Answer

This paper describes how a surgical orthopedic trauma department at Barnes Jewish Hospital (BJH) implemented a shift reporting procedure using Kotter’s change model.

BJH’s vision is to become national leaders in medicine and the patient experience. The rating for the workers knowledge of the vision is five.

Mission: BJH is committed to improving the health of communities they serve in a supportive, safe, and caring environment that meets the individual needs of their patients. The rating for the workers knowledge of the mission is five.

BJH Purpose: The staff are knowledge of BJH purpose which isto offer the best patient care using the outcomes for the patient with an absence of preventable harm.

Values: The staff are very knowledgeable on the hospital values which are compassion, respect, teamwork, safety, and excellence.

Diversity: BJH is a highly diverse hospital because it aims at ensuring their patients have equal access to high quality care irrespective of their ethnicities, race, gender or sexual orientation. Likewise, the hospital has a diverse workforce.

Inclusion: BJH is highly involved in inclusion as the hospital has a VP for diversity, equity, and inclusion. The VP’s role is to foster BJH’s mission of providing equitable, culturally aware care for all patient and guarantee a diverse, culturally adept workforce.

Goal:Implentation of a shift reporting procedure at the surgical orthopedic trauma department was successfully met.

Strategy: The hospital successfully used Kotter’s change modelto implement this change.

Communication: The communication methods used to communicate the change were weekly meetings, training session, and disseminating nursing articles on bedside handoffs to the staff.  Communication between the healthcare team is crucial to foster patient safety when changing shifts to avoid errors arising from miscommunication amid handoffs. Therefore, bedside reporting provides a patient-based method to a critical interaction between the healthcare team that can lessen mistakes in the hospital. The communication means that directed the nurses to evaluate and report vital aspects of the patient care was the handoff sheet. This communication tackled the patient’s present clinical condition so that the incoming nurse on another shift is aware of everypatient’s treatment plan.  Kotter’s model was used in planning and executing the hands-off.

Step One: Create Urgency:  The CEO acknowledges the significance of bedside communication. An impression of urgency was executed by demonstrating to the workforce the likelihood of sentinel actions causing poor results because of the imperfect handoff process. The thought of harm created by this error functioned as a motivation for change in the department.

Step Two: Form a Powerful Coalition: The change team is comprised of leaders mandated to foster buy-in for others to embrace the new practice. The coalition consisted of nurse-in-charge, CEO, bedside nurses, nurse educator, clinical officer, and resources nurses. The CEO gave them literature articles hoisting safety measures from IOM, RWJ Foundation, and Joint Commission to enlighten them on how bedside handoff improves communication between the healthcare team and the patients (Mardis et al., 2016).

 Step Three: Create a Vision for Change: The project’s vision was to enhance patient care and communication amongst the healthcare team and their patients and families at the bedside. The final results comprised better satisfaction in giving and getting care and averting adverse incidents. 

Step Four: Communicate the Vision: The message was through nursing articles that describe the pros of bedside handoffs. Also, weekly personnel meetings and education sessions were utilized by the team in communicating the vision (Nasarwanji et al., 2016).

Step Five: Remove Obstacles: Staff training was a vital part in empowering personnel to change, and also open communication with the workforce helped identify the challenges.

 Step Six: Create Short-Term Wins: One example of the quick win was that staff recognized missed medications at the start of the shift on the electronic medication administration record. Another success was that staff completed their shift more efficiently on time.

 Step Seven: Build on the Change: The team trained staff and maintained and strengthened the change by preserving the entire vision. Also, the team held changes through performance appraisals and underlining the need to uphold critical thinking outcomes in the creation of new procedures.

 Step Eight: Anchor the Changes in Corporate Culture: The beside handoff became the routine in the department by incorporating the vision in the orientation of new nurses. Hence the bedside handoff became a foundational activity in department identity because it became the department’s culture. The majority buy-in made the process easier to maintain the change.

A