NUR 514 What are the three key steps of leading the process of strategic change?

NUR 514 What are the three key steps of leading the process of strategic change?

NUR 514 What are the three key steps of leading the process of strategic change?

Successful change is one of the biggest challenges that modern organizations face. A strategic necessity for change is always needed in this fast-changing world. Besides, if things are not done differently, organizations are unlikely to succeed or last. I will start by describing the background of a situation in my current healthcare organization where change did not go as planned, including the rationale and the purposed goals of the change. In addition, I will identify the key interprofessional stakeholders, both internal and external, that should be involved in change efforts. I will then identify an appropriate change theory or model and discuss how it can be used to achieve results. I will also outline a plan that I would adopt to utilize the change in the healthcare organization. Lastly, I will discuss the impact on the organization if the change initiative would be unsuccessful again, and the potential steps the interprofessional team should take if the change is ineffective.

The differences according to Lucia (2018) between a good manager and a good leader stands at the intersection of skills, strategic thinking and ethical integrity specific to the manager and the emotional intelligence, power of persuasion, empathy, passion and open communication specific to the leader. Advanced practice nurse’s (APRN) can be placed into director positions at different levels within an organization. Within the managed care population, APRN’s have served as director of sector. For example, this may be in population health with the director having oversight of a large area either at a state, regional or corporate level. What I have seen personally is APRN’s set the tone for organizational business goal, provide details to that goal, statistics and then continue to push for that goal throughout upcoming months most often done in team huddles providing updates. In the past I led a team of 13 case managers. The entire department (statewide) was tasked to increase care plan production and meet metrics. The initial step was done as a company meeting. I followed up with a team meeting breaking down what each step meant and how I would be working with each of them at a team level and individually. This was a huge push on our stakeholders end to provide robust and lengthy care plans and it involved utilizing our systems in a way the team wasn’t accustomed to. I took time to listen to my teams’ concerns, set up training sessions, meet individually with each case manager and spend additional time with anyone who requested it. In many ways I like to take servant leadership and utilize this as my format as Neville, et al. (2021) states it is to help first then lead by example. This was true in my role as time to time I had to take on a case and took the time to incorporate what I taught and use mine and other case managers work as examples. Other tools servant leaders utilize is listening, empathy and persuasion. In persuasion it is a matter of providing the education and support rather than using your power of position (Neville, et al. 2021) to meet the organizational goals.

Brainstorming Questions

1.Do you remember the 3 C’s of change leadership?

2.What are the three key steps of leading the process of strategic change?

3.What are the crucial qualities of leading people?

4.How have you ever affected positive change in your current or former organization?

5.How can you spur positive change on behalf of your organization?●

In my current healthcare organization, the hospital management introduced the Computerized Physician Order Entry (CPOE) Systems, which were to be used by doctors, consultants, pharmacists, and nurses to prescribe, dispense and administer medications to patients. The prescribing clinician was supposed to use the CPOE to prescribe a patient’s drug by indicating patient information such as age, sex, known drug allergies, current medications, chronic illnesses, and the diagnosis (Baysari et al., 2018). The clinician was also supposed to input the correct medication, the dose, and the frequency of administration. The information would then be sent to the pharmacist who would receive the prescription, ensure the prescribed drug and dose is appropriate for the patient, and dispense the medication. The medication would then be distributed to the patient or a nurse for hospitalized patients. The system would also propose a preferable drug that would suit a patient’s condition and would have no drug interactions with current medications (Holmgren et al., 2019). Nevertheless, the training on the use of CPOE was conducted for four weeks and was done in a hurry. A majority of health providers in the organization did not attend all the training sessions, and for those who were on annual leave did not attend any training sessions. Besides, the sessions had more theory sessions than practical sessions, yet the providers required to be equipped with skills on how to enter patients’ information in the system, searching for drugs and rebooting the system.

There was a challenge in using the CPOE system since there was not adequate time to train the staff on how to use the system. This resulted in clinicians sending the wrong patient prescriptions, and the pharmacists had a hard time dispensing the drugs. This further caused delayed delays in the pharmacy since the pharmacists had to contact the clinician to correct the drug for most patients. Patients had to wait for long before being served due to the mix up in the prescriptions. The staff also had challenged in rebooting the system, which led to further delays as the IT team had to come to fix the system diagnostics issues.

