Benchmark – Change Initiative: Implementation, Evaluation, and Sustainability LDR 615

Benchmark – Change Initiative: Implementation, Evaluation, and Sustainability LDR 615

Benchmark – Change Initiative: Implementation, Evaluation, and Sustainability LDR 615

The University of Texas Medical Branch (UTMB) facility prides itself in being a premier institution of care. The application of evidence-based practice in several of its units has made it improve on its provision of services. However, the human aspect of the hospital has demonstrated certain weaknesses that the leadership should address. An analysis of the UTMB reveals that the ratio nurses to patients goes beyond the recommended level of 1: 6. The analysis further revealed that the high nurse to patient ratio exists due to a high turnover rate at the facility. As such, addressing the turnover rate will play an important role in ensuring that the ratio aligns with the recommendation of the American Nurses Association of 1:6. The present paper will thus focus on the implementation, evaluation and sustainability of the nurse turnover change initiative at the UTMB medical-surgical unit.

The Need for Change

Nurse turnover has created a rapidly growing human resource issue in the contemporary healthcare sphere. Hospital managers have stated that nurse turnovers have certain consequences since it leads to the disruption of hospital service operations (Tang & Hudson, 2019). The UMTB has suffered the consequence of high nurse turnover as demonstrated by its high nurse to patient ratio at the medical-surgical unit. As a consequence of high turnover rate at the medical-surgical unit, it experiences a high risk-adjusted mortality. Moreover, the medical-surgical unit also experiences higher lengths of stay at the unit compared to other units.

The presence of high turnover rates at the medical surgical unit of UMTB has also increased the cost of care for an individual patient. Due to the extended length of stay at the unit, the amount of money spent on individual patients have increased remarkably since the medical-surgical unit started registering increased nurse turnover. Suggestive evidence shows that high turnover rate at the unit has increased its operational costs (Tucker et al., 2019). An analysis shows that cost of hiring and training new nurses for the medical-surgical unit has skyrocketed since its nurses started leaving.

The loss of nurses for the medical-surgical unit has also led to staffing problems for the unit. Consequently, the unit suffers the loss the trained and experienced nurses, an imbalanced composition of remaining and new nurses and nurse shortages (Tang & Hudson, 2019). The staffing problems have resulted in challenges in arranging work and formulating schedules for nurse managers.  As a result, the situation necessitates increased overtime for remaining nurses. The resultant effects of nurse turnover cause reduced morale amongst the nurses at the unit, which negatively impacts most parameters of healthcare quality.

Driving Forces

            The driving forces for nurse turnover entails multifactorial factors in the form of economic, social and political aspects. The medical-surgical unit at UMTB suffers from factors such as absence of support from the nurse leadership. Organizational variables such as the lack of leadership play significant roles in the presence of nurse turnover (Scruth, Garcia, & Buchner, 2018). The nurse leadership at the medical-surgical unit of UMTB lacks the requisite skills to motivate the nurses hence their high turnover rates. Moreover, the high nurse-to-patient ratio results increased workload for the nurses. The overworking of nurses through strategies such as forced overtime makes them susceptible to burnout, which exacerbates the turnover rate issue.

The limited growth opportunities at the unit also leads to nurses quitting in pursuit of places where they abound for them. External factors such as the local labor economy does not favor the hospital hence the high rates of turnover. Moreover, State of Texas does not have a law guiding on the number of nurses per patients, which makes hospitals try to save money by keeping the ratio high (Cimiotti et al., 2019). Also, the presence of high competition from other healthcare players has accelerated the rate at which UMTB medical-surgical unit loses nurses. An analysis of the healthcare environment reveals that the competitors perhaps have better policies and offer more incentives, which attracts the medical-surgical nurses from UMTB.

The presence of a high turnover rate will have a direct impact of the remaining nurses and the patients. The remaining nurses have to work twofold and sometimes threefold due to understaffing. These nurses also have to persevere with forced overtime, which leads to other issues such as burnout (Scruth, Garcia, & Buchner, 2018). On the other hand, the patients suffer since the quality of services offered have reduced. The impact of nurse turnover on quality parameters has in turn negatively affected patient satisfaction with the services offered at the medical-surgical unit at UMTB.

Stakeholder Evaluation

            The proposed change for the issue of nurse turnover entails a multifactorial approach including inculcating the organizational culture during hiring, providing effective communication of organizational goals during the same period, and offering opportunities for growth through courses that improve competence. The nurse managers will take a frontline approach in the change initiative. During this period, nurse managers will need to change their approach in terms of communicating the unit’s goals, objectives and culture to the new nurses to make them feel part of the team (Hughes, 2017). Moreover, the new nurses at the facility will greatly benefit from the change initiative since they will find a new culture of doing things at the facility, which will persuade them to stay longer. The veteran nurses will also benefit from the change initiative since their workload will reduce and the facility will give them increased opportunity to grow at the facility.

