Benchmark – Evidence-Based Practice Project Proposal: Organizational Culture and Readiness
NUR 590 Benchmark – Evidence-Based Practice Project Proposal: Organizational Culture and Readiness
Benchmark – Evidence-Based Practice Project Proposal: Organizational Culture and Readiness
In 750-1,000 words, analyze the culture and level of readiness of the organization for which your evidence-based practice project is proposed.
- Describe the organization’s culture and explain to what degree the culture supports change. Consider organizational and leadership structure, mission and values, interprofessional collaboration/team engagement, communication, perception of the organization by employees, etc.
- Select an organizational readiness tool and assess the level or readiness for change
Benchmark – Evidence-Based Practice Project Proposal Organizational Culture and Readiness I
within your organization. Identify the readiness tool and summarize the survey results. Discuss the degree to which the culture will support and sustain an evidence-based practice change. Consider strengths and weaknesses, potential barriers, stakeholder support, timing of the proposal, and resources. Provide rationale.
- Discuss what health care process and systems you would recommend for improving quality, safety, and cost-effectiveness for the organization.
- Propose strategies to better facilitate the readiness of the organization.
- Identify the stakeholders and team members for the project. Include what their duties will be in the evidence-based practice project proposal.
- Explain what information and communication technologies are needed for the implementation and how they will be integrated in the setting by the internal stakeholders. Explain how these will help improve nursing practice and care delivery for individuals and populations for your intervention.
Nursing leader’s server as advocates within their organizations. Leaders have requisite knowledge, skills, and understanding and represent the front door into the healthcare service delivery. Nursing leaders need to be comfortable withing their administrative structures to use their powers to advocate for the role of nurses. Advocating in policy discussions to help reduce health care cost and improvement in patients’ outcomes and quality of life through collaborative team-based care. (Stevenson, 2021) Advocating for nursing staff can begins with assessing needs. Do the nurses have the correct tools they need to provide best practice care. Are nurses being treated fairly and are they assuring measures to prevent nursing fatigue and burn out such as appropriate breaks and lunches.
EBP is on fall reduction in a medical-surgical ward within 24 weeks
The provision of safe and high quality care is imperative in nursing and healthcare. Evidence-based interventions have proven effective in facilitating the realization of care outcomes in healthcare. Nurses and other healthcare providers have the responsibility of utilizing care interventions that optimize the care outcomes of patients. Therefore, this section of the project explores the organizational culture and readiness level of the organization to support the proposed intervention.
Culture plays an important role in the implementation of evidence-based and change interventions. An organizational culture should support the successful use and sustainability of change projects (Mallette & Rykert, 2018). The culture of the organization where the project will be implemented is supportive. The supportive nature of the culture can be seen from a number of aspects. Firstly, the organization utilizes transformational leadership styles that encourage innovation in the provision of care. The leadership of the organization supports its staff in implementing change projects that would contribute to safety, quality and efficiency in patient care. The organization also has values that support change. The values include openness in communication, transparency, teamwork, and active stakeholder involvement in implementing change. The organizational values are supportive in nature because they underpin collectivism in the assessment, planning, implementation, and evaluation of change.
The organization also supports two-way communication between employees, management and leadership. The employees have the freedom to express their ideas and concerns in the organization. The management and leadership also ensure openness in strategy analysis and implementation. Through it, the employees are motivated to play a proactive role in implementing change (Chaudhry, 2018). Consequently, the above aspects of organizational culture will support the implementation of change.
Survey Results
Health organizations should be assessed for their culture and readiness to embrace change. The organizational culture and readiness assessment was done using the tool by Buildingmovement.org. The tool examines the culture and readiness of the organization from the organization, leadership, and staff’s perspectives (Buildingmovement.org, n.d). The results showed that the organization performed excellently in its culture and readiness for change. The organization scored 17/24 in all the areas of rating in the yes its true component of the tool. This score implies that the organization has supportive culture and is ready to implement the change. The organization scored 5/24 in the ‘this is developing or in process’ component of the tool that implies the organization’s mechanisms being in place to facilitate change. Lastly, the organization scored 2/24 in the ‘don’t know/not sure’ column of the tool, representing the lack of awareness of the stakeholders on the culture and readiness level of the organization to support change.
