Question:

This assignment requires you to identify and then apply a change program to a particular aspect of your current practice.

Using information from all four Units of Module knowledge, create a summary of the planning, execution, and evaluation of a change initiative.

The essay should be completed by a description of a proposed change to your nursing care organization. This should include a clear explanation and evidence from clinical or other relevant sources.

Make sure you discuss the organization’s history, the leadership role and the strategies needed to successfully implement the change.

This will allow you to connect your theory with practical examples.

Answer to Question: HSC11900 Innovation And Change Management

Title: Nurses Shift at Patients’ Bedside

Introduction

In the past, nurses have changed shifts together with in-coming nurses via discussions in hallways or written reports.

These discussions and reports have proven to be effective in most cases.

Sometimes nurses may overlook issues or miscommunications, and sometimes this can lead to inaccurate information.

There have been instances when patients’ safety was compromised.

Some institutions feel it’s safer to change shifts at the patients’ bedside.

The nurse will be able to understand every aspect of patient care and can provide written reports to assist her.

This method is important as it includes the patient during the changeover. They feel like they are part of the process.

While privacy concerns are raised about information that is exchanged during conversations, it is important to ensure the safety of the patient.

This paper discusses what leadership, change management and evidence are needed to make this change a success.

A discussion is also made about the importance of innovation in healthcare, specifically in relation to how nurses are changing their shifts.

Management of Change

Change refers to a change in how things are done.

An organization can either force change by natural forces or intentionally.

Change is inevitable given current circumstances.

Organizations need to devise change management techniques to help harness the power of change and make it work.

Organization leadership is what initiates the change described in this paper (Lorenzi & Riley, 2000;2003).

While organizations often see change as essential and even inevitable, they are failing to implement it.

Some estimates suggest that as high as 70% fail to implement change in organizations.

The failure of leaders within organizations to properly plan and implement change has been blamed.

Other times, managers and leaders don’t have the skills to deal with the change that is inevitable.

Managers must be aware of the implications and necessity for change to be better equipped to manage it.

They can make the right plans and prepare staff accordingly (Song, 2009, Ferreira & Abbad (2013)).

Once leaders have recognized the need to change and identified its scope, their next task is to develop policies and processes for implementing the change.

Planning for change is essential because it helps leaders plan how the organization, as well as its individual components, will be affected (Gould Kelly White & Chidgey 2004, 2004).

It is not only a nursing matter that nurses will have to change how they shift.

It will also affect patients and medical personnel.

Therefore, the leader is responsible for ensuring that all aspects of any change he makes are taken into consideration.

This requires the placement of key staff to manage and dealing with employee resistance (Song (2009)

Next, the leaders will lead the organization’s implementation of the change.

The organization may implement the change in phases to assess its effects and adjust as necessary.

Once this is completed, the leader can make adjustments or changes to the plan.

You can modify the process or make better decisions.

To help them do this, leaders can be guided by specific leadership models (Williams and 2014).

In the 1970s, the transformational leadership theory emerged.

This theory shows leaders to be the result of their interactions and with their followers.

These interactions create trust and good relationships, which can be motivating for both leaders as well their followers.

This theory is vital in change management as followers need trust that the change they are being offered by their leader is good for them as well as for the organizations. (Hader 2013).

The theory of transactional leadership emphasized the importance of a positive, mutually-beneficial relationship between leader and follower.

The leader can create a system to reward or punish the follower according to their leader-assigned task.

While ensuring that the system aligns with organizational goals and individual needs, the leader is also able to make sure that it works for everyone.

Leaders need to personalize changes when they manage change.

This means that leaders should allow their followers to see how the proposed change will impact them as individuals and as an organisation.

This will empower them to take more responsibility for the change process (Abdourabl 2012.

For the proposed changes at the hospital, the most fitting theory for transformational leadership is the one that follows.

The leader of the hospital’s transformation will have the trust and support of his staff.

Hospitals, like many institutions, are interconnected in terms of their functions (Phang, 2014).

Changes that are affecting the nursing staff will likely also impact doctors and other medical or non-medical personnel.

This group includes lab technicians, health information professionals, and others.

All these groups can be influenced by transformational leadership. They will embrace change and work with their leaders to build trust and support them in overcoming any fears that might prevent them from accepting change.