The health providers further resisted the change since they had not been consulted on their views about the adoption of the CPOE system. Besides, they did not have a specific person they would consult when they needed guidance on the rebooting of systems or transmission of data (Baysari et al., 2018). The management was forced to stop the use of CPOE and advised the staff to prescription papers until they come up with a plan to have a smooth adoption of the system. The organization went back to using prescription papers, which were associated with medication errors that resulted in adverse drug reactions in some patients.

The rationale for changing the drug prescription process from using prescription papers to using technology systems was the need to adopt and integrate technology in the delivery of services within the organization. Other facilities had adopted the use of CPOE, which had been successful and had significantly reduced medication errors during the prescription and dispensing of drugs (Page, Baysari, & Westbrook, 2017). Besides, health organizations were continuously being encouraged to embrace technology and adopt the use of technology systems to reduce human errors and promote better health outcomes. The use of technology would ease and fasten drug ordering and save time hence enhancing services and improving customer satisfaction (Coustasse et al., 2015). Besides, the change was directed to enhance the drug prescription process since there were reports of patients adding their preferred medications in the paper prescriptions, which had not been authorized by the clinician. There was also a need to reduce medical errors, which were mostly caused by ambiguous handwriting and often gave the pharmacists a hard time reading and interpreting the written prescriptions.

The CPOE was also adopted to prevent cases where patients were prescribed with drugs they were allergic to and drugs that interacted with other medications that they were currently taking. By using the CPOE, the system would guide the clinicians on the most appropriate medications that would have minimal side effects and no interactions with other prescribed drugs (Gellert, Ramirez, & Webster, 2015). Moreover, the change to CPOE was a result of many complains of clinicians prescribing drug overdoses, and the system would help to correct the dosage as per a patient’s age and diagnosis.

Description:

As an advanced registered nurse, you will serve as a leader within your organization. Part of this role will entail being a change agent and spurring positive change on behalf of patients, colleagues, and the industry.

Consider a situation you experienced previously where change did not go as planned in your health care organization. Create a 10-15-slide PowerPoint presentation in which you will assess the situation and the steps that should have been taken to successfully implement change. Create speaker notes of 100-250 words for each slide. Include an additional slide for the title and references. For the presentation of your PowerPoint, use Loom to create a voice-over or a video. Refer to the study materials for additional guidance on recording your presentation with Loom. Include an additional slide for the Loom link at the beginning and another at the end for References.

Include the following in your presentation:

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1. Describe the background of the situation and the rationale for and goal(s) of the change. Consider the ethical, social, legal, economic, and political implications of practice change in your response.
2. Outline the advanced registered nurse’s role as change agent within the interprofessional and dynamic health care environment.
3. Identify the key interprofessional stakeholders (both internal and external) that should be involved in change

efforts.
4. Discuss an appropriate change theory or model that could be used to achieve results. Explain why the theory or model selected is best for the situation. Include the ethical, social, legal, economic, and political implications of applying the change management strategies to practice change in your response.
5. As an advanced registered nurse, outline how you would initiate the change.
6. Describe the impact to the organization if the change initiative is unsuccessful again, and potential steps the interprofessional team could take if the change is unsuccessful.
7. Predict what additional factors will drive upcoming organizational change for the organization and outline the advanced registered nurse’s role as change agent.

You are required to cite three to five sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Refer to the resource, “Creating Effective PowerPoint Presentations,” located in the Student Success Center, for additional guidance on completing this assignment in the appropriate style.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Course Materials if you need assistance.

Health care organizations apply different strategies to improve health outcomes. Practice change improves health outcomes by addressing performance gaps and introducing new processes (Busetto et al., 2018). However, change does not always occur as planned, which can have far-reaching impacts on financial assets and workplace relationships. Therefore, the purpose of this presentation is to describe a situation where change did not go as planned in the workplace and the steps that should have been taken to implement change successfully. Central discussion areas include a background of the situation, the nurse’s role as a change agent, and stakeholders essential in change management. Other areas include a presentation of change theory, impacts of unsuccessful change, and factors to drive upcoming organizational change.

