Implementing Change With an Interprofessional Approach Presentation
Implementing Change With an Interprofessional Approach Presentation: NUR 514 Assignment
Successful change is one of the biggest challenges that modern organizations face. A strategic necessity for change is always needed in this fast-changing world. Besides, if things are not done differently, organizations are unlikely to succeed or last. I will start by describing the background of a situation in my current healthcare organization where change did not go as planned, including the rationale and the purposed goals of the change. In addition, I will identify the key interprofessional stakeholders, both internal and external, that should be involved in change efforts. I will then identify an appropriate change theory or model and discuss how it can be used to achieve results. I will also outline a plan that I would adopt to utilize the change in the healthcare organization. Lastly, I will discuss the impact on the organization if the change initiative would be unsuccessful again, and the potential steps the interprofessional team should take if the change is ineffective.
Any organization cannot function without change. Change enables health organizations to implement interventions that help them succeed in the market and compete. Change also enables health organizations to more effectively respond to and adapt to emerging market needs. Health organizations must embrace the use of a change model to guide the process in order to successfully implement change. Change models serve as benchmarks for evaluating the success of the change process and the necessary improvement interventions. The evaluation is the final step in the change implementation process, and it determines whether or not the change was successful in facilitating the desired success.
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1.Do you remember the 3 C’s of change leadership?
2.What are the three key steps of leading the process of strategic change?
3.What are the crucial qualities of leading people?
4.How have you ever affected positive change in your current or former organization?
5.How can you spur positive change on behalf of your organization?●
In a complex and fast-paced healthcare environment, change is inevitable and constant. The advanced practice nurse is required to lead and adapt to the constant changing environment while working with multidisciplinary teams. Imagine you are assigned by your director to work with a multidisciplinary team that is assisting with transition from the current paper record-based system to an electronic health record (EHR).
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Create a PowerPoint presentation (10-15 slides) in which you will assess the situation and the steps that should be taken to successfully implement the change. Be sure to include 100-250 word presenter’s notes per slide. Your presentation should address the following:
- Describe the driving forces that relate to the need for implementing electronic health records.
- Identify the key interprofessional stakeholders (both internal and external) that should be involved in change efforts.
- Outline how you would initiate the change and be a change advocate. Utilizing change theory and innovative models of care, explain how you would provide a structure for the planned change to achieve successful implementation of the EHR.
- Demonstrate how the change will affect current workflows. What revised workflow would you implement?
- Identify resources (human, time, material, etc.) required for implementation.
Internal Inter-Professional Stakeholders
A number of internal inter-professional stakeholders could have been involved in the implementation of the change. One of them were the nurses. The nurses were the primary implementers of the change. It was therefore essential that training be provided to them on the ways of implementing the change. They could have also provided their insights into the ways in which the change could have been implemented efficiently. The other internal stakeholder that could have been involved in the implementation of the change were the nurse managers. The nurse managers could have worked with the other nurses in assessing the need for the change and ways of ensuring its success. The managers could have also used this opportunity to identify the behaviors and strategies that were needed for the success of the change initiative. The nurse managers could have also worked with the nurse leaders to ensure that the change initiative supported the vision of the hospital. They would have collaborated in exploring the most effective strategies that could have been used in implementing the change. The human resource manager could have assisted in performing needs assessment prior to the implementation of change. The information from need assessment could have been used to come up with appropriate goals for the implementation and training processes. Lastly, the finance manager could have assisted in the determination of whether the change initiative was financially sound or not. He could have assisted in exploring the most cost-effective ways of implementing the project.
- Identify risks within the implementation plan. What are the impacts of the poor planning on cost, quality, and safety?
- Identify potential barriers when implementing the change and discuss how you will handle resistance.