The Role of Nurse Leader in the Change Initiative

            Nurse leaders act as change agents to implement changes that will enhance nursing and improve the working conditions of floor nurses. In the present change initiative, the nurse leaders will play a fundamental role in implementing improved interpersonal relationships with new nurses during interviews and orientation. Moreover, the nurse leaders will ensure the formulation effective communication concerning the reorganization of the growth opportunities for existing nurses and how they align with organizational objectives (Nelson‐Brantley & Ford, 2017). In order to ensure that nurses remain with the facility for a long time, nurse leaders will explain to them the need to observe organizational culture and how the change initiative will impact the nurses going forward. In other words, nurse leaders will ensure the implementation of the various facets of the change initiative.

The Lippit’s seven step change theory will play an instrumental role in the change initiative at the UMTB medical-surgical unit. Using this theory, the present author will diagnose the issue of nurse burnout and evaluate the capability and motivation for change. Moreover, the author will assess the motivation of the change agent and available resources as well as elect progressive change objectives. Further, explaining the role of the change agent to the employees by ensuring clarity in their expectation and sustaining the change through feedback, effective communication and coordination regarding the effects of the change will occur (Burke, 2017). Lastly, the Lippit’s seven step change theory will allow the author to terminate the helping association of the change agent gradually.

Change Agents and their Roles

            Change agents play crucial roles in managing the change process. As such, the identification of these change agents and clearly outlining their roles becomes an important facet of a change initiative. In the present project, the chief financial officer, as part of the management, will need to support the project. Their role will entail providing resources for the project by convincing the management of the business essence of the change initiative (Jones-Schenk, 2017). Further, a quality improvement adviser will need to participate in the project and their main role will entail convincing the administrative leadership of the impact of the project on quality parameters.

Moreover, the nurse manager will work as a change advocate for the project. The role of the nurse manager as a change advocate will entail showing commitment to the objectives of the project and then influence others to become active (Kodama & Fukahori, 2017). The author will also identify a nurse from the remaining nurses to also act as a change advocate. The role of the nurse will entail convincing other nurses of the essence of the project and communicating the leadership’s objective to them.

Application of the Change Theory to Develop Strategies

            The change initiative related to the reduction of nurse turnover rates will occur based on Lewin’s Change Model. The adoption of the change model occurs due to its premise that seeks to influence organizational behavior (Shani & Noumair, 2017). The model will facilitate the acquisition of driving forces that will push the UMTB employees at the medical-surgical unit towards the desired direction by the unit’s leadership. Moreover, the theory will enable the leadership of the unit to determine the potency of the forces leading to a high nurse turnover and prescribe the requisite intervention to halt the same.

The first step of the model entails unfreezing, which encompasses altering the existing behavior so as to achieve equilibrium, conformity, and overcome resistance. During the phase, the unit leadership and change agents will undertake an examination of internal and external factors to support the need for change. Regarding internal factors, parameters such as nurse burnout, enhanced readmission rates, failing quality indicators, and high levels of mortality will convince the leadership of the need to have the change initiative and recruit change advocates from amongst them (Halter et al., 2017), Similarly, the management will need convincing using external parameters such as failing patronage, reduced patient satisfaction statistics, and failing revenues. The presence of information concerning the need for change will lead to the identification of a team that will oversee the improvement of interpersonal relationship through effective communication and other stratagem to improve change within the medical-surgical unit at UMTB.

The second phase of the change initiative based on Lewin’s model entails the change process. During this phase the change, the presence of effective communication strategies will play a significant role in institution change. The nurse leadership at the unit will adopt an informal communication strategy so as to take advantage of informal social dependencies, paths, and connections to improve interprofessional relationships between leadership and nurses at the medical-surgical unit (Zbieg, Batorski, & Żak, 2016). However, a form of formal communication known as the cascade strategy will also occur wherein nurse managers will train nurse leaders, who will in turn train the nurse advocates, who will pass the information to their peers. The unfreezing process will entail the implementation of the change initiative wherein proper interpersonal relationships starting with interviews will occur.

Overcoming Barriers to Change

            The success of the change initiative will depend on the stakeholder support that will exist from the leadership and personnel of the organization. Potential barriers may include lack of support from the leadership and limited financial resources from the administration. Moreover, ineffective communication could also hamper the initiative. To address the challenges, the advocates of change initiatives will lobby for enough funding while they will use data to convince the administration of the necessity for the project (Clayton, 2019). Moreover, formulation of an effective communication strategy to communicate the objectives of the initiative to the leadership and outline the roles of various change agents will overcome the barriers. Monitoring the implementation process will allow the change team wo address unforeseen circumstances and address it in timely fashion and intelligently.

Evaluation Methods

            The evaluation methods of the change initiative will focus on the quality parameters and the improvement of the wellbeing of nurses. One of the most significant determinants of the success of the project will entail a reduction of the mortality rates, improved patient satisfaction, and the cost of care per patient.  Moreover, other parameters such as the financial position of the unit, the rate of turnover and the nurse to patient ratio after the implementation of the initiative will also demonstrate the effectiveness of the project (Nelson‐Brantley & Ford, 2017). The evaluation of the change initiative will occur based on comparative data before the change initiative and after the implementation of the same. The analysis of the data will reveal whether the project will have succeeded or not based on individual parameters.

