Benchmark – Change Initiative: Implementation, Evaluation, and Sustainability
Benchmark – Change Initiative: Implementation, Evaluation, and Sustainability
Health organizations in the modern world are experiencing a wide range of challenges that threaten their performance. They include the increasing need for the adoption of new technologies that will enhance the quality, safety, and efficiency of operations. It also includes competition from other service providers. Health organizations also experience challenges in maintaining their workforce. It is recognized that poor workforce management increases the operational costs incurred in hiring of new employees. Therefore, it is important for them to find out effective strategies that will enhance their operational efficiency and provision of quality services to their clients. Consequently, this essay examines an area of my organization that will benefit significantly from initiation of change. The proposed change entails the provision of programs that aim at promoting employee development as a way of addressing the issue of poor retention of nurses in the hospital.
Cognizant of the role that training plays when it comes to improving a nurse’s competencies in EBP and thus empowering them to contribute to the development of EBP, here are certain strategies that can be undertaken from both an organizational level, to the larger professional level. At the organizational level, the organization can organize for opportunities where their nurses can get trained on evidence based practice. On the greater professional levels, professional bodies such as the ANA and the ANCC have developed certification program for nurses. By including components of evidence based practice in the certification exams, this ensures that nurses will prepare and apprise themselves on EBP and thus, in order to earn the certification, they will have to be competent in EBP. Alternatively, the institutions can include a whole different certification for EBP, where nurses will specifically be trained on EBP, tested on the same and thus, their competency will be proven by their certification. This will ultimately improve their ability to participate in the development and implementation of EBP.
Issues in the Area and Outcomes
The hospital I work with has been experiencing issues in human resource management. Recently, an audit that was performed revealed that most of the nurses leave the hospital within a period of one year. A small percentage of nurses were found to have stayed in the hospital for more than three years. An investigation into the factors contributing to the poor retention of the nurses in the hospital revealed that the methods adopted to increase their retention are ineffective. For example, the results of performance appraisals are not used to make decisions that have a positive impact on the nurses. The nurses are also not provided with opportunities to advance their personal and professional development. There is also the minimal use of reward packages to motivate these personnel. The consequences of these inefficiencies have been high rate of staff turnover within the first year of employment, decline in the quality of care, and high costs incurred by the hospital in hiring, training, orienting, and inducting new nurses (Hughes, 2019). Therefore, it is important that effective interventions be adopted to address this organizational issue.
External and Internal Forces Driving Forces and the Affected People
The issue of poor staff retention within the first year of employment in the hospital is attributed to the influence of internal and external forces. Internal forces refer to those within the organization while external forces exist outside the hospital. One of the internal forces contributing to the issue is dissatisfaction among the staffs. Employees need to be provided with work conditions that promote their personal and professional development. Examples of these conditions include job advancement, salary increase, and training opportunities for them to be updated on issues affecting their practice (Hughes, 2019). The lack of or poor provision of these conditions has increased the rate of staff turnover within their first year of employment.
The other internal force driving the poor retention of staffs in their first year of employment is ineffective human resources management. The human resources department of the hospital should find out the most effective ways in which the issue can be addressed. The other internal driving force is management inefficiencies. The management should be involved in identifying evidence-based interventions to address the issue. One of the external factors driving the issue is competition. Most hospitals offer nurses and other healthcare providers with competitive packages that pull them from the hospital. The other aspect is the changing needs of the nursing workforce. The hospital should identify the anticipated and actual needs of the nurses and come up with ways of addressing them (Pasmore, 2015). The issue of poor retention of nurses during their first year of employment affects stakeholders that include nurses, other healthcare providers, nurse managers, and patients.
