Change Initiative: Creating Vision









Change Initiative: Creating Vision

Health organizations in the modern world operate in highly dynamic and complex environments. They have to embrace change and innovative interventions to ensure their sustained performance and competitiveness in their markets. Health organizations also have to understand the actual and potential needs of their consumers to provide appropriate services for their competitive edge. Therefore, the purpose of this paper is to explore change in the organization that I work with as a nurse. The paper explores

topics that include internal and external forces driving change, interventions that the organization can adopt to address the selected force, and vision for the organization.

Description of the Organization

I work with the VA Healthcare System. VA Healthcare System is an institution that was developed to address the care needs of the veterans. The healthcare system has 1293 health care facilities that include 171 VA Medical Centers and 1112 outpatient clinics. The VA Healthcare System provides a wide range of services to its stakeholders that include dermatology, vision care, audiology and speech pathology, dental, podiatry, and neurology care. It also provides services such as organ transplant as well as plastic surgeries. The mission of the VA Healthcare System is fulfill the promise of President Lincoln promise of caring for those who have borne the battle and suffered its effects by serving and honoring them as the Veterans of America. Values that include commitment, respect, advocacy, integrity and excellence drive the organization (, n.d.). The stakeholders of the VA Healthcare System comprises mainly of the veterans and healthcare providers.

External and Internal Forces Driving Change

Internal and external factors drive change in the VA Healthcare System. Culture is the first internal factor that drives change in the organization. Culture refers to the manner in which organizational stakeholders that include healthcare providers act, decide, and respond to situations. It encompasses the values, beliefs and practices the provision of patient care in the organization. Enabling culture characterized by teamwork, effective leadership, innovation, and open communication is important for organizational excellence (Valenzuela et al., 2020). VA Healthcare System should consider the above cultural aspects to achieve its performance targets and standards.

The other internal factor driving change in VA Healthcare System is leadership. Organizational leadership is important for the realization of the desired goals and objectives. The leaders of VA Healthcare System have the responsibility of ensuring that the employees are motivated to adopt behaviors that align with the mission of the organization. They also empower the healthcare providers to patient-centered models of care that respond to the current and emerging needs of the patients (Sfantou et al., 2017). The leadership therefore ensures the effective implementation of change in the organization by ensuring that innovative interventions are utilized to achieve the mission and vision of the organization.

The external factor that is driving change in VA Healthcare System is legislation. VA Healthca

re System is a government institution that provides care to veterans in the state. The organization operates in alignment with the legal provisions that guide healthcare organizations. It has to embrace change initiatives that align with legal requirements such as HIPAA for the utilization of health information systems. The organization also has to ensure that it protects the rights of its stakeholders in providing its care services (Ali et al., 2021). For instance, it must ensure that patients have access to high quality, safe and efficient care. It also has to transform its systems and processes to ensure that it is responsive to the current and emerging needs in healthcare. Therefore, legislation is a critical external force that contributes to change in the VA Healthcare System.

Technology is the other external force that drives change in the VA Healthcare System. Health organizations in the modern world largely utilize health technologies to achieve their performance objectives. Health technologies are associated with benefits that include enhanced safety, efficiency and quality. VA Healthcare System has to adopt modern technologies to lead in the provision of patient-centered care. It has to utilize systems such as telehealth to enhance care coordination in providing services to its stakeholders. It also has to remain up-to-date with the current technological advances in healthcare to ensure its performance and competitiveness (Christensen, 2018). Therefore, VA Healthcare System has to constantly explore evolving technologies to provide appropriate services to its populations, hence, acting as a source of change.

Selected Force

Change Initiative Creating Vision

The selected force that drives change in the organization is culture. As noted initially, culture refers to the ways in which things are done in an organization. Culture is created with a number of issues in the organization. Firstly, it increases the need for the provision of culturally appropriate care to veterans by the healthcare providers. Healthcare providers have to ensure that the care that patients receive aligns with their values, needs, beliefs, and preferences. Culture also creates conflicts and misunderstandings among the healthcare providers. VA Healthcare System has healthcare providers from different backgrounds. The diversity implies that the risk for cultural conflicts and misunderstandings on the interpretation of needs exists. The conflicts may hinder the efficiency of teamwork and collaboration strategies utilized to achieve the desired care outcomes in the organization (Arefin et al., 2020). Therefore, as a driving force for change, the organization has to be sensitive in the strategies it utilizes to ensure their cultural appropriateness.

Steps for the Organization

VA Healthcare System is required to embrace a number of steps to respond effectively to cultural needs of the different stakeholders in healthcare. One of the steps is the provision of patient-centered care. The care given to patients in VA Healthcare System should target the unique needs of the veterans. The values, beliefs, preferences, and practices of the veterans should be incorporated into the care process. The needs of the veterans should be prioritized in decision-making (McCalman et al., 2017). The utilization of patient-centered interventions contributes to cultural competency since patients are empowered to play an active role in the care process.