Strategies for Sustaining Change

            To sustain change, identification of the threats to the project will become foundational and it will occur using the The National Health Service Sustainability Model. Afterwards, the UTMB will adopt the usage of tools such as such as process control boards, performance board, improvement hurdles, as well as standard work to guarantee change sustainability. Whereas process control and performance board will help the change agents to review the project to the leadership, the standard work will visually communicate to the nurses the best practices supported by the organization as a result of the change initiative (Silver et al., 2016). The improvement hurdles will assess the project through meetings between the leadership and the nurses, which facilitates the improvement of interpersonal relationships.

Overall Effectiveness of Change Plan

            The mission statement of the UTMB entails the provision of highest quality patient care. The fact that reduced turnover of nurses will improve quality parameters implies that the change initiative aligns with the mission statement of the facility and its goals. The change initiatives address stakeholder concerns by ensuring that the hospital’s patronage will improve, patient satisfaction will increase and other quality parameters of the facility will also improve. As relates to the community, the improvement of services through improving the nurse to patient ratio will ensure that the people of Texas benefit from quality healthcare as promised by the facility.

References

Burke, W. W. (2017). Organization Change: Theory and Practice. Thousand Oaks, CA : SAGE Publications

Cimiotti, J. P., Li, Y., Sloane, D. M., Barnes, H., Brom, H. M., & Aiken, L. H. (2019). Regulation of the nurse practitioner workforce: Implications for care across settings. Journal of Nursing Regulation, 10(2), 31-37.

Clayton, W. R. (2019). Overcoming barriers impeding nurse activation of rapid response teams. OJIN: The Online Journal of Issues in Nursing, 24(3).

Halter, M., Pelone, F., Boiko, O., Beighton, C., Harris, R., Gale, J., … & Drennan, V. (2017). Interventions to reduce adult nursing turnover: A systematic review of systematic reviews. The open nursing journal, 11, 108.

Hughes, V. (2017). Leadership strategies to promote nurse retention. Sci J Nurs Pract, 1(1), 1-5.

Jones-Schenk, J. (2017). Fostering personal power during change. The Journal of Continuing Education in Nursing, 48(8), 343-344.

Kodama, Y., & Fukahori, H. (2017). Nurse managers’ attributes to promote change in their wards: A qualitative study. Nursing open, 4(4), 209-217.

Nelson‐Brantley, H. V., & Ford, D. J. (2017). Leading change: a concept analysis. Journal of advanced nursing, 73(4), 834-846.

Scruth, E. A., Garcia, S., & Buchner, L. (2018). Work life quality, healthy work environments, and nurse retention. Clinical Nurse Specialist, 32(3), 111-113.

Shani, A. B., & Noumair, D. A. (2017). Research in organizational change and development: Volume 25. Bingley, UK: Emerald Publishing Limited.

You will utilize your change model for this assignment. Review the feedback submitted by your instructor on your previous change model assignment. Make any changes or modifications necessary for the submission of this assignment.

Evaluate your organization’s or department’s performance. Determine an area that would benefit greatly from initiating a change. Write a paper (1,500-1,750 words) describing the specific area you intend to address through a change initiative. Include the following in your company’s description:

Discuss the problems in this area as well as the current outcomes as a result of the problems.
Describe the external and/or internal motivators, contributing factors, and people affected.

Motivating Factors

The high rate of nurse turnover is caused by a variety of factors, including economic, social, and political considerations. The nursing leadership at UMTB is unsupportive of the medical-surgical unit. Nurse turnover is directly related to organizational characteristics such as a lack of leadership (Scruth, Garcia, & Buchner, 2018). The medical-surgical unit at UMTB has a high turnover rate because the nursing leadership lacks the skills needed to motivate the nurses. As a result of the high nurse-to-patient ratio, the nurses’ workload is increased. Methods such as mandatory overtime and other forms of overworked nurses exacerbate nurse burnout.

 

Implementation, evaluation, and long-term viability of a benchmark change initiative The LDR 615

Benchmark – Change Initiative: Implementation, Evaluation, and Sustainability LDR 615

Nurses leave the unit in search of better career prospects elsewhere because there aren’t many options for advancement on the unit. The high rate of turnover is due to external variables such as the local labor market. Even though Texas does not have any regulations on nurse-patient ratios, hospitals aim to save money by keeping the ratio high in an effort to save money (Cimiotti et al., 2019). In addition, UMTB’s medical-surgical unit has been losing nurses at an alarming rate because of the intense competition from other healthcare providers. A review of the healthcare environment suggests that the rivals may have stronger rules and incentives to entice the medical-surgical nurses from UMTB to their facilities.