The assessment of the culture and readiness level of the organization revealed a number of organizational strengths, weaknesses,
Benchmark – Evidence-Based Practice Project Proposal Organizational Culture and Readiness
barriers and facilitators for the change. One of the evident strengths in the assessment was the supportive nature of the organizational leadership. The assessment showed the organization to have effective leadership that supports transformational and innovative interventions in healthcare. The other strength is the existence of culture of teamwork in the organization. Teamwork is important in implementing change, as it minimizes resistance to change. One of the weaknesses identified in the assessment is the low level of knowledge among the staffs on the implementation of evidence-based interventions. Low level of knowledge may hinder the successful implementation of change due to lack of the needed skills as well as fear of the unknown effects of the change (Fagerström, 2021). One of the identified barriers to the change in the organization is staff shortage. Shortage of the needed staff may hinder the implementation process due to the high workload and lack of time for the staffs to engage in project initiatives. The barriers will be addressed by utilizing the existing resources in the organization to hire additional staffs in the setting where the project will be implemented. The project will also be implemented over an extended period to enable its adequate utilization in practice.
Recommended Healthcare Process and Systems
One of the recommendations that should be considered in the organization to improve quality, safety, and cost-effectiveness of care is increasing the adoption of health information technologies. Health information technologies such as telehealth and barcode system of medication administration should be adopted to promote efficiency, safety and quality of care. Health technologies such as telehealth have been shown to reduce healthcare costs and resource utilization for patients and healthcare institutions (Menachemi et al., 2018). The other recommendation is the need for increasing the ratio of nurses to patients in the institution. Adequate staffing level is important for the profession of high quality, safe and efficient care. Adequate staffing eliminates issues such as high workload, burnout, and low job dissatisfaction among the healthcare providers (Castro-Sánchez & Santillán-García, 2020).
Strategies to Facilitate Readiness
Successful implementation of change requires that the adopters have the required knowledge and skills to facilitate the process. A number of strategies will be utilized to facilitate readiness among the nurses to implement the proposed change. One of the strategies will be training. Nurses and key stakeholders involved in the implementation of the project will be trained. They will be trained about the implementation of the intervention to ensure that they have the desired knowledge and skills. Training minimizes resistance to change from those involved in the implementation process (Yazdani & Wells, 2018).
The second strategy will be encouraging active stakeholder participation. Nurses and other stakeholders will be actively involved in all the change processes such as assessment, planning, implementation, monitoring, and evaluation. Active involvement will promote their empowerment as well as ownership of the change initiative by the organizational stakeholders (Mallette & Rykert, 2018). The last strategy will be the provision of accurate information about the change. The need for change will be communicated consistently with accurate information about the benefits of change being provided to influence and persuade the adopters to implement it.
Stakeholders and Team Members
The stakeholders and team members for the change initiative will comprise of trainers, registered nurses, nurse managers, and laboratory technologists. Registered nurses will be the primary implementers of the change. They will implement the change by working with patients requiring urinary catheters. Registered nurses will also collect the data that will be used in determining the effectiveness of the intervention. Nurse Managers will oversee the implementation of the project. They will ensure that the right strategies are utilized in selecting the patients to be placed in the intervention and control group. Nurse managers will also coordinate with the project team on issues such as the needs and concerns of the implementers.
Moreover, laboratory technologists will be involved in the analysis of the urine samples of the patients involved in the project. Trainers will provide registered nurses, nurse managers, and laboratory technologists with the knowledge and skills they need for the successful implementation of the project. The information technologies that would be needed for the implementation of the project will include projectors and educational videos. Projectors will be used in the training and results dissemination phases of the project. Educational videos will be used as part of the reinforcements for the project in the unit. They will also be used for educational purposes for the new staffs in the department. Information and communication technologies will contribute to knowledge and skill development among nurses as well as reduction in the risk and rate of urinary tract infections among catheterized patients.
Conclusion
In summary, the organizational culture supports the implementation of change initiative. Recommendations that include the adoption of health information technologies and increasing the staffing in the institution should be considered for the improvement in processes and systems. Strategies such as stakeholder training and active participation will be utilized to facilitate change. Active stakeholder participation will be encouraged to minimize resistance to change by the adopters.
