Who Moved My Cheese?

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).

These changes are then reinforced to employees by the Charge Nurses in Morning Huddles and in special called Safety Huddles throughout the week. While management is very open to change, implementation of the changes must be carried out by the actual hands-on personnel, and this often times leads to fear of the unknown. As Yoder-Wise (2015) states, “All changes, whether perceived as positive or negative, large-scale or simply, are scary and generate fear” (p. 307). In the short time I have worked in the ED, I have seen both support and resistance among co-workers regarding change processes. While some embrace change, others resist, and are set in their ways viewing change as inconvenient and an addition of time-consuming steps to an already stressful environment. Most whom I work with, when presented with the facts and evidence behind the change, view it positively and have no problem implementing it.

Change is a hard concept for most, but change in the hospital setting can be beneficial for both staff and patients. According to Mclean (2011), “Every change begins with an ending” (p.79). How people respond to change can make the process easy or hard depending on how the change is presented.

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.

Do you know leaders in healthcare have a new style of managing? Healthcare field is one of the fields that changes occur frequently. With the introduction of the Affordable Care Act (ACA) brought a lot of changes in every aspect of healthcare delivery, from reimbursement to quality control to elimination of wasteful and inefficient practices and having huge impact on the U.S. healthcare delivery system, with many more changes to come. When leaders in healthcare organizations are asked, “what’s the one word that best characterizes the impact of the Affordable Care Act (ACA) on the U.S. healthcare delivery system,” most will answer “change”. These changes also brought new managing styles to healthcare leaders. I would be writing in my own discourse community, which is Health Systems Management. To give guide lines for a neighbor who is thinking of jointing this discourse community, how we operate and to be successful in this filed.

Who Moved My Cheese is about how to make changes in your life and work. The story has four characters Hem and Haw, who are human. And Sniff and Scurry, who are mice. They are metaphors for different parts of your life. They all have a task in hand, to find cheese. “Cheese” is a person’s life goals. In the maze, or a person’s environment is where they need to seek cheese.

It has been a long time coming of the much needed change with health care. Transformation will come whether people are ready or not. These changes have been talked about but have never gone in effect until recently and more are to come. The Affordable Care Act 2010 outlines some new health care structures, and with these structures will come new opportunities for new roles expanding the health care into a better one to have the health care grow, expand and improve care (Institute of Medicine, 2011).

William Bridge’s three-step change model “deals with change at a more granular, individual level, suggesting that change within a health care organization means that individuals must transition from one identity to a new identity when they are involved in a process of change” (Campbell, 2008, p. 23). According to Bridge, for change to take place, three transition periods must be experienced, including endings, the neutral zone, and beginnings (Campbell, 2008). This model is appropriate for the current changes made in our facility because it focuses on individuals and their ability to transition to change. ”Change is something that happens to people, even if they do not agree with it. Transition, on the other hand, is internal, it’s what happens in people’s minds as they go through change. Change can happen very quickly while transition usually occurs more slowly” (Mind Tools Editorial Team, n.d, p. 1). Changes made in the workplace require transitioning for employees, this is why I feel it is important that administrators and committee members utilize this model as our organization continues to adjust to the advancements in technology.

In a world where there is constant change, and individuals are constantly attempting to adapt and cope with these changes, the human experiences and responses to this process is central to nursing interest, (Meleis, 2012). Today’s global health problems in addition to the politically volatile health care system, and the rising cost of health care seem insurmountable. As nurses,

"Who Moved My Cheese?" tells a story of change, of how we react to it, and the trouble we can find ourselves in when we don't follow that change. The story is about four characters, two mice, and two "little people." The characters live in a maze chasing cheese. The cheese represents anything we chase after in life and believe it will make us happy. The story details the trials and troubles we all have in daily lives.

While some people are receptive to change, others may not be so forth coming. The concept of change in itself can be terrifying because people get used to doing things a particular way, therefore, any deviation from the norm poses difficulty. Within the context of this paper, I will examine two components related to my learning goal and my clinical placement at St. Michael’s hospital. First, the knowledge component will entail a critical review of five evidenced-based scholarly journals related to change and the Electronic Medical Record (EMR), incorporating the strengths and limitations of each study. Then, I will discuss the chosen framework and its use to guide my nursing practice and achieve my learning goal. Next, I will discuss the

The book “Who Moved My Cheese?” is a simple story about mice and “little people” that helps readers handle and deal with changes in their lives. The story is about two mice and two human-like individuals named “little people” (who are the size of the mice). The two mice’s names are Scurry and Sniff. The two little people’s names are Hem and Haw. The story takes place in a “maze” and the characters look for “cheese” to nourish them in the maze. When the characters find cheese, only to have it disappear, they experience change. The different characters show different ways of responding to this change and teach lessons that can be applied to our daily lives.

While many health care practitioners are willing to change, the issue is that change is often mismanaged by leaders whom are either incompetent or lack the resources to follow through in the implementation of change. An example was documented in a study of a California hospital unit where patient satisfaction scores rose and immediately fell. At the time, the hospital was going through transition. The nurses in the unit saw this as an opportunity to improve patient satisfaction score. They initiated the process by recommending that the new chief executive officer (CEO) change the current procedure to one that could led to the improvement of patients’ satisfaction. The result, in a few months

This book, by Spencer Johnson, reveals the truths about how we deal with change that happens in our lives which effects us in so many ways, either positively or negatively. The book takes an amusing approach to what happens when you don’t adapt to change and what happens when you do. In the book, cheese is used as a metaphor for what you want to have in life. All my life I wanted the nice house, the beautiful wife, the kids, money, the dog, the nice tuck to pull the nice boat, the great career, and so on , and so on. To me, it’s human nature to want those things and I eventually got all of those things and then some….. More on that later. There was another metaphor in the book, which was the maze.