If there is a high rate of staff turnover, the surviving nurses and their patients will suffer. Due to understaffing, the surviving nurses are forced to work twice as hard as they would normally. Furthermore, these nurses must work mandatory overtime, which can lead to burnout and other issues such as stress (Scruth, Garcia, & Buchner, 2018). Patients, on the other hand, suffer as service quality deteriorates. Nurse turnover has had a negative impact on the medical-surgical unit’s quality metrics, resulting in dissatisfied patients.

Stakeholder Assessment Simultaneously, a multi-factor approach to reducing nurse turnover is recommended, including instilling the organization’s culture in new employees and enabling effective communication of the organization’s goals. From the front lines, nurse managers will lead the reform effort. During this time, nurse supervisors will need to modify their communication methods with new nurses if they want them to feel like a part of the team and understand the unit’s goals, objectives, and culture (Hughes, 2017). Furthermore, the facility’s new nurses will benefit greatly from the change project because they will be introduced to a new way of doing things, which will encourage them to stay longer. The facility’s veteran nurses will benefit from this new initiative as well, with less work and more opportunities for advancement.

1. Evaluate the stakeholders involved and discuss how they will be affected by your change initiative.
2. Clarify your role and responsibility as a change leader. Discuss the leadership theory (or theories) you will use to guide the change process.
3. Discuss the change agents you need to recruit in order to successfully implement your change. Describe the roles of these change agents.

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1. Utilize your change model to develop strategies: (a) Explain the relevance of this model to your organization; and (b) Present the strategic aspects using your model. Be sure to clearly define the purpose of each aspect, the people involved, and the actions that need to be taken.
2. Identify, or predict, the potential barriers to change. Discuss possible ways to overcome these obstacles, including methods for dealing with emerging or unforeseen circumstances that could impede implementation.
3. Describe the evaluation methods you will use to determine the level of success of your change initiative. Discuss what metrics or measureable determinates you will use.
4. Propose strategies to anchor change or support continuous change.
5. Establish how your change plan supports the organizational mission/goal, genuinely addresses stakeholder concerns, and will serve as an equitable contribution for the community or society overall.

EHR Change Initiative: Implementation, Evaluation, and Sustainability

My current health setting is serving many patients and so, keeping the patients records in an organized and accessible manner is essential for the medical practice on the organization. Often, the medical records entails vital information about every patient such as the diagnosis, the kinds of medications that are taking, prescriptions, test results, personal addresses, billing information, social security numbers, and other personal data. Therefore, it is imperative to store the medical records in an effective way to facilitate access by the staff and also ensuring safety of the patients’ information. Notably, my organization still heavily relies on traditional paper-based records. However, this paper-based health record keeping is increasing more burdens to already overwhelmed filing system.  As a result, confusion, inconsistencies, and misguided choices in the provision of health care have been witnessed due to the complexities of the paper-based health records.  Essentially, the challenges associated with keeping health records manually are adequate proof that the paper-based system is hindering health care practices. For instance, paper-based health records involve many bulky files that make portability a problem. Besides, manual records are prone to incorrect entries that may take long to correct and/ or explain. The health care providers also tend to take remarkably long time to review patient files, the time that would have been utilized to attend to many patients or dedicated to other vital duties. Additionally, it is time consuming to update patient files. Besides, more efforts are required to ensure patients’ private information is safeguarded.

Consequently, electronic health records (EHRs) has been proposed as the change initiative to remedy the challenges emanating from the paper-based health records. Amply, EHRs refers to a digital adaptation of the patients’ paper chart such as reducing incidences of lost records, duplication, mistaken identity, inefficient billing, errors in drug administration, and making uninformed clinical decisions. Therefore, the implementation of EHRs is timely since it is expected to address the challenges of paper-based records. Ideally, the adoption of EHRs is necessitated by both internal and external forces. Regarding the external driving forces, the environment health care industry is rapidly evolving and becoming uniquely competitive. As such, it is imperative for health care organization to create strategies that are focused on internal environment to enhance competitive capability of the organization. The strategies may include health care cost reduction and quality care provision. In turn, adoption of EHRs will ensure the realization of these goals in the organization (Kruse, DeShazo, Kim & Fulton, 2014).

On the other hand, internal driving forces for EHRs include enhancement of quality of care. EHRs provide are real-time, patient-focused records that avails information immediately and safely to certified users. Other than having patient medical and treatment history, the EHRs system can also provides a wider perspective of patient care due to its ability to enable accessibility to evidence-based tools that can help health care professionals to make informed decision about patients’ care. The people who will be affected by EHRs adoption include health care providers and the patients. EHRs will foster the work of health care providers by automating and simplifying their workflow. EHRs will ensure real-time communication while providing care, eradicate time wasted in scrutinizing and discussing patient data, and ensure the privacy of patient health information. On the other side, EHRs will affect patients by addressing concerns such as confidentiality, security, and patient-centered care provision. Besides, the patients will benefit from improved quality of health care provision, reduced cost of care, and reduction in time spent in hospital.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. Benchmark – Change Initiative: Implementation, Evaluation, and Sustainability LDR 615

