Problem Statement
This case involves the cardiovascular unit at a large general hospital in a major American city. New equipment and new medications had been introduced within the past month. Healthcare staff received training on the new equipment and information sheets on the new medications. However, both the medication and technology changes were introduced without any accompanying changes to processes, procedures, or protocols.
As a result of lack of planned change, there have been breakdowns in communication and the unit had only narrowly averted a potentially fatal error in patient care. To address this issue, a thorough change to departmental behavior is recommended. The Kurt Lewin change theory offers the basic framework to facilitate change in the cardiovascular unit, aligning practices with the organization’s overall mission, vision, and values.
Proposed Change
The specific, realistic change that could be made to address the issue combines leadership, communication, and focusing on core competencies. It is recommended that healthcare staff align their practices with the organization’s mission to provide quality care first by instituting two main changes. Both of these changes will also promote the implementation of evidence-based practice in the unit. First, all healthcare staff will be trained on the new equipment. Currently, only leaders of the healthcare team have been trained, and this has led to service delays because junior staff needs to call a supervisor any time the equipment is needed for a patient assessment.
Second, all healthcare staff will be trained to input all patient medication changes into the individual databases. The new medication was not properly introduced, and because it might interfere with other medications patients are taking, the healthcare staff needs to leverage the power of informatics to promote the goal of quality of care.
These are two simple, specific, and realistic changes that can be made immediately to address the change management issue. Simply by having the nurse leaders on the unit devote an hour per day to training of the junior staff, it is expected that the proposed changes will result in improved patient satisfaction and improved patient outcomes. Moreover, the proposed changes will result in improved job satisfaction due to improved workflow and improved communications.
Aligning the Change
To be effective,...
References
Cummings, S., Bridgman, T. & Brown, K.G. (2016). Unfreezing change as three steps: Rethinking Kurt Lewin’s legacy for change management. Human Relations 69(1): 33-60.
Kobayashi, R.M. & Leite, M.M.J. (2015). Technological competencies in cardiovascular nursing education. Rev Esc Enferm USP · 2015; 49(6):971-977.
Mulholland, B. (2017). 8 critical change management models to evolve and survive. Process. https://www.process.st/change-management-models/
Rhydderch, M., Elwyn, G. Marshall, M., et al. (2004). Organisational change theory and the use of indicators in general practice. British Medical Journal 13(3): 213-217.
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