- PDSA theory could have been used
- Provides understanding of systematic introduction of change
- Implementation of change builds on the small successes in the organization
- System checks used to promote continuous quality improvement in implementation of change
The PDSA change theory could have been used to implement the change. Planning, doing, studying, and acting are all part of the theory. This theory is used by change implementers to test the needed change by first developing a plan. The plan is implemented and tested to determine its efficacy. The research phase identifies the strengths and weaknesses of the interventions used. The study’s findings are used to implement the change. The theory provides a practical approach to implementing change in which successful tested interventions are used to implement the necessary change in the organization. Process checks are also used to eliminate flaws in the implementation process and strengthen the use of best practices in the process alone (Katzenbach et al., 2019).
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At the charge nurse level, organizational change is frequently experienced as a bystander. The shift is clear, but the stakeholders and model remain unknown. After being purchased by a multinational corporation, the transition from a nonprofit to a for-profit acute care hospital was difficult. The majority of the change was viewed negatively by nursing staff. There were layoffs, supply shifts, leadership voids, and protracted contract negotiations, all of which resulted in significant delays in step and other raises. If you asked the nursing staff how the transition went, they’d probably say, “not great, but we got through it.” Because the change plan was successful, you would get a different answer if you asked the primary stakeholders who were affected by it. Five years later, things are back to normal, with the announcement of a new hospital on the horizon
All of the area’s hospitals are now for-profit enterprises. This is a common occurrence in the United States, where hospitals are increasingly merging and healthcare costs are rising (Findlay, 2018). Approximately one out of every five hospitals was acquired or merged between 2013 and 2017. (Findlay, 2018). Mergers are almost always necessary for the survival of a hospital. The only way to keep up with changing technology, modern data management, and top clinical skill is to merge with large organizations (Findlay, 2018).
Nonetheless, at what cost to the communities served by these hospitals? You’d think that community services would suffer; however, a recent study found that nonprofit facilities spent slightly more on charity care, while for-profit hospitals with 300 beds or more spent more (Garber, 2020). According to the same study, the most significant variation in charity care spending occurred between states and had little bearing on whether the facilities were nonprofit or for-profit (Garber, 2020). Major organizational change is difficult, and some areas of nursing suffer; however, the larger picture indicates the need to survive.
10.0 %Language Use and Audience Awareness (includes sentence construction, word choice, etc.) Inappropriate word choice and lack of variety in language use are evident. Writer appears to be unaware of audience. Use of primer prose indicates writer either does not apply figures of speech or uses them inappropriately. Some distracting inconsistencies in language choice (register) or word choice are present. The writer exhibits some lack of control in using figures of speech appropriately. Language is appropriate to the targeted audience for the most part. The writer is clearly aware of audience, uses a variety of appropriate vocabulary for the targeted audience, and uses figures of speech to communicate clearly. The writer uses a variety of sentence constructions, figures of speech, and word choice in distinctive and creative ways that are appropriate to purpose, discipline, and scope.
5.0 %Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style) 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.
100 %Total Weightage
Re: Topic 3 DQ 1
All the hospitals in the area are now for-profit facilities. This is a trend in the United States, hospitals are consolidating at an accelerating rate, and healthcare costs continue to rise (Findlay, 2018). From 2013 to 2017, nearly 1 in 5 hospitals were acquired or merged with another hospital (Findlay, 2018). In most cases, mergers are necessary for the survival of the hospital. To keep up with advancing technology, modern data management, and top clinical talent, merging with large corporations is the only option (Findlay, 2018).
Our world is a constant change. In healthcare, science is always in the throes of discovering medical and scientific breakthroughs. These changes are heading for the patient’s or an individual’s optimum well-being. Organizational change is a must to improve patient outcomes and the organization’s success, which is significantly determined by the environment, population, culture, politics, and power. In the study done by Hussain and company (2018), according to Lewins, there are three steps of organizational change. First is the “Unfreeze,” where the people are currently in the usual stagnant state. This stage is where the problem is found, or the change begins. Every individual is unique and has different ways of responding to the threat or inevitable change to happen. The unfreeze is when people react by being enthusiastic and anticipating the change or resistant to the fear of the unknown. The second step is the “Change Process.” This phase of organizational change is challenging. People might resist as they feel like losing something vital to them, and different personalities react in various ways. Some even might leave their jobs related to their reaction to the changes.
