically information on disabled people, which is then further classified into various kinds of disability and specifications, is much easy to operate. The current system stores information for both the normal and the disable hence; by the time an employee retrieves information for a disabled patient, a lot of time will have been wasted. Therefore, it is important that a new and separate health care system is developed to meet the needs of the disabled members of the society.
Conclusion
The interventions made in the RFP response were aimed at improving the on the health care service provision for people with disabilities in California. The first step would be developing a road map to the development of educational and training resources for people with disability in California. Cognitive and social learning theories will be used as the basis of developing the training guide. It is also important to evaluate the impact of the proposed intervention on employee motivation and how adverse effects can be mitigated. Measuring employee attitudes before, during and after implementation of the proposed intervention is important in measuring its success and future potential. Suggestions on how to update the current healthcare system to make it easier identify disabled persons. Lastly, it is important to create a roadmap for providing special healthcare facilities to persons with disability will be developed basing on their needs.
References
Ahmad, A. (2012, November). Role of Learning Theories in Training while Training Trainers. International Journal of Research in Business and Social Sciences, 11, 1-11.
Andersen, R. M., Rice, T. H., & Kominski, G. F. (2011). Changing the U.S. Health Care System: Key Issues in Health Services Policy and Management. New York: John Wiley & Sons.
Bandura, A. (1973, April 20). Aggression: A social Learning Analysis. Retrieved August 8, 2013, from http://www.uky.edu: http://www.uky.edu/~eushe2/Bandura/Bandura1973.pdf
Berg, M. (2005). Implementing Information Systems in Health Care Organizations: Myths and Challanges. International Journal of Medical Informatics, 143-156.
Brown, E. G. (2013, February 13). REQUEST FOR PROPOSALS (RFP) MATERIALS AND OUTREACH TARGETED TO INDIVIDUALS WITH DISABILITIES REGARDING THE AFFORDABLE CARE ACT RFP NO.12MC-SA021. Retrieved May 14, 2013, from Department of Managed Health Care.
Brum, S. (2007, May 12). What Impact Does Training Have on Employee Commitment and Employee Turnover. Retrieved August 4, 2013, from http://www.uri.edu: http://www.uri.edu/research/lrc/research/papers/Brum-Commitment.pdf
CQC. (2011, November 12). Health Care for Disabled Children and Young People. Retrieved August 8, 2013, from http://www.cqc.org.uk: http://www.cqc.org.uk/sites/default/files/media/documents/health_care_for_disabled_children.pdf
Fletcher, A., Smeeth, L., Nunes, M., Breeze, E., & Bulpitt, C. (2002). Reducing Hearing,Ownership and Use of Hearing Aid by the Elderly in the U.K. The MRC Trial of the assesment of Elderly People in the Community: A Cross Sectional Survey.
Grusec, J. (1992). Social Learning Theory and Development Psychology: The Legacies of Robert Sears and Albert Bandura. Journal of Development Psychology, 776-786.
Johnson, P. (2010, May 10). Quantitative, Qualitative, and Mixed Research. Retrieved April 22, 2013, from http://www.southalabama.edu: http://www.southalabama.edu/coe/bset/johnson/lectures/lec2.pdf
Likert, R. (1932). A Technique of Measuring Attitudes. Archives of Psychology, 140, 5-54.
Locke, E. (1968). Toward a Theory of Task Motivation and Incentives. Organisational Behaviour and Human Performance, 3, 59-178.
Mayo, E. (1927, December 30). “Hawthorne Experiments”, Western Electric Hawthorne Studies Collection. Retrieved August 8, 2013, from http://www.library.hbs.edu: http://www.library.hbs.edu/hc/wes/indexes/alpha/content/1001955886
McNeal, M., Carrothers, L., & Premo, B. (2002, April 10). Providing Primary Health Care for People with Physical Disabilities: A Survey of California Physicians. Retrieved August 8, 2013, from www.cdihp.org: www.cdihp.org/pdf/ProvPrimeCare.pdf
Roupa, Z., Nikas, M., Gerasimou, E., Zafieri, V., Lamprini, G., Kazitori, E., et al. (2010). The Use of Technology by the Elderly. Health Science Journal, 118-126.
Shared Action. (2012, June 10). Cognitive Behavioural Theory. Retrieved August 8, 2013, from http://www.sharedaction.orr: http://www.sharedaction.org/contentOnly/images/httpdocs/accionmutua/pdf/Cognitive%20Behavioral%20Theory.pdf
Tonascia, S. (1986). Clinical trials: design, conduct, and analysis. London: Oxford University Press.
Waclawski, J., & Church, A. H. (2002). Organization Development: A Data-Driven Approach to Organizational Change (Illustrated ed.). Newyork: Wiley & Sons.
Wright, P., Kacmar, M., Mchanan, G., & Jansen, G. (2005). Impact of Information Technology on Employee Attitudes: A Longitudinal Field Study. Centre for Advanced Human Resource Studies (CAHRS) Working Papers, 1-29.
