NUR 514 Implementing Change With an Interprofessional Approach Presentation
NUR 514 Implementing Change With an Interprofessional Approach Presentation
As an advanced registered nurse, you will serve as a leader within your organization. Part of this role will entail being a change agent and spurring positive change on behalf of patients, colleagues, and the industry.
Consider a situation you experienced previously where change did not go as planned in your health care organization. Create a 10-15-slide PowerPoint presentation in which you will assess the situation and the steps that should have been taken to successfully implement change. Create speaker notes of 100-250 words for each slide. Include an additional slide for the title and references. For the presentation of your PowerPoint, use Loom to create a voice-over or a video. Refer to the study materials for additional guidance on recording your presentation with Loom. Include an additional slide for the Loom link at the beginning and another at the end for References.
Include the following in your presentation:
- Describe the background of the situation and the rationale for and goal(s) of the change. Consider the ethical, social, legal, economic, and political implications of practice change in your response.
2. Outline the advanced registered nurse’s role as change agent within the interprofessional and dynamic health care environment.
3. Identify the key interprofessional stakeholders (both internal and external) that should be involved in change efforts.
4. Discuss an appropriate change theory or model that could be used to achieve results. Explain why the theory or model selected is best for the situation. Include the ethical, social, legal, economic, and political implications of applying the change management strategies to practice change in your response.
5. As an advanced registered nurse, outline how you would initiate the change.
6. Describe the impact to the organization if the change initiative is unsuccessful again, and potential steps the interprofessional team could take if the change is unsuccessful.
7. Predict what additional factors will drive upcoming organizational change for the organization and outline the advanced registered nurse’s role as change agent.
You are required to cite three to five sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.
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Refer to the resource, “Creating Effective PowerPoint Presentations,” located in the Student Success Center, for additional guidance on completing this assignment in the appropriate style.
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
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. A link to the LopesWrite technical support articles is located in Course Materials if you need assistance.
Topic 3 DQ 1
Describe an organizational change model that can be used in a dynamic health care environment. Based on this model, how is organizational change is managed? What role do stakeholders play during organizational change?
The healthcare system is constantly changing and evolving to meet the needs of diversifying populations and advancing technology. To meet these dynamic changes, effective systems and change models must be in place. There are several change models that have been developed throughout history and all include four similar steps: identifying a problem, setting objectives, implementing change, and evaluating change (DeNisco, 2021). One example of a change theory was developed by Kurt Lewin and utilizes three steps. The first is the “unfreezing” stage where current systems are questioned. The second phase is called “freezing” and is where change is implemented. The final step is the “refreezing” stage where the change is solidified into practice (DeNisco, 2021). While this is one of the oldest change theories, it is still applicable to the current healthcare system.
Advanced practice nurses are being called on more than ever to lead healthcare change initiatives. Change can be suggested by any member of the healthcare team at any level including upper administration, mid-level providers, and direct caregivers. Implementation is most effective when utilized in a team setting and should be initiated by a group rather than one or a couple of people. The ideal result of change needs to be instilled into team members to build a collective vision. Team leaders need to identify those that support change as well as barriers to change as well. Leaders must listen to the opinions and ideas of team members involved in implementing change and positive impact should be rewarded with positive reinforcement to sustain change (DeNisco, 2021). There are so many different stakeholders involved in organizational changes. These include upper hospital administration, nurse managers and leaders, floor staff, patients, and community members. While hospital staff stakeholders are implementing the change, patients and community members feel the impact of change and initiatives.
Topic 3 DQ 2
You have been selected to serve on a community outreach committee within your state’s nursing organization. The committee includes registered nurses of different specialties. At your first meeting, it becomes evident that not everyone is in agreement with a recent position statement about the role of spiritual care, with some members arguing they will no longer support the committee if the position statement is not revised or reversed. As a nurse leader and change agent, how would you approach the committee? How could you draw from change theory to address these concerns and encourage collaboration on the committee?
Topic 3 Participation
Topic 3: Organizational Change Theories and Strategies
- Discuss the advanced registered nurse’s role as change agent within the interprofessional health care environment.
2. Analyze factors driving organizational change within health care organizations.3. Evaluate change theories and collaborative models for promoting change.
4. Evaluate the ethical, social, legal, economic, and political implications of practice change.
Topic 4: Nurse Leadership and Health Care Policy and Advocacy
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- Propose strategies to support patient advocacy in health care policy making as an advanced practice nurse.
2. Analyze the impact health care policy on health care organizations and cost-effective quality care.
Review Chapter 23 in Advanced Practice Nursing: Essential Knowledge for the Profession.
Leadership in Nursing Practice: Changing the Landscape of Health Care
Read Chapters 11 and 13-15 in Leadership in Nursing Practice: Changing the Landscape of Health Care.
Preparing Nurses for Leadership in Public Policy
Read “Preparing Nurses for Leadership in Public Policy” (2014), located on the Robert Wood Johnson Foundation website.
Arizona State Legislature
Explore your state legislature website and access legislation information. The link to the Arizona State Legislature website is provided, but learners living in other states should access their state departments. This resource will be used for the Topic 5 assignment.
Consumer Information and Insurance Oversight
Read “Consumer Information and Insurance Oversight,” located on the Programs and Initiatives page of the Centers for Medicare and Medicaid Services (CMS, 2019).