Others are eager and will embrace the change and support the organization’s movement of changes. The Third and final stage is the “Refreeze,” where people accept change and come to terms, and will feel committed and favorable to the new organization. For example, I worked once in a hospital and experienced the hospital’s participation in the Pathway to Excellence Journey. Nurses were encouraged and supported in their advancement of education. During those times, Licensed Vocational Nurses (LVNs) worked on the acute medical floor. The hospital is changing to primary care nursing. With the LVNs’ limited nursing scope of practice, the change had them reassigned to work in the rehabilitation unit, long-term care, and clinics. The change has impacted our LVNs and the rest of the nursing population. This is the Unfreeze stage in an organizational change. Some of the LVNs were almost at retirement and found returning to nursing school impractical. They are used to their nursing roles and working in that acute unit for a significant amount of time. Suddenly, transferring to a new working environment is a relatively huge change. The LVNs are seasoned and skilled nurses, and we grieved when we lost them from our unit. As the movement of LVNs came into actualization, this is the change process begins; the positive impact that the change created to charge nurses and RNs as stakeholders led them to no longer be responsible for our LVNs admission. RNs are all independent in their scope of practice, like blood transfusion and IV medication administration, and patient-centered. LVNs from acute settings transferred to their respective new units could apply a culture of teamwork to clinics and rehab. Although it took much adjustment, eventually, they settled and adjusted to their new working environment. Other younger LVNs were inspired to advance their education, bring more bright ideas within the unit, and contribute to the success as a designated Pathway to Excellence organization, leading to the final stage of refreezing in an organizational change.
Re: Topic 3 DQ 1
The change theory could be utilized to reformulate the position statement about the role of spiritual care. The leader should establish communication amongst all members that there is a need for change and that all participants must put aside their differences to collaborate to create a new position statement (DeNisco & Barker, 2016). The team needs to develop a plan of action that states the participants, the process, the expectations, and the outcome. The first stage is the assessment to identify the problem that needs to be changed (Weberg et al., 2019). Research may be necessary to design the position statement. Clinical or relevant expertise may be used. The team may need to review the old statement to assess what the conflict is about. The next step is team reflection (Weberg et al., 2019). The team gathers together to develop ideas on what should be incorporated in the position statement and why. The leader guides the team toward a positive outcome. The leader maintains the direction of the collaborative effort. In the third step, the ideas are organized and categorized into a plan to be implemented. The leader may have to assist team members in their resistance to change in the position statement.
There may need to be further assessment and revision of the position statement in order to create a final statement that everyone agrees upon. The ideas proposed by DeNisco & Barker (2016) and Weberg et al. (2019) suggest that the team identify and recognize ways to work together in an established document that defines those terms to be able to agree and prepare a new position statement reflective of the ideas of all participants. When there is disagreement, the leader may need to step in to drive the conversation in a rational and logical manner towards consensus. A compromise may be necessary. A calm temperament is needed for heated debate.ReferencesDeNisco, S. M., & Barker, A. M. (2016). Advanced practice nursing: Essential knowledge for the profession (3rd ed.). Jones & Bartlett Learning. https://www.gcumedia.com/digital-resources/jones-and-bartlett/2016/advanced-practice-nursing_essential-knowledge-for-the-profession_3e.phpWeberg, D., Mangold, K., Porter-O’Grady, T., & Malloch, K. (2019). Leadership in nursing practice: Changing the landscape of health care (3rd ed.). Jones & Bartlett Learning. https://www.gcumedia.com/digital-resources/jones-and-bartlett/2018/leadership-in-nursing-practice_changing-the-landscape-of-healthcare_3e.php
- Discuss the advanced registered nurse’s role as change agent within the interprofessional health care
- Analyze factors driving organizational change within health care organizations, including stakeholders and
- Evaluate change theories and collaborative models for promoting successful
- Evaluate the ethical, social, legal, economic, and political implications of practice
How have you seen or experienced organizational change within an organization? Did it go well or not? Was there any correlation in how the organizations used stakeholders or change models?