Stakeholders Involved and how they will be affected by the Change Initiative
The proposed change will affect a number of stakeholders in the hospital. According to Hodges (2016), stakeholders are personnel will are directly involved or influenced by the change to be implemented. They determine the manner in which the change agent will be adopted in an organization. Effective interventions must therefore be developed to ensure that minimal resistance is experienced from them during the adoption of the change in their practice. The stakeholders who will be involved in the case will include the nurses, patients, and management of the hospital. The nurses will benefit from the change. They will be provided with opportunities for their professional development such as training, attractive package, and safe work conditions. The other stakeholder to be affected by the change is the patients. The patients will benefit from high quality of services due to the enhanced level of motivation among the nurses. The management of the hospital will also be affected by the change. It will have to find out effective ways in which the change can be sustained. It will also have to adopt an effective management approach that will ensure sustainability of the change. The above stakeholders will be affected by the change in a number of ways. As asserted earlier, there will be an improvement in the quality of care given to the patients. This will translate into a reduction in mortality rates in the hospital. The proposed change targets at ensuring that the nurses are provided with opportunities that will enhance their retention rates. As a result, it is anticipated that their level of motivation will be enhanced significantly with the change (Hodges, 2016). The management of the hospital will have to ensure that the existing resources are utilized to achieve the desired organizational outcomes.
Role, Responsibility and Leadership Theory
My roles in the proposed change will include assessor, planner, implementer, disseminator, and coordinator. I will assess the existing organizational systems and the need for change to support the proposal. I will also work in collaboration with other stakeholders in
determining the strategies that need to be embraced for the change to be effective. I will assist in the determination of the resources that should be used in the process. I will also lead the implementation of the selected strategies. I will also act as a disseminator in the project by providing the information needed by the implementers. Lastly, I will act as a coordinator in the implementation of the change. I will ensure that the allocated resources are used efficiently to achieve the goals of the change. I will utilize the theory of change by Kurt Lewin in implementing the change. The theory identifies change to occur in stages that include unfreezing, change, and refreezing. The first stage focuses on creating awareness about the need for change in the organization. I will assist the nurses and management to identify the issue in this stage. The second stage is changing where the needed interventions are implemented to facilitate change. The last stage is refreezing where I will implement sustainability strategies to ensure the incorporation of change into the culture of the organization (Mendy, 2018).
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Change Agents and their Role
The managers of the hospital will be the change agents tasked with leading the implementation of the proposed change. The agents will play roles that include consulting, research, and training. The managers will act as consultants in the implementation of the change by providing the implementers with the necessary information that is needed for the success in the project. They also help the implementers in finding solutions to the issue based on the analysis of the available evidences. The managers will also play the role of being trainers. They will help the implementers of the change understand the ways of using data of the change in effecting it. They will also help them to derive their actions from the collected organizational data. Lastly, the managers will act as researchers (Hughes, 2019). They will train the adopters on the skills that are needed for effective implementation of the change. They will also utilize best available evidence to come up with strategies to evaluating the project.
Utilization of the Change Model
The change model that was developed earlier focuses on the implementation of change with a consideration of a number of steps. They include assessment, creation of awareness, building knowledge as well as commitment, implementation, monitoring and evaluation, and sustaining the change. The first step is assessment where the needs of the organization are identified by the leaders of the change. An organizational assessment is done to identify its strengths, weaknesses, threats, and opportunities. This stage will entail assessing the factors contributing to the poor retention of nurses within their first year of employment. The second step is awareness creation where the data obtained in assessment stage is presented to the management and implementers of change. They are made aware of the issue facing the organization and the need for the change. The third step in the change model is building knowledge and commitment. The stakeholders are involved in the determination of the strategies that should be embraced to address the issue. The implementers are also provided with adequate information on ways of addressing the change. Support in the form of training may be provided to ensure that the implementers have the right knowledge and skills needed for the change. The fourth step is implementation where all the strategies that were developed to address the issue are put into action. The implementation phase occurs concurrently with monitoring since the management ensures that the strategies and resources are used efficiently. The fifth step is evaluation where the change agents determine whether the goals of the change were achieved or not. Outcome and process measures are used to provide the information needed in this stage (Pasmore, 2015). Once the change is found effective, efforts to sustain it are explored. The change agents implement measures to sustain change such as the creation of open channels of communication, rewarding performance, and coaching to ensure sustainability of the change.
