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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,...
The organization’s mission is to provide the best quality healthcare services to all patients. To fulfill this mission, organization management has invested in the latest tools and technologies to help patients in the cardio unit. However, cardio unit staff also needs to contribute to the mission of the organization by ensuring that the new equipment is being used properly. The change will improve knowledge and awareness, and help prevent medical errors.
The vision of the organization is to interface with the community to provide cutting-edge, patient-centered care. The proposed changes perfectly align with that vision. Core values expressed by the healthcare administration include collaboration, compassion, and respect. Collaboration is the primary value the cardiovascular unit leadership needs to focus on while planning for and implementing the change. Relevant professional standards and core competencies in cardiovascular nursing also need to be addressed. Technological competencies and competencies in informatics are of particular importance to the cardiovascular nursing team (Kobayashi & Leite, 2015). Therefore, improving these competencies via regimented, scheduled, specific training programs will help the organization’s to fulfill its own mission and vision.
Change Model
The Kurt Lewin change model involves a three-stage process that is straightforward and easy to implement in the healthcare setting. The first stage is to unfreeze the status quo. To unfreeze does not mean stopping everything the team is doing, but to take an assessment of current practices and procedures, making sure to also be self-aware about bias and “commonly accepted mistakes” about nursing practice (Mulholland, 2017, p. 1). Resistance to change is going to be due in part to clinging to familiar models, so if staff is made aware of the inefficiencies and even dangers inherent in current practices, it will be more possible to initiate the next step of the change model: making the change.
Making the change requires “communication, support, and education,” which is why strong nurse leadership and comprehensive training are the recommended solutions to the problem (Mulholland, 2017, p. 1). Adapting staff to a new technology necessitates upgrades to…
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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