RESPOND HERE (150 WORDS, 2 REFERENCES)
This is insightful, Marion; organizational change can sometimes become sudden due to the lack of involvement of some professionals in the change process. In most cases, charge nurses are left out in the decision-making processes, a scenario that makes it so hard for them to realize that the change process has been initiated (Nielsen et al., 2020). The change from profit to a non-profit organization can prove to be a challenge for most healthcare workers due to the changes in the roles for nurses that ought to be implemented. Given the increase in demand for effective healthcare care services, the change processes are always dynamic; this is a trend in the United States, hospitals are consolidating at an accelerating rate, and healthcare costs continue to rise (DeNisco et al., 2016). Sometimes, when organizational changes are implemented, nurses, particularly charge nurses, experience challenges in the process of transition. Therefore, there is the need to involve nurses in the decision-making processes geared towards implementing changes in the healthcare systems.
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Health care organizations apply different strategies to improve health outcomes. Practice change improves health outcomes by addressing performance gaps and introducing new processes (Busetto et al., 2018). However, change does not always occur as planned, which can have far-reaching impacts on financial assets and workplace relationships. Therefore, the purpose of this presentation is to describe a situation where change did not go as planned in the workplace and the steps that should have been taken to implement change successfully. Central discussion areas include a background of the situation, the nurse’s role as a change agent, and stakeholders essential in change management. Other areas include a presentation of change theory, impacts of unsuccessful change, and factors to drive upcoming organizational change.
The situation where change did not occur as planned involved the introduction of a zero-tolerance policy in the organization in response to increased cases of bullying. As Mrayyan (2018) stated, zero tolerance towards workplace violence encourages nurses not to endure violence and report it immediately after they encounter it. The law also severely punishes those who commit violent acts like bullying against health care providers. Like other practice change activities, the nursing staff was supposed to be adequately prepared for policy change to embrace it fully. Unfortunately, the management introduced the policy abruptly, which reduced the staff’s commitment to implementing it fully. Hence, it did not achieve the outcomes as projected.
Health care professionals should work in safe care environments to deliver quality patient care. According to Al-Ghabeesh and Qattom (2019), bullying is damaging to the health and productivity of nurses since it impairs their emotional health and increases their desire to quit their occupations. Therefore, zero tolerance towards bullying is a practical intervention for optimizing employee productivity and protecting nurses from the adverse effects of workplace incivility. Homayuni et al. (2021) found that bullying is associated with depression and distress in nurses, which hampers interprofessional collaboration and their ability to provide quality care. A zero-tolerance policy protects the staff from such health dangers and ensures civil conduct among employees as they work to achieve a common goal.
Nurse leaders should introduce and guide while looking forward to achieving multi-dimensional impacts. Practice change achieved by implementing zero-tolerance policies can help to promote ethical conduct among nurses, which is characterized by behaviors that prevent harm and ensuring that employees are responsible for their actions. From a social dimension, nursing practice is conducted in social environments with diverse practitioners. Preventing behaviors that hamper teamwork and cooperation is instrumental in building healthy relationships among diverse teams. Mrayyan (2018) stressed the importance of a zero-tolerance policy in preventing costly medical errors. Preventing such errors also minimizes legal issues stemming from patient harm and improves the organization’s reputation and relationship with partners.
The advanced registered nurse’s role as a change agent is critical for the progressive improvement of patient care outcomes. According to Rafferty (2018), nurses and nurse leaders are directly involved in patient care, and their influence, skills, and guidance are valuable in change implementation. Skills utilization is demonstrated by continuous assessment of practice gaps and introduction of interventions for enhancing performance. Nurse leaders also use their knowledge and skills to promote evidence-based innovation and lead behavior change practices like zero-tolerance policies, motivation programs, and infection control. Other roles include designing and delivering health policy as nurses and patient advocates and mentoring nurses to embrace change to reduce resistance toward new practices.
