Benchmark – EBP Project Proposal: Organizational Culture

Benchmark – EBP Project Proposal: Organizational Culture

Benchmark – EBP Project Proposal: Organizational Culture

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Assessment Description

In order to successfully implement a change within an organization, the change agent must assess the organization’s culture and readiness for change. In 750-1,000 words, analyze the culture and level of readiness of the organization for which your evidence-based practice project is proposed. You will use the assessment of the organization’s culture and readiness in the Topic 8 assignment, during which you will synthesize the various aspects of your project into a final paper detailing your evidence-based practice project proposal.

Include the following:

  1. Describe the organization’s culture and explain to what degree the culture supports change. Consider organizational and leadership structure, mission and values, interprofessional collaboration/team engagement, communication, perception of the organization by employees, etc.
  2. Select an organizational readiness tool and assess the level or readiness for change within your organization. Identify the readiness tool and summarize the survey results. Discuss the degree to which the culture will support and sustain an evidence-based practice change. Consider strengths and weaknesses, potential barriers, stakeholder support, timing of the proposal, and resources. Provide rationale.
  3. Discuss what health care process and systems you would recommend for improving quality, safety, and cost-effectiveness for the organization.
  4. Propose strategies to better facilitate the readiness of the organization.
  5. Identify the stakeholders and team members for the project. Include what their duties will be in the evidence-based practice project proposal.
  6. Explain what information and communication technologies are needed for the implementation and how they will be integrated in the setting by the internal stakeholders. Explain how these will help improve nursing practice and care delivery for individuals and populations for your intervention.

Refer to the “Evidence-Based Practice Project Proposal – Assignment Overview” document for an overview of the evidence-based practice project proposal assignments.

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NUR 590 Topic 3 DQ 2

Review the different models and frameworks that can be used to facilitate change. Compare two and explain which is best for your evidence-based practice proposal and why. Provide rationale.

The Star Model explains how specific forms of knowledge, such as the systematic review and the clinical practice guideline, are solutions for moving research into practice. It is a model for understanding the cycles, nature, and characteristics of knowledge that are utilized in various phases of EBP in moving evidence into clinical decision making. The clinical scholar model was developed and implemented to promote the spirit of inquiry, educate direct care providers, and guide a mentorship program for EBP and the conduct of research at the point of care. It began as an interactive, outcomes-oriented educational program for nurses but has evolved into an interdisciplinary educational program for direct care providers (Melnyk, 2019).

In my evidence-based practice proposal, the Star Model would be most beneficial. This model reviews current practice and applies knowledge for change. For my proposal, there is a lot of research on both patient and nurse dissatisfaction with the current bereavement process when a patient experiences a miscarriage in the ED. There is not a lot of research on implementation of better practice and protocols. Therefore, the Star Model will allow for me to take the knowledge of the subject and develop a change.

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Resource:

Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Wolters Kluwer Health.

Change facilitation requires forethought and intentional planning and execution if a well-supported, sustainable change is going to be made on a larger scale – especially in healthcare. Evidence-base practice models may include theoretical models grouped into evidence-based practice/research utilization and knowledge transformation processes, strategic organizational change theory or knowledge exchange and synthesis for application and inquiry (Melnyk & Fineout-Overholt, 2019). However, it is becoming more widely acknowledged that a formalized approach must be considered to successfully implement these evidence-based models.

Eight different models have been identified as key drivers for evidence-based integration and change management. These include: 1. The Stetler Model of Evidence-Based Practice, 2. The Iowa Model of Evidence-Based Practice, 3. The Model for Evidence-Based Practice Change, 4. The Advancing Research and Clinical practice through close Collaboration (ARCC) model for implementation and sustainability of EBP, 6. The Clinical Scholar Model, 7. The Johns Hopkins Nursing Evidence-Based Practice Model, and 8. The Stevens Star Model of Knowledge Transformation (Melnyk & Fineout-Overholt, 2019).