The other step that should be considered in VA Healthcare System is offering training on culture-related issues to healthcare providers. Regular training opportunities are needed to raise the knowledge and skills of the healthcare providers on offering culturally appropriate care. Training also builds their competence on ways in which organizational systems and processes can be transformed to support the provision of culturally sensitive care. The other step is providing care that addresses barriers to care. An example is focusing on the use of interventions such as interpreters and decision aids to eliminate communication barriers in VA care. Community workers can also be involved in the provision of care to veterans to enhance care coordination. Addressing barriers to access to care will improve patient satisfaction with care, adherence to treatment and enhance their quality of life (Abrishami, 2018). The additional steps that are needed for the organization include the incorporation of culturally appropriate values and attitudes into tools of health promotion, including family members in decision-making and expanding linguistic competency beyond the patient encounter in the clinical settings.

Prediction of Employee Response

The employees in the organization will support the above interventions to ensure cultural competence in the organization. Cultural competence is a critical skill for healthcare providers to offer appropriate care to diverse populations. The cultural needs of patients often change, increasing the need for cultural awareness among the healthcare providers. The healthcare providers in the institution understand that culturally appropriate care contributes to outcomes such as patient satisfaction, empowerment and involvement in the care process. Therefore, the employees in all the levels of the organization are likely to support the implementation of the above interventions to promote patient care.

Vision for Change

The employees in VA Healthcare System do not appear to behave in accordance with the mission of the institution. The employees have a negative attitude towards the use of culturally appropriate interventions to meet the vision of the organization. Therefore, my vision of change is to create an organization where the employees understand the importance of cultural competence in contributing to the realization of the organizational mission.

How the Vision will assist Internal Stakeholders

The vision will assist internal stakeholders in supporting the change initiative. The vision will help the employees learn about culturally appropriate behaviors in the provision of patient care. They will also learn about the strategies needed to promote the creation of a culturally inclusive environment in the organization. Lastly, the vision will help internal stakeholders to learn effective strategies for sustaining culturally appropriate interventions in patient care. Some of the potential considerations that the stakeholders may pose include cost and benefit analysis of the interventions, sustainability strategies and ways of ensuring that the healthcare providers support the intervention. I will respond to them using evidence-based data about the importance of the interventions and providing training for the healthcare providers.


In summary, change is important for organizational success. Change enables health organizations to embrace innovative strategies to address current and unidentified needs. Internal and external factors drive change in VA Healthcare System. VA Healthcare System should embrace interventions that ensure culturally appropriate care is offered to the stakeholders. Through it, the needs of the patients and other stakeholders will be addressed effectively.




Abrishami, D. (2018). The Need for Cultural Competency in Health Care. Radiologic Technology, 89(5), 441–448.

Ali, A., Iqbal, S., Haider, S. A., Tehseen, S., Anwar, B., Sohail, M., & Rehman, K. (2021). Does Governance in Information Technology Matter When It Comes to Organizational Performance in Pakistani Public Sector Organizations? Mediating Effect of Innovation. SAGE Open, 11(2), 21582440211016556.

Arefin, Md. S., Hoque, Md. R., & Rasul, T. (2020). Organizational learning culture and business intelligence systems of health-care organizations in an emerging economy. Journal of Knowledge Management, 25(3), 573–594.

Christensen, J. K. B. (2018). The Emergence and Unfolding of Telemonitoring Practices in Different Healthcare Organizations. International Journal of Environmental Research and Public Health, 15(1), 61.

McCalman, J., Jongen, C., & Bainbridge, R. (2017). Organisational systems’ approaches to improving cultural competence in healthcare: A systematic scoping review of the literature. International Journal for Equity in Health, 16(1), 78.

Sfantou, D. F., Laliotis, A., Patelarou, A. E., Sifaki- Pistolla, D., Matalliotakis, M., & Patelarou, E. (2017). Importance of Leadership Style towards Quality of Care Measures in Healthcare Settings: A Systematic Review. Healthcare, 5(4), 73. (n.d.). About VA [Homepage]. Retrieved from

Valenzuela, M. A., Flinchbaugh, C., & Rogers, S. E. (2020). Can organizations help adjust?: The effect of perceived organizational climate on immigrants’ acculturation and consequent effect on perceived fit. Journal of International Management, 26(3), 100775.

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Please read through the following information on writing a Discussion question response and participation posts.

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Important information on Writing a Discussion Question

  • Your response needs to be a minimum of 150 words (not including your list of references)
  • There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
  • Include in-text citations in your response
  • Do not include quotes—instead summarize and paraphrase the information
  • Follow APA-7th edition
  • Points will be deducted if the above is not followed

Participation –replies to your classmates or instructor

  • A minimum of 6 responses per week, on at least 3 days of the week.
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  • Follow APA 7th edition
  • Points will be deducted if the above is not followed
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