The situation where change did not occur as planned involved the introduction of a zero-tolerance policy in the organization in response to increased cases of bullying. As Mrayyan (2018) stated, zero tolerance towards workplace violence encourages nurses not to endure violence and report it immediately after they encounter it. The law also severely punishes those who commit violent acts like bullying against health care providers. Like other practice change activities, the nursing staff was supposed to be adequately prepared for policy change to embrace it fully. Unfortunately, the management introduced the policy abruptly, which reduced the staff’s commitment to implementing it fully. Hence, it did not achieve the outcomes as projected.

Health care professionals should work in safe care environments to deliver quality patient care. According to Al-Ghabeesh and Qattom (2019), bullying is damaging to the health and productivity of nurses since it impairs their emotional health and increases their desire to quit their occupations. Therefore, zero tolerance towards bullying is a practical intervention for optimizing employee productivity and protecting nurses from the adverse effects of workplace incivility. Homayuni et al. (2021) found that bullying is associated with depression and distress in nurses, which hampers interprofessional collaboration and their ability to provide quality care. A zero-tolerance policy protects the staff from such health dangers and ensures civil conduct among employees as they work to achieve a common goal.

Nurse leaders should introduce and guide while looking forward to achieving multi-dimensional impacts. Practice change achieved by implementing zero-tolerance policies can help to promote ethical conduct among nurses, which is characterized by behaviors that prevent harm and ensuring that employees are responsible for their actions. From a social dimension, nursing practice is conducted in social environments with diverse practitioners. Preventing behaviors that hamper teamwork and cooperation is instrumental in building healthy relationships among diverse teams. Mrayyan (2018) stressed the importance of a zero-tolerance policy in preventing costly medical errors. Preventing such errors also minimizes legal issues stemming from patient harm and improves the organization’s reputation and relationship with partners.

The advanced registered nurse’s role as a change agent is critical for the progressive improvement of patient care outcomes. According to Rafferty (2018), nurses and nurse leaders are directly involved in patient care, and their influence, skills, and guidance are valuable in change implementation. Skills utilization is demonstrated by continuous assessment of practice gaps and introduction of interventions for enhancing performance. Nurse leaders also use their knowledge and skills to promote evidence-based innovation and lead behavior change practices like zero-tolerance policies, motivation programs, and infection control. Other roles include designing and delivering health policy as nurses and patient advocates and mentoring nurses to embrace change to reduce resistance toward new practices.

Stakeholders play a critical role in change implementation. The type, direction, and success of organizational change depend on stakeholder engagement, participation, and support (Jasinska, 2020). One of the key stakeholders involved in change efforts is the caregivers, including nurses and physicians. They are directly involved in change efforts since many practice changes cannot be conducted without them. The organization’s management plays a crucial role in supporting change through resources and preparing the organization for change. Other stakeholders with varying roles include patients, partners and suppliers, political and legal representatives, and accreditation agencies. These stakeholders should be adequately informed about organizational practices to determine whether the organization promotes care quality and patient safety as professionally obliged.

Kurt Lewin’s change management model is highly appropriate for change implementation in a dynamic health care environment. Its basic concepts include driving forces that push change in the desired direction, restraining forces that counter change efforts, and a state of equilibrium. As Hussain et al. (2018) explained, practice change occurs progressively in three basic steps: unfreezing, changing, and refreezing. Unfreezing is primarily about preparing the nursing staff and other stakeholders to understand and embrace change to counter possible resistance. The changing phase involves transitioning to new behaviors and work routines, while refreezing involves sustaining the new status to achieve lasting effects.

Change leaders apply different change models for different reasons. Besides guiding change management in a simple and straightforward process, Lewin’s change theory aims to understand and demonstrate why change occurs (Hussain et al., 2018). Accordingly, change leaders can justify the change and visualize the outcomes. Lewin’s theory also accounts for uncertainties and resistance to change. In most instances, resistance to change occurs when the nursing staff and other stakeholders are not engaged in the change process. To overcome resistance, Lewin’s theory stresses the need for clear and convincing communication and education about the need for the change during the unfreezing phase (Deborah, 2018). Above all, the phased change management helps change leaders to introduce and implement organizational change procedurally.