In practice, followers and leaders will have to be motivated to improve their organizations.

They must be able to trust and cooperate with each other in order for the leader to successfully initiate the change process (Abdourabl (2012); Al-Sawai (2013)).

It is now a fact that nurses are essential in improving global health care.

This is due in part to the role of nurses in shaping the health policy, both at the hospital and at the national level.

Nurses are also able to build strong relationships and trust with patients.

This allows them to identify the most relevant patient-centered care initiatives.

This paper discusses one change that would make healthcare more patient-centered. It also highlights nurses’ unique role in providing healthcare to patients.

The ability to lead in clinical behaviors is demonstrated and can have a significant impact on all levels. (Hartley & Bennington (2010)Innovation In Healthcare

SWOT Analysis

A Swot analysis is an internal assessment that evaluates the status of an organization.

The assessment looks at the strengths, weaknesses of opportunities, threats, and threats that face an organisation or process with the ultimate goal to improve it.

Swot analysis also has a lot of importance as it considers both internal elements and external factors of an organization, or a process, and details how these interact.

Strengths

These bedside shifts between nurses have helped improve the accuracy and efficiency of information being shared during the changeover process.

This has improved the quality of patients’ science by ensuring that the information exchanged between nurses is accurate.

Patient involvement is enhanced because they can understand the process better than nurses who are not in the same room.

This can be a valuable way for hospitals to ensure patient-centered care.

The nurses can also leave work on their own by switching shifts while they are at bedside.

This is because both nurses realize that they need to be there for the changeover (Gregory, 2014).

This is a risk to patient safety as well as employee morale.

Because nurses are treated with compassion, love, and empathy, a happy patient will be a happier nurse.

Nurses become more involved in the well-being of their patients and are able to establish the trust necessary to provide quality care.

This improves hospital services quality (Wakefield et. al., 2012).

Weaknesses

Changes in bedside shifts are costly to implement and manage.

It is costly to implement and maintain bedside shift changes. This means that nurses need to spend sufficient time with patients. In order to adequately provide their services, the hospital will likely need more nurses. The process also needs extensive training, so that nurses can properly(Sand-Jecklin & Sherman, 2014; Spinks, 2015).

A continuous training program should be implemented to help all employees at the hospital.

This development should include trainings, surveys that both clients as well the nurses focus on three key questions. They are: What do you do to make your service better? How can you improve it? And what would everyone prefer to see.

Assisting management with brainstorming is also a way to solve problems.Opportunities

It is possible to dramatically improve the quality of healthcare services through this method.

You can also use the change to pilot other care initiatives that will improve the overall quality and service.

The hospital will have to support the shift changeover policy for nurses.

The success of the policy will serve as a guideline for the organization as it attempts to implement further changes within the hospital (Rush (2012)).

Bedrohungs

Nurses are worried that sharing information might be in breach of HIPAA regulations.

Fears that they could be found guilty of gross misconduct while in the line for duty may cause them to resist any change.

This will require more training, a deep understanding of HIPAA regulations and the bedside switchover policy.

While patients may not be comfortable sharing their personal data with multiple nurses, it is possible that they aren’t too comfortable. Care must be taken to ensure that patients have the information they need to make informed decisions.

You should also consider how nurses will react to the changes.

The strong leadership that inspires trust and motivates participants in change will counter negative changes (Sand-Jecklin & Sherman 2014.

Management of Change

Change is a three-step process and not an instant.

Every form of change, no matter how voluntary or forced, involves the transition from the current to the new standard.

In most organizations, the change process never ends.

This is truer in hospitals because they constantly look for ways to streamline operations and improve service delivery.

It is important to manage change well.

Organizational change can be described as a summation of individual actions.

While the process is not easy for everyone, change management offers support and guidance to those employees who are struggling.

Individual change is more likely to be successful if the individual is aware and knowledgeable about the change.

To support individual changes, an organization must make a number of plans.

Training is essential.

Training helps individuals to improve their skills and be ready for any changes.

Communication is key during the whole process.

Participants in the change process should be fully aware of all steps so they can improve (Prosci. 2017).

Lewin’s theory, which is a three-step process that can be easily applied to the case, is called Lewin’s Theory.

Successful change requires leaders who can understand the opposing forces. This will enable them to shift the power and effect positive change.