References
Buildingmovement.org. (n.d.). Organizational Readiness Assessment. http://www.buildingmovement.org/wp-content/uploads/2020/03/Organizational_Readiness_Assessment_Tool.pdf
Castro-Sánchez, E., & Santillán-García, A. (2020). Smart lobbying for minimum nurse staffing ratios in spain: not just numbers. Policy, Politics & Nursing Practice, 21(2), 60–61. https://doi.org/10.1177/1527154420923753
Chaudhry, S. (2018). Managing employee attitude for a successful information system implementation: a change management perspective. Journal of International Technology and Information Management, 27(1), 57–90.
Fagerström, L. M. (2021). Leading Change When Implementing Advanced Practice Nursing. In L. M. Fagerström (Ed.), A Caring Advanced Practice Nursing Model: Theoretical Perspectives And Competency Domains (pp. 219–233). Springer International Publishing. https://doi.org/10.1007/978-3-030-53555-1_12
Mallette, C., & Rykert, L. (2018). Promoting positive culture change in nursing faculties: Getting to maybe through liberating structures. Journal of Professional Nursing, 34(3), 161–166. https://doi.org/10.1016/j.profnurs.2017.08.001
Menachemi, N., Rahurkar, S., Harle, C. A., & Vest, J. R. (2018). The benefits of health information exchange: An updated systematic review. Journal of the American Medical Informatics Association, 25(9), 1259–1265. https://doi.org/10.1093/jamia/ocy035
Yazdani, A., & Wells, R. (2018). Barriers for implementation of successful change to prevent musculoskeletal disorders and how to systematically address them. Applied Ergonomics, 73, 122–140. https://doi.org/10.1016/j.apergo.2018.05.004
Organizational culture is a system of shared values and beliefs that contributes to behavior norms and determines an organizational way of life. Organizational culture is evaluated based on core values, shared assumptions, and common approaches to work (Nguyen Van et al., 2018). This paper seeks to analyze the culture and level of readiness of the organization for which my EBP project is proposed.
Organizational Culture and Degree to Which Culture Supports Change
The project on incorporating peer support in trauma-informed care will be implemented in my current healthcare organization. Our organization has an Adhocracy culture, which is defined by the flexibility and external focus aspects. Our culture is rooted in energy and creativity and involves innovation as a way of organizational functioning (Nguyen Van et al., 2018). Besides, the employees are encouraged to take risks, and our leaders are perceived as innovators. The work environment is agile and transformative, which has made the Adhocracy culture thrive (Nguyen Van et al., 2018). In addition, we emphasize specialization and rapid change within the organization, and thus change will be highly appreciated. Due to the innovative spirit in the organization, the employees are continuously engaging in activities that will promote positive change in the organization to achieve our goals and vision.
Organizational Readiness Tool and Readiness Assessment
The cultural assessment questionnaire developed by the World of Work Project (2019) will be used to conduct an organizational culture and readiness assessment. The tool is useful for organizations or teams that are going through change. The cultural assessment questionnaire evaluates several dimensions of organizational culture, including the decision-making process, treatment of employees, teamwork, tradition, and change implementation (World of Work Project, 2019). The organization scored high in teamwork, objectives-driven employees, change, a strong emphasis on employees, consensus decisions, team communication, and cooperation. However, low scores were noted in decentralization, focusing on customer service, building long-term customer relationships, and attention to detail.
The culture assessment results reveal that our organization’s culture will support and sustain an evidence-based practice change. As a result, incorporating peer support in TIC will be readily accepted and implemented in the department and staff that provide TIC services. Strengths that will facilitate change implementation of the peer support intervention include: employees are driven by targets and objectives, encouraging and rewarding teamwork, leaders encourage change and innovation, consensus decision, frequent and transparent team communication, and coordination and cooperation in the delivery of patient care.
Weaknesses and potential barriers exist and might hinder change implementation. Weaknesses include a lack of a decentralized decision-making system and a lack of attention to detail with staff employing the 80/20 rule. Barriers include shortage of qualified peer support workers, self-care needs of peer workers, and lack of finances to pay for service and wages of peer support workers. The change proposal will be readily implemented since stakeholders’ support change in the organization. Besides, the timing of the proposal is appropriate since the organization has many clients on TIC.
