Making A Change For A Better Process

Implementing change among all organizations is necessary to achieve success; within the health care industry change is constant and it is the role of management teams to assess, plan, implement and evaluate change to ensure satisfaction. Considering this among the other aspects of running a successful organization it is essential to ensure that there is minimal resistance and familiarity to change. Demands of the consumers and staff as well as regulations are continuously changing. The responsibility of managers is to successfully lead these inevitable changes.

According to Porter-O’Grady, 2016 et al p 324, our healthcare systems today are at the center of what is considered major change. Much of the change today is directly related to the foundational principles, concepts and associated with complexity in systems and relationships, and an understanding by nurse leader and follower; of what it takes to make meaningful change. Nurse Leaders, registered nurses, advance practice nurses, and other followers, at every level of our organizations must be increasingly aware of meaningful and sustainable changes that improves our healthcare systems (Porter-O’Grady, 2016 et al p 324).

Implementing a change in practice within these environments can produce anxiety or fear of failure in nurses, leading to a resistance to change. Several studies (Bozak, 2003; Lehman, 2008; Spetz, Burgess & Phibbs, 2012) expounded the need for a concise plan and clear communication between nurses and management when implementing a change of this nature. The use of Lewin’s Change Management theory can support nurses through the transitions and identify areas of strengths and resistances prior to implementing change. Without a framework for guidance, it can be difficult to keep on track.

Kotter’s (2012) 8-step model of organizational change was selected as the change theory for the proposed project. Kotter’s change model has been implemented in many different organizational settings and industries (Kotter, 2012). Kotter’s model is designed as a microsystem or organizational-level change program, not as an individual change theory or model. Kotter’s (2012) model has been frequently cited as the change theory used in nursing quality improvement projects and other healthcare organization-based change projects (Kotter & Schlesinger, 2008; Mate & Rakover, 2016). Kotter’s change theory was selected for use in the proposed study not only because it has been successfully used in various healthcare settings and change programs, but also because the model includes guidelines for program implementation as well as strategies for addressing resistance to change and other change

As the technology is being implemented in health care system, computerized provider order entry (CPOE) has become the standard of care in most hospitals. According to Cherry and Jacob (2014), “CPOE contributes to safety and quality by eliminating lost orders automatically, monitoring for duplicate or contradictory orders, and reducing time to fill orders” (p 256). However, there are some barriers using the system which leads to medical errors including alarm However; some barriers are using the system which leads to medical errors including alarm fatigue, lack of communication, and clinicians’ hesitance to adapt to new system. CPOE alert physicians on a constant basis about “various drug-drug, drug-patient, and guideline-based recommendations during the ordering process” causing alert fatigue in clinicians (Payne & Weir, 2015, p 6).

Computerize provider order entry has had a tremendous impact on improving patient safety and health care outcomes. As a post-operative unit secretary, I often had the wonderful task of transcribing physician orders. I spent more time trying to contact the physician’s to ensure that I understood their handwriting then actually transcribing the order. There were numerous medication errors made through the assumption of transcribed orders. Consequently, computerized provider order entry helped to significantly reduce those risks. However, I have witness computerized provider order entry errors made by clinicians that the system fails to recognize. For example, a patient reported taking an anxiety medication X 2.5mg PO daily upon admission. Four

While focusing on several key areas that are critical to the success in transforming to the new healthcare policy, the importance is in ensuring the efficiency in managing care for the patients. With these changes, the nurse must be prepared to shape and lead the emerging

Health care is in a constant state of change. Health care organizations must recognize that change is needed to improve the quality and safety of patient care, retain employees, and restructure the organizational chart to maintain their viability. When changes are carefully and deliberately thought through using the knowledge and skill of leaders, this is considered planned change. The change agent plays a major role in the outcome of the change; whether the change is successful or unsuccessful (Marquis & Huston, 2012). The purpose of this paper is to identify a deficiency within a department of a healthcare organization. A description of the planned change to address the deficiency will be

The healthcare field is constantly changing and frequent practices and procedures are reviewed and updated based on evidence-based practice (EBP). Research and EBP guides us in identifying areas that need improvement or revision. Whether it be new practices, procedures, protocols, or equipment, nurses are expected to be able to adapt to change. At Sacred Heart hospital, a new intravenous pump (IVP) will be introduced hospital-wide. The purpose of this paper is to describe what leadership style, change theory, and collaborative practice will be utilized in implementing the new IVP and how healthcare economics plays a role in its implementation.