Organizational change has profound impacts on care quality and work processes. Hence, the change management strategies applied should be centered on achieving change without adverse impacts on behaviors, social relationships, and finances. Due to its straightforward nature and simplicity, Lewis change management model ensures that change is implemented without ethical misconduct or negative impacts on workplace behaviors. The simple process is also economical since it does not include many steps that can be tiring or consume massive resources. Change management through positive behavior change also protects patients, health care professionals, and other populations. Doing so protects the organization from possible reputational damage, which can be politically, ethically, and legally costly.

Advanced registered nurses should be aware of change implementation barriers before initiating practice change. After identifying the change and potential impacts, I would develop a comprehensive implementation plan to share with the management and the nursing staff. Next, I would communicate the change to nurses and all stakeholders since lack of it was the main reason for the initial change failure in the facility. Communication is crucial in the unfreezing phase of change management since it helps stakeholders to understand the change and its importance (Deborah, 2018). The next step would be actively engaging stakeholders to implement the change before its evaluation to determine whether it achieved the desired effects.

Change implementation is usually a lengthy, laborious, and resource-intensive process. It requires preparation, continuous communication, and engagement of stakeholders. Unsuccessful change implies potential misuse of the organization’s resources such as zero tolerance policy handouts and finances used communication and other crucial processes. Since the goal of the change process is to prevent bullying, failure to achieve this goal would increase nurses’ exposure to workplace bullying. Al-Ghabeesh and Qattom (2019) found that bullying lowers nurses productivity since it is psychologically harming, and the same would be witnessed in the organization. Other potential outcomes include increased risk to patient care and disappointment with the change process.

Nurse leaders should never give up with organizational change. Consequently, they should have a backup plan if change is unsuccessful. The most effective intervention to address the current scenario if change does not succeed is a collaborative process and impact assessment. In this case, nurses, nurse leaders, and the management would collaborate to assess why practice change failed and practical remedies. The role of the collaborative assessment would be helping the change team to address implementation barriers before reintroducing the change.  Such barriers include communication problems, a resistance culture, and a lack of stakeholder support (Busetto et al., 2018). As the implementation progresses, the change team should seek continuous feedback from stakeholders while monitoring reactions and impacts. Such an impact would help to fix any issue hampering the process timely and conveniently.

Successful organizational change is achieved through a combination of factors. Besides stakeholder engagement and communication as mentioned earlier, employee growth and development will play a crucial role in driving upcoming organizational change. Largely, employee growth and development will equip employees with the skills, knowledge, and attitudes necessary for continuous quality improvement in health practice. Organizations ready for change must foster innovation through nurse leaders who seek new ways to transform and influence higher care quality through new care delivery models (Snow, 2019; Mutonyi et al., 2021) Accordingly, the advanced registered nurse must be at the center of innovation and transformation through continuous assessment of performance gaps and fostering a culture of change in the organization.

As demonstrated in this presentation, the primary goal of practice change is to optimize health outcomes. As a result, nurse leaders and other health care professionals in advanced practice should continually assess performance gaps, promote innovation, and lead behavior-change practices. Since practice change should be systematic and procedural, the advanced registered nurse should initiate change using theoretical guidelines. Kurt Lewin’s change management theory can be applied to introduce change in the organization to achieve the best results. It stresses preparation for change and sustaining it, which are critical to successful change. Additional drivers of change in the organization include the management investing in innovation and employee growth and development programs.