Stakeholders play a critical role in change implementation. The type, direction, and success of organizational change depend on stakeholder engagement, participation, and support (Jasinska, 2020). One of the key stakeholders involved in change efforts is the caregivers, including nurses and physicians. They are directly involved in change efforts since many practice changes cannot be conducted without them. The organization’s management plays a crucial role in supporting change through resources and preparing the organization for change. Other stakeholders with varying roles include patients, partners and suppliers, political and legal representatives, and accreditation agencies. These stakeholders should be adequately informed about organizational practices to determine whether the organization promotes care quality and patient safety as professionally obliged.
Kurt Lewin’s change management model is highly appropriate for change implementation in a dynamic health care environment. Its basic concepts include driving forces that push change in the desired direction, restraining forces that counter change efforts, and a state of equilibrium. As Hussain et al. (2018) explained, practice change occurs progressively in three basic steps: unfreezing, changing, and refreezing. Unfreezing is primarily about preparing the nursing staff and other stakeholders to understand and embrace change to counter possible resistance. The changing phase involves transitioning to new behaviors and work routines, while refreezing involves sustaining the new status to achieve lasting effects.
Change leaders apply different change models for different reasons. Besides guiding change management in a simple and straightforward process, Lewin’s change theory aims to understand and demonstrate why change occurs (Hussain et al., 2018). Accordingly, change leaders can justify the change and visualize the outcomes. Lewin’s theory also accounts for uncertainties and resistance to change. In most instances, resistance to change occurs when the nursing staff and other stakeholders are not engaged in the change process. To overcome resistance, Lewin’s theory stresses the need for clear and convincing communication and education about the need for the change during the unfreezing phase (Deborah, 2018). Above all, the phased change management helps change leaders to introduce and implement organizational change procedurally.
Organizational change has profound impacts on care quality and work processes. Hence, the change management strategies applied should be centered on achieving change without adverse impacts on behaviors, social relationships, and finances. Due to its straightforward nature and simplicity, Lewis change management model ensures that change is implemented without ethical misconduct or negative impacts on workplace behaviors. The simple process is also economical since it does not include many steps that can be tiring or consume massive resources. Change management through positive behavior change also protects patients, health care professionals, and other populations. Doing so protects the organization from possible reputational damage, which can be politically, ethically, and legally costly.
Advanced registered nurses should be aware of change implementation barriers before initiating practice change. After identifying the change and potential impacts, I would develop a comprehensive implementation plan to share with the management and the nursing staff. Next, I would communicate the change to nurses and all stakeholders since lack of it was the main reason for the initial change failure in the facility. Communication is crucial in the unfreezing phase of change management since it helps stakeholders to understand the change and its importance (Deborah, 2018). The next step would be actively engaging stakeholders to implement the change before its evaluation to determine whether it achieved the desired effects.
Change implementation is usually a lengthy, laborious, and resource-intensive process. It requires preparation, continuous communication, and engagement of stakeholders. Unsuccessful change implies potential misuse of the organization’s resources such as zero tolerance policy handouts and finances used communication and other crucial processes. Since the goal of the change process is to prevent bullying, failure to achieve this goal would increase nurses’ exposure to workplace bullying. Al-Ghabeesh and Qattom (2019) found that bullying lowers nurses productivity since it is psychologically harming, and the same would be witnessed in the organization. Other potential outcomes include increased risk to patient care and disappointment with the change process.
Nurse leaders should never give up with organizational change. Consequently, they should have a backup plan if change is unsuccessful. The most effective intervention to address the current scenario if change does not succeed is a collaborative process and impact assessment. In this case, nurses, nurse leaders, and the management would collaborate to assess why practice change failed and practical remedies. The role of the collaborative assessment would be helping the change team to address implementation barriers before reintroducing the change. Such barriers include communication problems, a resistance culture, and a lack of stakeholder support (Busetto et al., 2018). As the implementation progresses, the change team should seek continuous feedback from stakeholders while monitoring reactions and impacts. Such an impact would help to fix any issue hampering the process timely and conveniently.