According to Lewin the most important parts of this process include unfreezing, movement, and refreezing.

After unfreezing, a new equilibrium can be achieved and the results of that experiment are set as the new standard.

Prochaska & DiClemente’s theory on change follows a similar pattern, but is more detailed.

According to the two theories, change involves five steps: pre-contemplation, contemplation before the change, contemplation, preparation for action, maintenance, and follow-up.

This theory can be considered a cyclical process.

It helps to demonstrate that change does not have a defined beginning or end.

It is a process, which can sometimes fail, requiring adjustments to the plan (Kritsonis and DiClemente, 2005).

Prochaska and DiClemente will be used to explain the complex nature of this change (Caldwell 2008.

The five phases of the change model will be implemented.

The pre-contemplation period is where the hospital’s nursing staff continue to operate as normal.

Changeovers are made through a discussion within the hallway. After that, a brief note is either written or handed here to the patient.

Management at the hospital is currently looking into a new model because of the problems with this approach.

This new shift switchover will see nurses talking to the patient in bed and exchanging any information that is necessary.

The new nurses can provide better care for the patient even though they are not familiar with the particular case (Peterson & Mace 2006.

In the third phase, employees and managers prepare for the change process.

This phase may include extensive training, as well as dealing with any concerns.

Clear communication is important to ensure that everyone involved in the change process is on the exact same page, particularly nurses and supervisors.

After all the preparations have been made, the fourth phase begins.

This is the time of actual change.

The change is implemented, and nurses will no longer be responsible for patients’ care in their absence.

The process is under constant surveillance.

This will ensure that change proceeds as planned and that any issues that arise from the change are addressed quickly.

Once the change has been completed, management will adopt it as their new way of doing things.

There are several steps that can be taken to make the change permanent. These include further training and getting rid of the old ways of doing business (Hewitt, Taylor, 2013).

In this whole process, nurses are crucial.

They act as change agents.

This means that the organization will experience significant and positive changes over time.

The improvements will be in quality of care provided to patients and staff morale.

This may seem expensive but the expected increase in revenues should make up for it.

Nursing is an essential part of healthcare delivery.

It is evident that the change will have a significant impact on nurses’ duties. This will result in a fundamental shift in the hospital’s clinical services.

Given the nurse’s important role in healthcare, this proposed change will affect not only nurses but also other professionals like doctors, clinical officers and health information officials.

There’s Evidence To Support Change

Good communication between healthcare personnel regarding a patient is a key aspect of quality healthcare.

The best way to ensure that nurses communicate accurately is by having them switch shifts at the bedside.

This ensures that nurses are able to provide the right medication and other information to their patients.

The hospital has seen an improvement in service.

This was done at a hospital with 20 beds. The result is better statistics in all areas.

Sometimes the process is just as important as the change itself.

Studies have shown that nurses are more involved in the process when they are fully involved.

As the primary agent of change, and as the central element of the change process, it is essential that they have the ability to control the process.

This can be achieved by consulting them before the change is implemented and electing champions to assist other nurses with the implementation (Herceg, 2015).

Appreciating the complexity involved in change management will greatly help.

As an example, this paper proposes five phases for change, each with its own intricacies.

Resistance to change as well as a lack of a clearly defined plan are two main obstacles to change.

Resistance to change occurs when people can’t accurately predict the future in relation to the change.

Management that fails to communicate effectively and properly train agents for change is doomed to failure.

Management that cannot predict the fate of their organization and its members in the wake of a change will result in confusion and resistance by employees.

Based on the analysis above, it is evident that shift changing at the bedside has strong support from evidence. This will lead to many benefits for all.

Most important is bringing in nurses for implementation. Strong leadership can also be deemed transformative and inspiring to all.

Conclusion

Because of its inevitable nature and the world’s constant and rapid change, change management is essential.

Prochaska’s theory and DiClemente’s are both correct in that change is not an ongoing process. It is more like a cycle.

An organization must be prepared for changes by making the necessary preparations and having the right people in charge.

These leaders can build trust through relationships and ensure the change is championed by the people who are most responsible.

In certain cases, the change can be very significant. For example, the above-mentioned change has clear benefits for everyone.

It raises some problems that, if not addressed, can spell doom for the entire process.

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