Guide to Healthcare Reimbursement Models
Read “Guide to Healthcare Reimbursement Models,” located on the DECO Recovery Management website (2019).
Understanding the Value-Based Reimbursement Model Landscape
Read “Understanding the Value-Based Reimbursement Model Landscape,” by LaPointe (2020), located on the Revcycle Intelligence website.
Generational Differences and Professional Memberships
Read “Generational Differences and Professional Memberships,” by Martin and Waxman, from Nurse Leader (2017).
Differences and Importance of IPPS, OPPS, MPFS and DMEPOS
Read “Differences and Importance of IPPS, OPPS, MPFS and DMEPOS,” located on the NursingAnswer.net website.
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NUR 514 Implementing Change With an Interprofessional Approach Presentation Rubrics
5.0 %Driving Forces of EHRS A description of the driving forces that related to need for implementing EHRs is not included. A description of the driving forces that related to need for implementing EHRs is incomplete or incorrect. A description of the driving forces that related to need for implementing EHRs is included, but lacks supporting detail. A description of the driving forces that related to need for implementing EHRs is completed and includes supporting detail. A description of the driving forces that related to need for implementing EHRs is extremely thorough and includes substantial details.
10.0 %Change Initiative and Being a Change Advocate An outline of how change would be initiated is not included. An outline of how change would be initiated is incomplete or incorrect. An outline of how change would be initiated is included, but lacks supporting detail. An outline of how change would be initiated is completed and includes supporting detail. An outline of how change would be initiated is extremely thorough and includes substantial details.
5.0 %Key Interprofessional Stakeholders Identification of the key interprofessional stakeholders is not included. Identification of the key interprofessional stakeholders is incomplete or incorrect. Identification of the key interprofessional stakeholders is included, but lacks supporting detail. Identification of the key interprofessional stakeholders is completed and includes supporting detail. Identification of the key interprofessional stakeholders is extremely thorough and includes substantial details
5.0 %Impact of the Change on Current Workflows A description of how the change will affect current workflows is not included. A description of how the change will affect current workflows is incomplete or incorrect. A description of how the change will affect current workflows is included, but lacks supporting detail. A description of how the change will affect current workflows is completed and includes supporting detail. A description of how the change will affect current workflows is extremely thorough and includes substantial details.
5.0 %Required Resources for Implementation Identification of required resources for implementation is not included Identification of required resources for implementation is incomplete or incorrect. Identification of required resources for implementation is included, but lacks supporting detail. Identification of required resources for implementation is completed and includes supporting detail. Identification of required resources for implementation is extremely thorough and includes substantial details.
5.0 %Risks Within Implementation A description of potential risks within the implementation plan is not included. A description of potential risks within the implementation plan is incomplete or incorrect. A description of potential risks within the implementation plan is included but lacks supporting detail. A description of potential risks within the implementation plan is completed and includes supporting detail. A description of potential risks within the implementation plan is extremely thorough and includes substantial details.
30.0 %Presentation of Content The content lacks a clear point of view and logical sequence of information. Includes little persuasive information. Sequencing of ideas is unclear. The content is vague in conveying a point of view and does not create a strong sense of purpose. Includes some persuasive information. The presentation slides are generally competent, but ideas may show some inconsistency in organization or in their relationships to each other. The content is written with a logical progression of ideas and supporting information exhibiting a unity, coherence, and cohesiveness. Includes persuasive information from reliable sources. The content is written clearly and concisely. Ideas universally progress and relate to each other. The project includes motivating questions and advanced organizers. The project gives the audience a clear sense of the main idea.
5.0 %Potential Barriers A description of potential barriers when implementing the change and handling resistance is not included. A description of potential barriers when implementing the change and handling resistance is incomplete or incorrect. A description of potential barriers when implementing the change and handling resistance is included, but lacks supporting detail. A description of potential barriers when implementing the change and handling resistance is completed and includes supporting detail. A description of potential barriers when implementing the change and handling resistance is extremely thorough and includes substantial details.
10.0 %Layout The layout is cluttered, confusing, and does not use spacing, headings, and subheadings to enhance the readability. The text is extremely difficult to read with long blocks of text, small point size for fonts, and inappropriate contrasting colors. Poor use of headings, subheadings, indentations, or bold formatting is evident. The layout shows some structure, but appears cluttered and busy or distracting with large gaps of white space or a distracting background. Overall readability is difficult due to lengthy paragraphs, too many different fonts, dark or busy background, overuse of bold, or lack of appropriate indentations of text.
The layout uses horizontal and vertical white space appropriately. Sometimes the fonts are easy to read, but in a few places the use of fonts, italics, bold, long paragraphs, color, or busy background detracts and does not enhance readability. The layout background and text complement each other and enable the content to be easily read. The fonts are easy to read and point size varies appropriately for headings and text. The layout is visually pleasing and contributes to the overall message with appropriate use of headings, subheadings, and white space. Text is appropriate in length for the target audience and to the point. The background and colors enhance the readability of the text.
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 %Mechanics of Writing (includes spelling, punctuation, grammar, language use) Slide errors are pervasive enough that they impede communication of meaning. Frequent and repetitive mechanical errors distract the reader. Some mechanical errors or typos are present, but they are not overly distracting to the reader. Slides are largely free of mechanical errors, although a few may be present. Writer is clearly in control of standard, written, academic English.
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.
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.
NUR 514 Implementing Change With an Interprofessional Approach Presentation 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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