References

• Al-Ghabeesh, S. H., & Qattom, H. (2019). Workplace bullying and its preventive measures and productivity among emergency department nurses. Israel Journal of Health Policy Research, 8(1), 1-9. https://doi.org/10.1186/s12913-019-4268-x
• Busetto, L., Luijkx, K., Calciolari, S., Ortiz, L. G. G., & Vrijhoef, H. J. M. (2018). Barriers and facilitators to workforce changes in integrated care. International Journal of Integrated Care, 18(2), 1-13. http://doi.org/10.5334/ijic.3587
• Deborah, O. K. (2018). Lewin’s theory of change: Applicability of its principles in a contemporary organization. Journal of Strategic Management, 2(5), 1-11. https://stratfordjournals.org/journals/index.php/journal-of-strategic-management/article/download/229/274
• Homayuni, A., Hosseini, Z., Aghamolaei, T., & Shahini, S. (2021). Which nurses are victims of bullying: the role of negative affect, core self-evaluations, role conflict and bullying in the nursing staff. BMC Nursing, 20(1), 1-9. https://doi.org/10.1186/s12912-021-00578-3
• Hussain, S. T., Lei, S., Akram, T., Haider, M. J., Hussain, S. H., & Ali, M. (2018). Kurt Lewin’s change model: a critical review of the role of leadership and employee involvement in organizational change. Journal of Innovation & Knowledge, 3(3), 123-127. https://doi.org/10.1016/j.jik.2016.07.002
• Al-Ghabeesh, S. H., & Qattom, H. (2019). Workplace bullying and its preventive measures and productivity among emergency department nurses. Israel Journal of Health Policy Research, 8(1), 1-9. https://doi.org/10.1186/s12913-019-4268-x
• Busetto, L., Luijkx, K., Calciolari, S., Ortiz, L. G. G., & Vrijhoef, H. J. M. (2018). Barriers and facilitators to workforce changes in integrated care. International Journal of Integrated Care, 18(2), 1-13. http://doi.org/10.5334/ijic.3587
• Deborah, O. K. (2018). Lewin’s theory of change: Applicability of its principles in a contemporary organization. Journal of Strategic Management, 2(5), 1-11. https://stratfordjournals.org/journals/index.php/journal-of-strategic-management/article/download/229/274
• Homayuni, A., Hosseini, Z., Aghamolaei, T., & Shahini, S. (2021). Which nurses are victims of bullying: the role of negative affect, core self-evaluations, role conflict and bullying in the nursing staff. BMC Nursing, 20(1), 1-9. https://doi.org/10.1186/s12912-021-00578-3
• Hussain, S. T., Lei, S., Akram, T., Haider, M. J., Hussain, S. H., & Ali, M. (2018). Kurt Lewin’s change model: a critical review of the role of leadership and employee involvement in organizational change. Journal of Innovation & Knowledge, 3(3), 123-127. https://doi.org/10.1016/j.jik.2016.07.002

Implementing Change With an Interprofessional Approach Presentation Rubrics
1
Unsatisfactory
0.00% 2
Less than Satisfactory
80.00% 3
Satisfactory
88.00% 4
Good
92.00% 5
Excellent
100.00%
100.0 %Conte
5.0 %Driving Forces of EHRS A description of the driving forces that related to need for implementing EHRs is not included. A description of the driving forces that related to need for implementing EHRs is incomplete or incorrect. A description of the driving forces that related to need for implementing EHRs is included, but lacks supporting detail. A description of the driving forces that related to need for implementing EHRs is completed and includes supporting detail. A description of the driving forces that related to need for implementing EHRs is extremely thorough and includes substantial details.

10.0 %Change Initiative and Being a Change Advocate An outline of how change would be initiated is not included. An outline of how change would be initiated is incomplete or incorrect. An outline of how change would be initiated is included, but lacks supporting detail. An outline of how change would be initiated is completed and includes supporting detail. An outline of how change would be initiated is extremely thorough and includes substantial details.

5.0 %Key Interprofessional Stakeholders Identification of the key interprofessional stakeholders is not included. Identification of the key interprofessional stakeholders is incomplete or incorrect. Identification of the key interprofessional stakeholders is included, but lacks supporting detail. Identification of the key interprofessional stakeholders is completed and includes supporting detail. Identification of the key interprofessional stakeholders is extremely thorough and includes substantial details

5.0 %Impact of the Change on Current Workflows A description of how the change will affect current workflows is not included. A description of how the change will affect current workflows is incomplete or incorrect. A description of how the change will affect current workflows is included, but lacks supporting detail. A description of how the change will affect current workflows is completed and includes supporting detail. A description of how the change will affect current workflows is extremely thorough and includes substantial details.

