Laboratory employee’s reflections towards change in transitioning from a public to a private laboratory service

Abstract

Laboratory testing plays a critical role in health-care, providing clinicians with information that enables disease prevention, diagnosis and treatment. However like all public health care systems, laboratory services face increasing pressures that come from marketplace, environmental and political factors. These factors led the three District Health Boards (3DHBs) of the Wellington region i.e. Wairarapa, Hutt and Capital & Coast District Health Boards to work together towards service integration of hospital and community based laboratory testing which subsequently led to privatisation of the hospital laboratory services.

The topic this research investigates is ‘laboratory employee’s reflections towards change in transitioning from a public to a private laboratory service’. This research topic is important as analysis of the literature revealed the small amount of data available on how employees view and undergo change and the mechanisms they employ to cope with change. The research topic is also relevant at the organisational level as the findings will enable a review of the transformational change process based on employee’s reflection which may also reveal ways in which transitioning through the change as well as through privatisation can be made easier for employees.

This investigation is based on an interpretative qualitative approach, as the focus is on understanding the social world through an examination of the interpretation of that world by its participants i.e. laboratory employees (Bryman & Bell, 2011). Thus, this study explored the views of laboratory employees based at Wellington Regional Hospital and Hutt Hospital laboratory sites. Semi-structured interviews with thirteen participants were conducted to collect the data. The data was analysed via thematic analysis and then coded to reflect common themes and conceptual relationship underlying the employee’s reflection of the transformational change process.

The findings of the interviews suggested that communication plays a key role in the respondents understanding, engagement and involvement in a change process. Communication was cited as the biggest barrier towards change. It was also acknowledged that there is strong presence of public sector ethos amongst the laboratory employees, which can create a lack of commitment towards the privatisation process, as employees perceive a loss of quality in the service provided to patients as a result of decisions being driven by commercial imperatives.

Additional barriers to change were also identified in the form of change fatigue, lack of engagement and involvement of employees in key decisions in regards to the way the future service would be provided. Healthcare professionals show high levels of autonomy due to the nature of their profession, hence any change initiative that does not have the support of these professionals or is perceived to decrease quality of the service will be resisted to some extent.

The process model of stressors and coping mechanisms in transformational change presented by Robinson & Griffiths (2005) was useful in determining what the sources of stress were for the respondents and the mechanisms they used to cope with these stressors. The stressors identified to be aggravated for the current change process included increased workload, uncertainty and interpersonal conflict. The coping mechanisms utilised by the respondent’s strongly correlated with the coping mechanisms that the process model proposed in the literature. This report highlights employee’s reflection of the drivers and barriers to change as well as how employees cope with transformational change in the form of privatisation.