Upon comparing the Stetler Model and Johns Hopkins Model, the Stetler Model has been regularly revised, and involves integrating evidence-base practice information into practical, sustainable day to day standards for patient care. With critical thinking and utilization of both internal and external evidence to support practice change, the Stetler Model hinges on five phases, and multiple steps to identify and support use of evidence, determined by critical thinking (Melnyk & Fineout-Overholt, 2019). A “toolkit” of sorts has been developed to implement consensus guidelines and evidence-base practice change. Upon comparison, the Johns Hopkins Model supports its use by bedside registered nurses with aim to implement research results in an evidence-based practice format. The key objective is to make it easy for direct caregivers to make change at a grass-roots level, while positively impacting patient outcomes in a meaningful way. A problem-solving approach to address clinical questions, the 18-step process allows for non-randomized control trial designed evaluations and quality improvement initiatives to take place(Melnyk & Fineout-Overholt, 2019).. With mindfulness that registered nurses encounter challenges that require a fix “tomorrow”, with potential use of nonresearch evidence by use of four pathways.

For my PICOT with aim to reduce occurrence of CLABSIs in patients with a central line, I believe either model could be used to implement meaningful change. However, the Stetler model is better suited for a randomized control trial approach, which is the method I believe to be best suited to gain the most sound, valid and reliable results. By way of using critical thinking and various types of evidence (internal AND external), the Stetler model allows for easy implementation of evidence gathered by way of a toolkit and use of consensus guidelines and policy change.

References

Melnyk, B.M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing and healthcare: A guide to best practice (4th ed.). Wolters Kluwer. ISBN-13:9781496384539

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Benchmark – EBP Project Proposal: Organizational Culture

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Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

MBA-MSN; MSN-Nursing Education; MSN Acute Care Nurse Practitioner-Adult-Gerontology; MSN Family Nurse Practitioner; MSN-Health Informatics; MSN-Health Care Quality and Patient Safety; MSN-Leadership in Health Care Systems; MSN-Public Health Nursing

3.1:  Assess health care processes and systems to recommend measures for improving quality, safety, and cost-effectiveness across an organization.

3.3:  Integrate appropriate information and communication technologies to improve nursing practice and care delivery for individuals and populations.

Section A: Organizational Culture and Readiness Assessment

Evidence-based practices (EBP) are increasingly adopted by the health care organizations to help in maximizing patient outcomes and ensure provision of patient-oriented, quality care. Essentially, a meaningful adoption of EBP can be realized when the health care organization is ready and able to recognize the limitations and facilitators that may influence the process of EBP implementation (Schaefer & Welton, 2018).Therefore, to foster the implementation of the current EBP project at the VA healthcare system, the Norwegian version of the Evidence-Based Practice Attitude Scale (EBPAS) will be used as a tool to assess the organizational readiness for EBP (Egeland et al., 2016). The assessment revealed that VA healthcare system was ready for new EBP implementation.

Barriers and Facilitators

The major project barriers included lack of commitment to EBP adoption by the health care staff. Moreover, time limitation impeded the implementation of the project. This is due to overwhelming workload, which cannot allow the staff to review the emerging evidence. As a result, there was inadequate experience in EBP application. Conversely, the facilitators of the project included availability of existing providers who were ready to promote the EBP. Moreover, the project enjoyed management support.

Benchmark – EBP Project Proposal: Organizational Culture

High Scores and Low Scores

Concerning the high scores, the EBPAS assessment tool comprises of 19 categories and the VA healthcare system showed exemplary performance in 12 categories. Among the best scored categories included management support and the willingness by the health care providers to adopt EBP (Egeland et al., 2016). Contrarily, low scores were demonstrated in six categories, with major one being inadequacy of leading professionals in EBP implementation such as librarians to direct nurses and other providers on EBP implementation.

Integration of Clinical Inquiry

To optimize application of EBP, healthcare providers in VA health care system will be provided with training on EBP to encourage them and increase their confidence. The training will be crucial in identifying and working on areas that need improvement. Moreover, a study will be performed on the areas that need improvement to identify potential solutions to improve in them. Consequently, policy to direct EBP implementation will be designed to help in adopting the identified solutions. 

benchmark – Evidence-Based Practice Project Proposal: Organizational Culture and Readiness 

Healthcare organizations adopt evidence-based practice (EBP) interventions to enhance patient outcomes through the provision of quality and patient-centered care. Effective implementation of the EBP proposed project requires these organizations to identify both facilitators and barriers through use of tools that evaluate readiness and culture for change (Melnyk et al., 2022). The organizational culture and readiness assessment is a critical step in ascertaining if the organization is prepared for the EBP implementation. Dearing (2018) advances the need for EBP project implementers to use simple tools to assess the culture and readiness of an entity to implement EBP. The purpose of this paper is to provide the outcomes of the organizational culture and readiness assessment to implement the proposed EBP project.  