5.0 %Required Resources for Implementation Identification of required resources for implementation is not included Identification of required resources for implementation is incomplete or incorrect. Identification of required resources for implementation is included, but lacks supporting detail. Identification of required resources for implementation is completed and includes supporting detail. Identification of required resources for implementation is extremely thorough and includes substantial details.

5.0 %Risks Within Implementation A description of potential risks within the implementation plan is not included. A description of potential risks within the implementation plan is incomplete or incorrect. A description of potential risks within the implementation plan is included but lacks supporting detail. A description of potential risks within the implementation plan is completed and includes supporting detail. A description of potential risks within the implementation plan is extremely thorough and includes substantial details.

5.0 %Potential Barriers A description of potential barriers when implementing the change and handling resistance is not included. A description of potential barriers when implementing the change and handling resistance is incomplete or incorrect. A description of potential barriers when implementing the change and handling resistance is included, but lacks supporting detail. A description of potential barriers when implementing the change and handling resistance is completed and includes supporting detail. A description of potential barriers when implementing the change and handling resistance is extremely thorough and includes substantial details.

30.0 %Presentation of Content The content lacks a clear point of view and logical sequence of information. Includes little persuasive information. Sequencing of ideas is unclear. The content is vague in conveying a point of view and does not create a strong sense of purpose. Includes some persuasive information. The presentation slides are generally competent, but ideas may show some inconsistency in organization or in their relationships to each other. The content is written with a logical progression of ideas and supporting information exhibiting a unity, coherence, and cohesiveness. Includes persuasive information from reliable sources. The content is written clearly and concisely. Ideas universally progress and relate to each other. The project includes motivating questions and advanced organizers. The project gives the audience a clear sense of the main idea.

10.0 %Layout The layout is cluttered, confusing, and does not use spacing, headings, and subheadings to enhance the readability. The text is extremely difficult to read with long blocks of text, small point size for fonts, and inappropriate contrasting colors. Poor use of headings, subheadings, indentations, or bold formatting is evident. The layout shows some structure, but appears cluttered and busy or distracting with large gaps of white space or a distracting background. Overall readability is difficult due to lengthy paragraphs, too many different fonts, dark or busy background, overuse of bold, or lack of appropriate indentations of text. The layout uses horizontal and vertical white space appropriately. Sometimes the fonts are easy to read, but in a few places the use of fonts, italics, bold, long paragraphs, color, or busy background detracts and does not enhance readability. The layout background and text complement each other and enable the content to be easily read. The fonts are easy to read and point size varies appropriately for headings and text. The layout is visually pleasing and contributes to the overall message with appropriate use of headings, subheadings, and white space. Text is appropriate in length for the target audience and to the point. The background and colors enhance the readability of the text.

10.0 %Language Use and Audience Awareness (includes sentence construction, word choice, etc.) Inappropriate word choice and lack of variety in language use are evident. Writer appears to be unaware of audience. Use of primer prose indicates writer either does not apply figures of speech or uses them inappropriately. Some distracting inconsistencies in language choice (register) or word choice are present. The writer exhibits some lack of control in using figures of speech appropriately. Language is appropriate to the targeted audience for the most part. The writer is clearly aware of audience, uses a variety of appropriate vocabulary for the targeted audience, and uses figures of speech to communicate clearly. The writer uses a variety of sentence constructions, figures of speech, and word choice in distinctive and creative ways that are appropriate to purpose, discipline, and scope.

5.0 %Mechanics of Writing (includes spelling, punctuation, grammar, language use) Slide errors are pervasive enough that they impede communication of meaning. Frequent and repetitive mechanical errors distract the reader. Some mechanical errors or typos are present, but they are not overly distracting to the reader. Slides are largely free of mechanical errors, although a few may be present. Writer is clearly in control of standard, written, academic English.

5.0 %Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style) Sources are not documented. Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors. Sources are documented, as appropriate to assignment and style, although some formatting errors may be present. Sources are documented, as appropriate to assignment and style, and format is mostly correct. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

100 %Total Weightage