Health care organizations are in a continual state of change so they can adapt and grow. Effective nurse leaders must be well equipped to handle the complexities of change, and be prepared to deal with resistance to change. According to Marquis and Huston (2015), change is a complicated process that requires planning, and it takes time to be able to recognize, address, and overcome resistance. Resistance to change can vary, but nurse leaders need to be empowered to buffer the negative effects of resistance (Montani, Courcy, Giorgi, & Boilard, 2015). The purpose of this paper is to discuss the importance of change and the how the effective nurse leader confronts and deals with resistance to change.

Change can be challenging and studies have shown that most nurses practice the way they were taught, not by what has been proven to work (White & Spruce, 2015). Strategies for implementing practice changes that involve careful planning and the utilization of employees who can motivate participation, be champions for change, and influence others are important (Huber, 2014). Job descriptions, mission statement, and vision should all be incorporated with evidence-based practice and it is useful to have discussions with staff during any meetings. Using a variety of interactive strategies to encourage the acceptance of change and having leaders that are positive examples, who advocate for the use of evidence-based practice, provide resources and processes, and who are accountable for their actions is essential. Health care culture is affected by current issues and trends such as the expectation of patient-centered care with improved quality and safety, reimbursement changes, introduction of electronic medical records, and the increased need for

Monitoring change processes during/after implementation determines the effectiveness of the organizational change, unsuspected problems and reveal potential solutions to problems that surface during the change. Dr. Lindsey Medical Clinic recently employed a filing staff to sort records, file records in accordance with the correct patient, and scan records into electronic format. The monitoring process consist of training two file room employees to use a computerized change monitor software. The change monitor software implementation addresses performance evaluations based on

Change fatigue is an organizational term defined as poor emotional responses to attempted change (McMillan & Perron, 2013). Behaviors include change leaders failing to follow through on assignments, little transparency regarding project progress, staff impatience with efforts, diversion of utilized resources, and value of the project questioned (Reineck, 2007). It can result from rapid, continuous, and relentless organizational or individual changes that are implemented in daily healthcare work practices (Buchanan et al., 2005). As the largest group of all healthcare providers, nurses are well-positioned to contribute to the success of change initiatives (Iacono & Altman, 2015). The majority of change initiatives address patient care, therefore also engages nursing. Whether as a result of evidenced-based care practices, quality measures, financial incentives, or regulatory statues, the trickle-down effect of change stops with the nurse (McMillan & Perron, 2013). Thus, nursing is in the most danger of developing change fatigue.

In the article entitled “Lewin’s Theory of Planned Change as a Strategic Resource”, the author, Shirey (2013) stated that Lewin’s approach to change involves looking at the forces that are needed to diminished or strengthened in order to bring about change within an organization. Burnes and Cooke (2012) added to Shirey’s point by noting that it is important to understand the psychological forces influencing peoples’ behavior at a given point in time before change can be made. Both authors main point of agreement is that there are a number of forces that drive, restrain or balance peoples’ behavior. These authors stated that organizational change is necessary to meet consumer needs. Also, as technology changes, such as the change from the paper medical record to the EMR, health care organizations have to adopt these changes to improve patient safety. In addition, change provides a learning opportunity for employees and allows

As a nurse leader, whether planning to develop and implement a change within an organization either through policy changes or evidence-based protocols, the readiness for change requires a keen understanding of the organization need based on the prioritized quality initiatives and requires the support of the stakeholders due to potential barriers. Roussel & Swansburg, (2009) identified “habits, complacency, fear of disorganization, set patterns of response to change, conservatism, perceived loss of power, ego involvement, insecurity, perceived loss of current or meaningful personal relationships, and perceived lack of rewards” as motivation factors to resist change (, p. 121).