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Course Code Class Code Assignment Title Total Points
LDR-615 LDR-615-O500 Benchmark – Change Initiative: Implementation, Evaluation, and Sustainability 250.0

Criteria Percentage Unsatisfactory (0.00%) Less than Satisfactory (74.00%) Satisfactory (79.00%) Good (87.00%) Excellent (100.00%)
Content 80.0%
The Need for Change 10.0% The need for change including specifying the issue and the current outcomes resulting from the issue is not discussed. The need for change including specifying the issue and the current outcomes resulting from the issue is discussed, but discussion is incomplete or inaccurate. The need for change including specifying the issue and the current outcomes resulting from the issue is included, but discussion is cursory and lacking in depth. The need for change including specifying the issue and the current outcomes resulting from the issue is discussed, including all necessary elements. The need for change including specifying the issue and the current outcomes resulting from the issue is thoroughly discussed with rich detail, including all necessary elements.

Driving Forces 5.0% Description of internal and/or external driving forces, contributing issues, and people affected is not included. Description of internal and/or external driving forces, contributing issues, and people affected is incomplete or inaccurate. Description of internal and/or external driving forces, contributing issues, and people affected is included, but discussion is cursory and lacking in depth. Description of internal and/or external driving forces, contributing issues, and people affected is discussed, including all necessary elements. Description of internal and/or external driving forces, contributing issues, and people affected is thoroughly discussed with rich detail, including all necessary elements. Benchmark – Change Initiative: Implementation, Evaluation, and Sustainability LDR 615

Stakeholder Evaluation 5.0% Evaluation of stakeholders and how they will be affected by the change initiative is not included. Evaluation of stakeholders and how they will be affected by the change initiative is incomplete or inaccurate. Evaluation of stakeholders and how they will be affected by the change initiative is included, but discussion is cursory and lacking in depth. Evaluation of stakeholders and how they will be affected by the change initiative is discussed, including all necessary elements. Evaluation of stakeholders and how they will be affected by the change initiative is thoroughly discussed with rich detail, including all necessary elements.

The Role of the Leader in the Change Initiative 10.0% The role of the leader in the change initiative is not addressed. The role of the leader in the change initiative is present, but it is incomplete or inaccurate. The role of the leader in the change initiative is presented, but it is cursory and lacking in depth. The role of the leader in the change initiative is presented and includes discussion of all necessary elements. The role of the leader in the change initiative is thoroughly presented with rich detail and includes discussion of all necessary elements.

Change Agents and Roles 10.0% Discussion of necessary change agents and their respective roles in implementing change is not included. Discussion of necessary change agents and their respective roles in implementing change is incomplete or inaccurate. Discussion of necessary change agents and their respective roles in implementing change is included, but discussion is cursory and lacking in depth. Discussion of necessary change agents and their respective roles in implementing change is discussed, including all necessary elements. Discussion of necessary change agents and their respective roles in implementing change is thoroughly discussed with rich detail, including all necessary elements. Benchmark – Change Initiative: Implementation, Evaluation, and Sustainability LDR 615

Application of the Change Model to Develop Strategies (Competency 3.5) 10.0% The change model is not applied to develop strategies. The change model is applied, but the resulting strategies are incomplete or inaccurate. The change model is applied, but the resulting strategies are cursory and lacking in depth. The change model is thoroughly applied and the resulting strategies include all necessary elements. The change model is thoroughly applied with rich detail and the resulting strategies include all necessary elements.

Overcoming Barriers to Change (Competency 1.5) 10.0% Overcoming barriers to change is not addressed. Overcoming barriers to change is presented, but it is incomplete or inaccurate. Overcoming barriers to change is presented, but it is cursory and lacking in depth. Overcoming barriers to change is presented and includes discussion of all necessary elements. Overcoming barriers to change is thoroughly presented with rich detail and includes discussion of all necessary elements.

Evaluation Methods 10.0% Evaluation methods for determining the success of the change initiative are not included. Evaluation methods for determining the success of the change initiative are incomplete or inaccurate. Evaluation methods for determining the success of the change initiative are included but lack specific metrics or measurable determinants and relevant details. Evaluation methods for determining the success of the change initiative are complete and include specific metrics or measurable determinants and relevant details. Evaluation methods for determining the success of the change initiative are extremely thorough with specific metrics or measurable determinants clearly defined and numerous relevant details.

Strategies for Sustaining Change 5.0% Strategies for sustaining change are not addressed. Strategies for sustaining change are incomplete or inaccurate. Strategies for sustaining change are presented, but discussion is cursory and lacking in depth. Strategies for sustaining change are complete and include discussion of all necessary elements. Strategies for sustaining change are thoroughly presented with rich detail and include discussion of all necessary elements.

