White Water Changes

Whitewater change inspires quick-f ix schemes to fix problems, which needs numerous alternatives, to accommodate internal and external analysis of the data from the environment. (Johnson 2009, pg 298) For many people change is a difficult process, and in the health care organization is can be a slow process.

One example of a whitewater change in the health care organization is Medicare plans to institute a pay-for-performance program at the primary care physician level. This change was implemented in 2006, tested and found to do quite well. The program starts with a patient who enters the Medicare program then they are entitled to a paid initial physical exam. The primary care physician most often takes advantage of this, but many will not. The physician is the one who performs the physical and he must accomplish examination details and actions laid out by Medicare. In order to be paid for the exam, the doctor must adhere to the examination details. But the Doctors that meet requirements of the program are rewarded with extra money for that patient. This could boost their practice income considerably. The problem is that many are not rising to the opportunity, because of the upcoming plan of Medicare cuts in reimbursements. This change would rest with the leadership of the healthcare organization, and this new procedure would be standardized for all to adopt. (Medicine Information,)The decision for change should go bey the management level, because of balance of power would be threaten by the primary stakeholders of the organization. (Johnson 2009, pg 300)

The second example of whitewater changes in health care is the rising advancement of technology in health care. There is a growing contentious debate over how doctors should be trained in the procedure of implanting new sophisticated medical devices. The new advanced pacemakers and carotid artery stints have increased in demand, after the federal government expanded the number of Medicare beneficiaries eligible to receive coverage for the devices. The fast track training guidelines have been offered for the doctors that have not had a lot of experience performing defibrillator implantations. This free training has been offered by the Hear Rhythm Society. (Meir, New York Times, 8/1)

The medical device can only be implanted by "highly trained heart device specialist", but Federal officials have began collecting data to determine if the rate of complications to patients are related to procedures different from the heart specialists and other specialist (doctors) . (Meir, New York Times, 8/1)

The government is placing pressure on executives of healthcare organization s to meet requirements of new programs and advance technologies. There is a need for development of alternative methods for best quality of care. The advance technology change requires a response for the health care industry that leads