Organization’s Culture and Level of Readiness 

Organization’s culture is a vital part of its readiness for change as it has values and attributes, assumptions, and common goals that all stakeholders share and focus on in their operations and processes. The leadership structure in the organization is supportive of the change while the culture is also change-oriented. The leadership encourages participation of all providers, especially nurses who have new ideas. The culture supports change because it values innovative ways of offering patient care. The mission and the values of the organization like transformative care provision based on integrity, respect, and honesty imply that the organization has an effective culture. The evaluation also shows that the organization and its leadership value inter-professional collaboration and engagement of team through effective communication (DeNisco, 2021). The employees’ perception in the organization is positive as many believe in making change a normal occurrence for better outcomes and care delivery. Therefore, the EBP project will enhance the level of readiness for the organization to implement more projects to improve quality of care delivered to patients.  

Organizational Readiness & Degree of Support by the Culture 

Organizational culture also impacts the evaluation of readiness in implementing the EBP project. The primary areas of assessment for the proposed change include beliefs, leadership, quality improvement, and degree of awareness. To evaluate the readiness level for the organization, the selected assessment tool is the organizational readiness to change assessment (ORCA). The tool focuses on the level of evidence for the proposed change and the entity’s capacity to execute change and the suggested context (Dearing, 2018). On the application of the survey tool, the results indicate that nursing leadership was well prepared to implement the change because it communicates the importance of EBP to the clinical staff. The implication is that based on this tool, the level of readiness in the organization is about 4.5 out of the possible 5. The results of the scale-based survey completed showed that the organization was fairly prepared to incorporate EBP in the clinical setting. The nursing team and other stakeholders, especially those supporting nursing, were aware of the need to make changes to the current processes and operations.  

The culture will also support the proposed EBP since it is change-oriented, participative, and transformative. The organizational culture in the facility encourages input from all stakeholders. However, a core weakness may be its inability to establish limits and effective ways of presenting change issues. Possible barriers may include financial support and sufficient resources to implement the EBP in the facility (DeNisco, 2021). Stakeholder support will be critical as the evaluation shows increased support from all players. Again, the timing of the proposal is effective as it emerged during the evaluation that the organization has been keen on implementing initiatives aimed at improving the quality of care.  

Health Care Process and System 

Improving quality, safety and cost-effectiveness in this organization would require changes in the process and systems of the organization. The organization should establish processes that are patient-centered and encourage submission of opinions and views from diverse individuals and stakeholders. The organization should establish systems that leverage on health information technologies to improve assessment of patients and delivery of care (Tzeng et al., 2021). The incorporation of monitoring technology will assist nurses and physicians to adhere to the correct procedures and processes for all patients under their care. Further, patient involvement ensures that they are aware and understand their treatment plans. This will enhance their safety and ensure that they exercise their ethical principles of autonomy and beneficence. Cost efficiency approaches would also be significant for the organization. Therefore, the entity should consider patient care approaches that lead to better experiences and outcomes.  

Strategies to Facilitate Readiness of the Organization 

The initial strategy to facilitate change in the organization is to define and align it with the business goals of the entity. Through this approach, the organization demonstrates its readiness for change. Secondly, the organization should identify those who will be affected by the change through knowing the purpose of change and its long-term effects on the various levels of its operations (Melnyk et al., 2022). The third strategy is having an effective communication model to create awareness, enhance participation of all people, and ensure that employees do not resist change.  

Stakeholders and Team Members 

The EBP project will have different stakeholders with diverse roles. These include project manager, nurse leaders, organizational managers from different departments, especially the executive and quality assurance manager, the finance manager, and nurses. Patients will be also critical stakeholders as the end users of this EBP project proposal. The project manager will be in charge of all processes and operations as well as the deliverables of the initiative (Tucker et al., 2019). The nurse leaders will ensure that nurses implement the TIPS care bundle while the organizational manager will allocate financial resources. The quality assurance manager will ensure that the TIPS model leads to quality outcomes and protects patients from harm (Tzeng et al., 2021). Patients will be the end users with better outcomes aimed at preventing falls during their stay in the facility.  

Information & Communication Technologies Required in the EBP Implementation 

The use of TIPS bundled model to reduce falls will integrate diverse information and communication technologies to improve care delivery. These will include electronic health records, the use of patient portals, and clinical decision support systems (CDSS). The project will also require integration of telehealth and even telemedicine for patients to get alerts among other integrated technological aspects. These will improve nursing practice by allowing nurses to closely monitor patients and customize their interventions based on status and other aspects (Khasnabish et al., 2020). The use of these technologies will enhance patient participation in decision making and ensure that all providers align their treatment goals with patient preferences. 