Overall Effectiveness of Change Plan 5.0% Discussion of how the change plan supports the organizational mission and goals, addresses stakeholder concerns, and contributes to the community of society is not included. Discussion of how the change plan supports the organizational mission and goals, addresses stakeholder concerns, and contributes to the community of society is incomplete or inaccurate. Discussion of how the change plan supports the organizational mission and goals, addresses stakeholder concerns, and contributes to the community of society is cursory and lacking in depth. Discussion of how the change plan supports the organizational mission and goals, addresses stakeholder concerns, and contributes to the community of society is presented and includes discussion of all necessary elements. Discussion of how the change plan supports the organizational mission and goals, addresses stakeholder concerns, and contributes to the community of society is thoroughly presented with rich detail and includes discussion of all necessary elements.

Organization and Effectiveness 13.0%
Thesis Development and Purpose 3.0% Paper lacks any discernible overall purpose or organizing claim. Thesis is insufficiently developed or vague. Purpose is not clear. Thesis is apparent and appropriate to purpose. Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose. Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.

Argument Logic and Construction 5.0% Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources. Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility. Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis. Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative. Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.

Mechanics of Writing (includes spelling, punctuation, grammar, and language use) 5.0% Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is employed. Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied. Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed. Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech. The writer is clearly in command of standard, written, academic English.

Format 7.0%
Paper Format (use of appropriate style for the major and assignment) 2.0% Template is not used appropriately or documentation format is rarely followed correctly. Appropriate template is used, but some elements are missing or mistaken. A lack of control with formatting is apparent. Appropriate template is used. Formatting is correct, although some minor errors may be present. Appropriate template is fully used. There are virtually no errors in formatting style. All format elements are correct.

Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style) 5.0% Sources are not documented. Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors. Sources are documented, as appropriate to assignment and style, although some formatting errors may be present. Sources are documented, as appropriate to assignment and style, and format is mostly correct. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error. Benchmark – Change Initiative: Implementation, Evaluation, and Sustainability LDR 615