Health Care Process and Systems Recommended for Improving Quality, Safety, and Cost-Effectiveness
A quality improvement (QI) program would be an effective healthcare process to improve quality, safety, and cost-effectiveness. A QI program entails systematic activities organized and executed by an organization to track, evaluate, and enhance its quality of health care (De La Perrelle et al., 2020). The activities are usually repeated so that the organization continues to strive for higher performance levels to improve the care for its patients. I would recommend a QI program since it helps an organization improve patient health outcomes that entail both process outcomes and health outcomes (De La Perrelle et al., 2020). It also enhances the efficiency of managerial and clinical processes. An organization can minimize waste and costs attributed to system failures and redundancy by improving processes and outcomes related to high-priority health needs.
Strategies to Facilitate Organizational Readiness
Organizational readiness to change is the organizational members’ commitment to change and mutual belief in their collective capability. Strategies that would better facilitate readiness in our organization include consistent leadership messages and actions, teamwork, and active stakeholder involvement. Consistent leadership messages and actions can promote organizational readiness by leaders conveying consistent messages and acting consistently to foster change (Metwally et al., 2019). This can inspire employees to embrace common perceptions of readiness to change and foster cooperation when implementing the project. Fostering teamwork would promote organizational readiness since it encourages employees to collaborate to implement the change and achieve desired goals. Besides, active stakeholder involvement can facilitate organizational readiness since stakeholders determine if a change will be implemented and how the change process will occur (Metwally et al., 2019). Stakeholders in the organization can be encouraged to be active in implementing change to encourage other employees to put more effort, be persistent, and cooperative in the change process.
Stakeholders and Team Members Needed
Stakeholders and team members needed for the TIC project will include the hospital administrator, nurses, physicians, therapists, peer support trainers, and peer support workers. The hospital administrator will be responsible for overseeing the project’s activities and approving resource allocation to the project. Nurses and physicians will be tasked with screening patients for trauma, developing patients’ treatment plans, and referring patients to therapists and peer support workers (Shalaby & Agyapong, 2020). In addition, therapists will be involved in providing psychotherapy to patients affected by trauma. Peer support trainers will provide special training to peer support workers before they are part of the care team (Shalaby & Agyapong, 2020). Lastly, peer support workers will be tasked with implementing peer support interventions to overcome the isolation among patients with trauma experiences.
Information and Communication Technologies Needed
Communication about the project will be facilitated by technologies such as the internet and email. Stakeholders and team members will be sent emails to inform them of the project proposal and its implementation. Peer support trainers will require technologies such as computers and projectors to facilitate training. Besides, the internet, computers, and referral software will be needed to facilitate the referral of patients to therapists and peer support workers.
Conclusion
The organization for the EBP project has an Adhocracy culture with a culture rooted in energy and creativity. The culture highly supports change since the work environment is agile and transformative. A cultural assessment using the World of Work Project tool revealed that the organization would support and sustain the EBP change. It scored high in aspects that promote organizational change such as objectives-driven employees, change, emphasis on employees, consensus decisions, team communication, and cooperation. Strategies that would better facilitate readiness in our organization include consistent leadership messages and actions, teamwork, and active stakeholder involvement.
References
De La Perrelle, L., Radisic, G., Cations, M., Kaambwa, B., Barbery, G., & Laver, K. (2020). Costs and economic evaluations of quality improvement collaboratives in healthcare: a systematic review. BMC health services research, 20(1), 1-10. https://doi.org/10.1186/s12913-020-4981-5
Metwally, D., Ruiz-Palomino, P., Metwally, M., & Gartzia, L. (2019). How ethical leadership shapes employees’ readiness to change: the mediating role of an organizational culture of effectiveness. Frontiers in psychology, 10, 2493. https://doi.org/10.3389/fpsyg.2019.02493
Nguyen Van, H., Nguyen, A. T., Nguyen, T. T., Nguyen, H. T., Bui, H. T., Tran, P. T., & Nguyen, A. L. (2018). Individual and occupational differences in perceived organizational culture of a central hospital in Vietnam. BioMed research international, 2018. https://doi.org/10.1155/2018/3759290
Shalaby, R. A. H., & Agyapong, V. I. (2020). Peer support in mental health: literature review. JMIR Mental Health, 7(6), e15572. https://doi.org/10.2196/15572
World of Work Project. (2019). A Simple Organizational Culture Assessment Questionnaire. The World of Work Project. https://worldofwork.io/2019/07/organizational-culture-assessment-questionnaire/