Conclusion 

The readiness of an organization to implement EBP interventions is based on the effective assessment and evaluation using recommended tools. In this case, the evaluation demonstrates that the organization is ready for change based on its supportive culture and management. As such, all stakeholders and team members must integrate effective technologies to attain the goals of the proposed EBP project of using TIPS model to reduce falls among patient in medical-surgical settings.  

 References 

Dearing, J. W. (2018). Organizational Readiness Tools for Global Health Intervention: A  

Review. Frontiers in Public Health. https://doi.org/10.3389/fpubh.2018.00056 

DeNisco, S. M. (2021). Advanced practice nursing: Essential knowledge for the profession.  

Jones & Bartlett Learning 

Khasnabish, S., Burns, Z., Couch, M., Mullin, M., Newmark, R., & Dykes, P. C. (2020). Best  

practices for data visualization: creating and evaluating a report for an evidence-based fall prevention program. Journal of the American Medical Informatics Association, 27(2), 308-314. DOI: 10.1093/jamia/ocz190. 

Melnyk, B. M., & Fineout-Overholt, E. (2022). Evidence-based practice in nursing &  

healthcare: A guide to best practice. Lippincott Williams & Wilkins 

Tucker, S., Sheikholeslami, D., Farrington, M., Picone, D., Johnson, J., Matthews, G., … &  

Cullen, L. (2019). Patient, nurse, and organizational factors that influence Evidence‐Based fall prevention for hospitalized oncology patients: an exploratory study. Worldviews on Evidence‐Based Nursing, 16(2), 111-120. DOI: 10.1111/wvn.12353. 

Tzeng, H.-M., Jansen, L. S., Okpalauwaekwe, U., Khasnabish, S., Andreas, B., & Dykes, P. C.  

(2021). Adopting the Fall Tailoring Interventions for Patient Safety (TIPS) Program to Engage Older Adults in Fall Prevention in a Nursing Home. Journal of Nursing Care Quality.  https://doi.org/10.1097/ncq.0000000000000547 

 APA Checklist 

Appendix: APA Checklist 

APA Writing Checklist 

Use this document as a checklist for each paper you will write throughout your GCU graduate program. Follow specific instructions indicated in the assignment and use this checklist to help ensure correct grammar and APA formatting. Refer to the APA resources available in the GCU Library and Student Success Center. 

  • APA paper template (located in the Student Success Center/Writing Center) is utilized for the correct format of the paper. APA style is applied, and format is correct throughout. 
  • The title page is present. APA format is applied correctly. There are no errors. 
  • The introduction is present. APA format is applied correctly. There are no errors. 
  • Topic is well defined. 
  • Strong thesis statement is included in the introduction of the paper.  
  • The thesis statement is consistently threaded throughout the paper and included in the conclusion. 
  • Paragraph development: Each paragraph has an introductory statement, two or three sentences as the body of the paragraph, and a transition sentence to facilitate the flow of information. The sections of the main body are organized to reflect the main points of the author. APA format is applied correctly. There are no errors. 
  • All sources are cited. APA style and format are correctly applied and are free from error. 
  • Sources are completely and correctly documented on a References page, as appropriate to assignment and APA style, and format is free of error. 

Scholarly Resources: Scholarly resources are written with a focus on a specific subject discipline and usually written by an expert in the same subject field. Scholarly resources are written for an academic audience. 

Examples of Scholarly Resources include: Academic journals, books written by experts in a field, and formally published encyclopedias and dictionaries. 

Peer-Reviewed Journals: Peer-reviewed journals are evaluated prior to publication by experts in the journal’s subject discipline. This process ensures that the articles published within the journal are academically rigorous and meet the required expectations of an article in that subject discipline. 

Empirical Journal Article: This type of scholarly resource is a subset of scholarly articles that reports the original finding of an observational or experimental research study. Common aspects found within an empirical article include: literature review, methodology, results, and discussion. 

Adapted from “Evaluating Resources: Defining Scholarly Resources,” located in Research Guides in the GCU Library. 

  • The writer is clearly in command of standard, written, academic English. Utilize writing resources such as Grammarly, Lopes Write report, and Thinking Storm to check your writing. 

 

 

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