Assignment of Benchmarks

In the modern world, health organizations face a wide range of challenges that jeopardize their performance. They include the growing need for new technologies that will improve the quality, safety, and efficiency of operations. Competition from other service providers is also included. Health organizations face similar challenges in terms of workforce retention. It is widely acknowledged that poor workforce management raises the operational costs of hiring new employees. As a result, it is critical for them to devise effective strategies for increasing operational efficiency and providing quality services to their clients. As a result, this essay examines an area of my organization that will benefit greatly from the implementation of change. The proposed change entails the implementation of programs aimed at promoting employee development in order to address the issue of low nurse retention in the hospital.
Issues and Results in the Field
Human resource management issues have arisen at the hospital where I work. An audit recently conducted revealed that the majority of nurses leave the hospital within a year. A small percentage of nurses were found to have spent more than three years in the hospital. An investigation into the factors influencing poor nurse retention in the hospital revealed that the methods used to increase their retention are ineffective. For example, the results of performance appraisals are not used to make decisions that benefit nurses. In addition, nurses are not given opportunities to advance their personal and professional development. There is also a limited use of incentive packages to motivate these employees. As a result of these inefficiencies, the hospital has experienced a high rate of staff turnover within the first year of employment, a decline in the quality of care, and high costs associated with hiring, training, orienting, and inducting new nurses (Hughes, 2019). As a result, it is critical that effective interventions be implemented to address this organizational issue.
External and Internal Pressures People Affected and the Driving Forces The influence of internal and external forces is attributed to the issue of poor staff retention within the first year of employment in the hospital. Internal forces are those within the organization, whereas external forces are those that exist outside of the hospital. Staff dissatisfaction is one of the internal forces contributing to the problem. Employees must be given work environments that promote their personal and professional development. Job advancement, salary increases, and training opportunities to keep them up to date on issues affecting their practice are examples of these conditions (Hughes, 2019). Staff turnover has increased due to a lack of or poor provision of these conditions during their first year of employment. Ineffective human resource management is another internal force driving low staff retention in their first year of employment. The hospital’s human resources department should investigate the most effective ways to address the problem. Inefficiencies in management are the other internal driving force. Management should be involved in the identification of evidence-based interventions to address the problem. Competition is one of the external factors driving the issue. Most hospitals offer competitive packages to nurses and other healthcare providers in order to entice them to leave the hospital. The changing needs of the nursing workforce are another factor. The hospital should identify the nurses’ anticipated and actual needs and devise solutions to meet them (Pasmore, 2015). Nurses, other healthcare providers, nurse managers, and patients are all affected by the issue of poor retention of nurses during their first year of employment.
Stakeholders Involved and How the Change Initiative Will Affect Them
The proposed change will affect a number of stakeholders in the hospital. According to Hodges (2016), stakeholders are individuals who will be directly involved or influenced by the proposed change. They determine the manner in which the change agent will be adopted in an organization. Effective interventions must therefore be developed to ensure that they experience minimal resistance during the implementation of the change in their practice. Nurses, patients, and hospital management will be among the stakeholders involved in the case. The nurses will benefit from the change. They will be given opportunities for professional development such as training, an attractive compensation package, and safe working conditions. Patients are another stakeholder who will be impacted by the change. Patients will benefit from high-quality services as a result of the nurses’ increased motivation. The change will also have an impact on the hospital’s management. It will have to figure out effective ways to keep the change going. It will also need to implement an effective management strategy to ensure the change’s long-term viability. The above stakeholders will be impacted in a variety of ways by the change. As previously stated, there will be an improvement in the quality of care provided to patients. This will result in a decrease in hospital mortality rates. The proposed change aims to provide nurses with opportunities that will increase their retention rates. As a result, it is expected that the change will significantly increase their level of motivation (Hodges, 2016). The hospital’s management must ensure that existing resources are used to achieve the desired organizational outcomes.
Theory of Role, Responsibility, and Leadership
My responsibilities in the proposed change will include assessing, planning, implementing, disseminating, and coordinating. To support the proposal, I will assess the existing organizational systems and the need for change. I will also collaborate with other stakeholders to determine the strategies that must be implemented for the change to be effective. I will help to determine which resources should be used in the process. I will also oversee the implementation of the chosen strategies. I will also serve as a project disseminator, providing the information required by the implementers. Finally, I will serve as a coordinator for the change’s implementation. I will ensure that the allocated resources are used effectively to achieve the change’s objectives. In order to implement the change, I will apply Kurt Lewin’s change theory. According to the theory, change occurs in stages that include unfreezing, change, and refreezing. The first stage focuses on raising awareness of the organization’s need for change. In this stage, I will assist the nurses and management in identifying the problem. The second stage involves shifting where the necessary interventions to facilitate change are implemented. The final stage is refreezing, where I will implement sustainability strategies to ensure that change is incorporated into the organization’s culture (Mendy, 2018).
The Role of Change Agents
The hospital’s managers will be the change agents in charge of implementing the proposed change. The agents will be responsible for consulting, research, and training. The managers will act as consultants in the implementation of the change, providing the necessary information to the implementers to ensure the project’s success. They also assist implementers in identifying solutions to problems based on evidence analysis. Managers will also be responsible for training. They will assist change implementers in understanding how to use data from the change to effect it. They will also help them to derive their actions from the collected organizational data. Finally, the managers will serve as researchers (Hughes, 2019). They will train the adopters in the skills required for effective change implementation. They will also use the best available evidence to develop project evaluation strategies.
Implementation of the Change Model
The previously developed change model focuses on the implementation of change while taking a number of steps into account. They include assessment, raising awareness, increasing knowledge, as well as commitment, implementation, monitoring and evaluation, and change maintenance. The first step is assessment, in which the change leaders identify the organization’s needs. An organizational assessment is performed to determine the organization’s strengths, weaknesses, threats, and opportunities. This stage will involve evaluating the factors that contribute to poor retention of nurses in their first year of employment. The second step is to raise awareness, in which the data gathered during the assessment stage is presented to management and change implementers. They are made aware of the organization’s problem and the need for change. Building knowledge and commitment is the third step in the change model. The stakeholders are involved in determining the strategies to be used to address the issue. The implementers are also given adequate information on how to address the change. Training may be provided to ensure that the implementers have the necessary knowledge and skills for the change. The fourth step is implementation, which involves putting all of the strategies developed to address the issue into action. Because management ensures that the strategies and resources are used efficiently, the implementation phase occurs concurrently with monitoring. The fifth step is evaluation, in which the change agents determine whether or not the goals of the change were met. In this stage, outcome and process measures are used to provide the information required (Pasmore, 2015). When a change is found to be effective, efforts to sustain it are investigated. To ensure the sustainability of the change, change agents implement measures such as open channels of communication, rewarding performance, and coaching.
Potential Obstacles and Strategies for Overcoming Them
One of the potential barriers to implementing the proposed change is resistance to change. It could be attributed to factors such as implementers’ fear, a lack of awareness, and insufficient information. The challenge will be met by training the implementers, utilizing open communication channels, and involving them in all aspects of the change. Another potential barrier is a lack of hospital support. This could be due to a lack of financial resources to put it into action. The problem will be solved by aligning the change with the hospital’s mission. The final potential barrier is the stakeholders’ unwillingness to participate in the change’s implementation (Pasmore, 2015). The problem will be solved by giving each of them a role in the implementation process. Unanticipated events will be addressed by closely monitoring the implementation process and providing regular feedback to stakeholders. Close monitoring will allow for the early detection and management of potential problems.
Methods of Evaluation
The effectiveness of the proposed change will be assessed using process and outcome measures. Outcome measures will determine whether or not the change’s pre-determined goals were met. This will include determining the nurse turnover rate one year after the change is implemented. Other outcome measures will be used, such as the patients’ perceived quality of care, the organization’s operational costs, and nurses’ job satisfaction with the change’s implementation. Process metrics will also be used to assess the change (Hughes, 2018). The nature of change implementation will be the focus. This will include determining stakeholder involvement, strategy implementation challenges, and the use of assigned resources. The process will be considered successful if the allocated resources are used effectively, active stakeholder involvement is active, and there are few challenges in implementation.
Continuous Change Support Strategies
Developing guidelines and policies that should be used in the organization is one way to support continuous change in the proposed project. The guidelines should be incorporated into the human resources department’s organizational processes for promoting employee development. The second strategy is to incorporate change strategies into organizational culture. This will incorporate them into organizational behaviors and processes. The final intervention is to reward performance (Hughes, 2018). Incentives will be provided on a regular basis to ensure long-term change and the implementation of its strategies. Hodges (2016) proposes another method, which is the use of regular feedback mechanisms in the organization. Staff should be given regular feedback on their accomplishments and areas for improvement. The other intervention is the use of open communication frameworks. Different organizational stakeholders should be able to communicate freely with one another. This will provide insights into how continuous improvement and change are accomplished.
How the Change Plan Contributes to the Organization’s Mission, Addresses Stakeholder Concerns, and Promotes Equity in Society
Our hospital’s mission is to promote care that is high in quality, efficient, and cost-effective. However, the identified issue is impeding the completion of this mission. As a result, the proposed change helps to realize the mission statement by ensuring cost-efficiency in healthcare operations through staff retention. Staff retention through the proposed intervention will improve the quality and safety of care provided to patients (Pasmore, 2015). The change also addresses issues affecting nurses and other stakeholders in the institution, such as managers and patients. It is expected that the change will improve patient and societal health outcomes, and thus social equity.
Conclusion
The proposed change aims to address the issue of low nurse retention in the hospital by implementing strategies that promote staff development. Employee recognition and the provision of opportunities for professional and personal development should be used as interventions. Several stakeholders in the organization will be impacted by the change. As a result, interventions to address any barriers should be developed prior to the change’s implementation.
References
J. Hodges (2016). Managing and leading people through organizational change: The theory and practice of sustaining change through people. Page Publishers, Kogan.
M. Hughes (2019). Management and leadership of organizational change. Routledge, New York, NY.
Mendy, J. (2018). Human resources and organizational behavior are taught at the college level.
W. A. Pasmore (2015). Managing churn in the real world: Leading continuous change. Berrett-Koehler Publishers, Oakland, CA. Hershey: Reference for Business Science.