Successful organizational change is achieved through a combination of factors. Besides stakeholder engagement and communication as mentioned earlier, employee growth and development will play a crucial role in driving upcoming organizational change. Largely, employee growth and development will equip employees with the skills, knowledge, and attitudes necessary for continuous quality improvement in health practice. Organizations ready for change must foster innovation through nurse leaders who seek new ways to transform and influence higher care quality through new care delivery models (Snow, 2019; Mutonyi et al., 2021) Accordingly, the advanced registered nurse must be at the center of innovation and transformation through continuous assessment of performance gaps and fostering a culture of change in the organization.
As demonstrated in this presentation, the primary goal of practice change is to optimize health outcomes. As a result, nurse leaders and other health care professionals in advanced practice should continually assess performance gaps, promote innovation, and lead behavior-change practices. Since practice change should be systematic and procedural, the advanced registered nurse should initiate change using theoretical guidelines. Kurt Lewin’s change management theory can be applied to introduce change in the organization to achieve the best results. It stresses preparation for change and sustaining it, which are critical to successful change. Additional drivers of change in the organization include the management investing in innovation and employee growth and development programs.
Implementing Change With an Interprofessional Approach Presentation: NUR 514 Assignment References
- Al-Ghabeesh, S. H., & Qattom, H. (2019). Workplace bullying and its preventive measures and productivity among emergency department nurses. Israel Journal of Health Policy Research, 8(1), 1-9. https://doi.org/10.1186/s12913-019-4268-x
- Busetto, L., Luijkx, K., Calciolari, S., Ortiz, L. G. G., & Vrijhoef, H. J. M. (2018). Barriers and facilitators to workforce changes in integrated care. International Journal of Integrated Care, 18(2), 1-13. http://doi.org/10.5334/ijic.3587
- Deborah, O. K. (2018). Lewin’s theory of change: Applicability of its principles in a contemporary organization. Journal of Strategic Management, 2(5), 1-11. https://stratfordjournals.org/journals/index.php/journal-of-strategic-management/article/download/229/274
- Homayuni, A., Hosseini, Z., Aghamolaei, T., & Shahini, S. (2021). Which nurses are victims of bullying: the role of negative affect, core self-evaluations, role conflict and bullying in the nursing staff. BMC Nursing, 20(1), 1-9. https://doi.org/10.1186/s12912-021-00578-3
- Hussain, S. T., Lei, S., Akram, T., Haider, M. J., Hussain, S. H., & Ali, M. (2018). Kurt Lewin’s change model: a critical review of the role of leadership and employee involvement in organizational change. Journal of Innovation & Knowledge, 3(3), 123-127. https://doi.org/10.1016/j.jik.2016.07.002
- Jasinska, J. (2020). Stakeholders identification affecting the scope and the changes in the health care system. Frontiers, 1(03), 1-15. doi: 10.2020/fmcr/000013120
- Mrayyan, M. (2018). Work place violence: A “zero tolerance” policy. EuroMediterranean Biomedical Journal, 13(16), 078-079. 10.3269/1970-5492.2018.13.16
- Mutonyi, B. R., Slåtten, T., & Lien, G. (2021). Fostering innovative behavior in health organizations: a PLS-SEM analysis of Norwegian hospital employees. BMC Health Services Research, 21(1), 1-15. https://doi.org/10.1186/s12913-021-06505-1
- Rafferty, A. M. (2018). Nurses as change agents for a better future in health care: the politics of drift and dilution. Health Economics, Policy and Law, 13(3-4), 475-491. https://doi.org/10.1017/S1744133117000482
- Snow, F. (2019). Creativity and innovation: An essential competency for the nurse leader. Nursing Administration Quarterly, 43(4), 306–312. https://doi.org/10.1097/NAQ.0000000000000367
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