Potential Barriers and Ways of Overcoming Them
Resistance to change is one of the potential barriers to affect the proposed change. It could be attributed to factors such as fear among the implementers, lack of awareness, and inadequate information. The challenge will be addressed by training the implementers, utilizing open channels of communication, and involving them in all the activities of the change. The other potential barrier is lack of support from the hospital. This could be due to lack of financial resources to implement it. The issue will be addressed by aligning the change with the mission of the hospital. The last potential barrier is laxity of the stakeholders to participate in the implementation of the change (Pasmore, 2015). The issue will be addressed by ensuring that each of them has a role to play in the implementation process. Unforeseen events will be addressed by monitoring closely the implementation process and providing regular feedback to the stakeholders. Close monitoring will enable early identification and management of potential issues.
Evaluation Methods
Process and outcome measures will be used to evaluate the effectiveness of the proposed change. Outcome measures will determine if the pre-developed goals of the change were achieved or not. This will include the determination of the turnover rate among the nurses one year after implementation of the change. Other outcome measures such as the perceived quality of care by the patients, operational costs incurred by the organization, and job satisfaction among the nurses with the implementation of the change will also be used. Process measures will also be used to evaluate the change (Hughes, 2018). The focus will be placed on the nature of change implementation. This will include the determination of stakeholder involvement, challenges in strategy implementation, and the use of the assigned resources. An effective use of the allocated resources, active stakeholder involvement, and minimal challenges in the implementation will be considered a success of the process.
Strategies to Support Continuous Change
One of the ways to support continuous change in the proposed project is developing guidelines and policies that should be used in the organization. The guidelines should form part of the organizational processes used by the human resources department for promoting employee development. The second strategy is incorporating the strategies of the change into organizational culture. This will make them part of the organizational behaviors and processes. The last intervention is through rewarding performance (Hughes, 2018). Incentives will be provided on a regular basis to ensure sustained change and its strategies. The other way that is proposed by Hodges (2016) is the use of regular feedback mechanisms in the organization. The staffs should be provided with regular feedback on their success and weaknesses that should be addressed. The other intervention is adopting open frameworks of communication. There should be free exchange of communication between different organizational stakeholders. This will provide insights into the ways in which continuous improvement and change is achieved.
How the Change Plan Supports Organizational Mission, Addresses Stakeholder Concerns and Equity in the Society
The mission of our hospital is promoting quality, efficiency, and cost-effectiveness in care. However, the identified issue hinders the realization of this mission. Therefore, the proposed change supports the realization of the mission statement by ensuring cost-efficiency in healthcare operations through retention of staffs. Retention of staffs through the proposed intervention will improve the quality and safety of care offered to the patients (Pasmore, 2015). The change also addresses the issues affecting nurses and other stakeholders such as managers and patients in the institution. It is expected that the change will improve the health outcomes of the patients and the society at large, hence social equity.
Conclusion
The proposed change aim at addressing the issue of poor retention of the nurses in the hospital using strategies that promotes the development of staffs. The interventions that should be used include employee recognition and provision of opportunities that promote staff professional and personal development. The change will affect several stakeholders in the organization. Therefore, interventions to address any barriers should be developed prior to implementation of the change.
References
Hodges, J. (2016). Managing and leading people through organizational change: The theory and practice of sustaining change through people. Kogan Page Publishers.
Hughes, M. (2019). Managing and leading organizational change. New York, NY: Routledge.
Mendy, J. (2018). Teaching human resources and organizational behavior at the college level.
Pasmore, W. A. (2015). Leading continuous change: Navigating churn in the real world. Oakland, CA: Berrett-Koehler Publishers. Hershey: Business Science Reference.