In the field of technology and software development, facilitating continuous change without compromising quality or causing burnout among employees is crucial to staying competitive and innovative. To achieve this, several essential systems must be in place (HealthIT.gov; Kotter & Cohen, 2012).

Essential Systems for Facilitating Continuous Change:

Agile Development Methodology: Implementing an Agile development methodology, such as Scrum or Kanban, can help in managing continuous change effectively. Agile principles emphasize collaboration, adaptability, and iterative development (HealthIT.gov). Cross-functional teams work on small, manageable tasks with regular feedback and review cycles, reducing the likelihood of burnout by ensuring a sustainable pace of work.

DevOps Practices: A robust DevOps (Development and Operations) culture is essential for continuous change. DevOps promotes automation, collaboration, and continuous integration/continuous delivery (CI/CD) (HealthIT.gov). By automating repetitive tasks and streamlining the software delivery process, organizations can reduce the stress on employees and maintain high-quality standards.

Learning and Development Programs: To prevent burnout and promote employee growth, invest in comprehensive learning and development programs (Kotter & Cohen, 2012). These programs should focus on both technical skills and soft skills, fostering a culture of continuous learning. Encourage employees to acquire new skills, and provide opportunities for them to experiment and innovate in a safe environment.

Factors for Permanently Embedding Changes in Organizational Culture:

Leadership Commitment: Leadership plays a critical role in embedding changes in an organization’s culture (Kotter & Cohen, 2012). Leaders must champion the changes and consistently demonstrate their commitment through actions and communication. When leaders model the desired behavior, employees are more likely to embrace and adopt new practices.

Clear Communication: Effective communication is key to ensuring that changes become ingrained in the culture (Kotter & Cohen, 2012). Communicate the reasons behind the changes, the expected benefits, and the impact on employees’ roles and responsibilities. Create channels for feedback and address concerns promptly. Regularly update employees on progress and celebrate milestones to maintain enthusiasm.

Alignment with Values and Incentives: Ensure that the changes align with the organization’s core values and are supported by appropriate incentives (Kotter & Cohen, 2012). When employees see that the changes align with the company’s mission and values, they are more likely to embrace them. Incentives can include recognition, rewards, or career development opportunities tied to the successful implementation of new practices.

In summary, continuous change in the technology and software development field requires a foundation built on Agile methodologies, DevOps practices, and a strong commitment to employee growth and well-being (HealthIT.gov). To make these changes a permanent part of the organizational culture, leaders should lead by example, communicate effectively, and align the changes with the company’s values and incentives (Kotter & Cohen, 2012). By doing so, organizations can adapt and thrive in an ever-evolving industry while maintaining high-quality standards and employee satisfaction.

Reference:

Benefits of health IT | HealthIT.gov. (n.d.). https://www.healthit.gov/topic/health-it-and-health-information-exchange-basics/benefits-health-it

Kotter, J. P., & Cohen, D. S. (2012). The heart of change real-life stories of how people change their organizations. Harvard Business Review Press.