Planned Change in a Department or Unit

Answer

• Planned Change in a Department or Unit

1. Identification of the Problem, Inefficiency, or Issue

Ineffective Hand-Off Communication

Change is an inevitable process as long as the world keeps rotating. The current manager in the healthcare sector is undergoing a tough time in trying to maintain the quality standards of the healthcare facility while managing the constant changes. Specifically, the advancement in technology, as well as the changes in policies, requires that managers embrace those changes for the benefit of the patient in the healthcare facilities (Marquis, & Huston, 2015). As leaders, managers have the task of ensuring that they succinctly explain to the departments they lead the need for change, and how the change will be executed without affecting the due process of the healthcare sector (McAlearney et al., 2014) I work in the oncological department where I am headed by the Unit Director as well as the Unit Manager. Additionally, as charge nurses, we work in shifts whereby we rotate so that there is always a nurse on the unit, which consists of 18 beds.

The problem that arises in the oncological department is that of inefficient hand-off communication. Notably, before charge nurses rotate, they have to exchange information about the details of the patients that they take care of so that the next nurse will know how to handle the patient (McAlearney et al., 2014). However, the model of exchanging this information is ineffective as many errors are occurring due to insufficient and inaccurate information. This has cost the patients vast sums of money and in extreme cases even their lives. This problem is occasioned by the limited time that nurses have in their rotation period. Additionally, the lack of respect for individual nurses can also be an important issue. Moreover, there is the lack of proper communication when the patient is transferred from the emergency department to the inpatient unit. This breakdown in communication is costly to the patients and their families. As such, there is a need for change in the manner in which information is shared among nurses as they rotate in the oncological department, specifically in our unit.

2. Specific, Realistic Change That Could Be Made To Address The Issue

To solve the issue of the inefficiency of the dissemination of hand-off information, the healthcare organization should make standardized forms that must be signed by the nurses before they rotate or change their shifts. These standardized forms will contain critical details about the oncological patients; their treatment history, their level of therapy and their next appointment with the physician. If the new nurse does not understand the information in the standard form, then there should be an opportunity for asking questions. This will provide an opportunity for the future nurse to have adequate hand-off information before he/she takes on the shift. Additionally, this change will face out the common behavior where charge nurses leave little information to their counterparts hence leading to the suffering of the patients. The healthcare facility has a role to play in this change. Specifically, they will have to train the charge nurses on what constitutes real hand on information. This will ensure that they fill the standard hand-off form in a manner that is understandable to the next person attending to the patient in the oncological department. Indeed, this will solve the issue of errors, which are indeed detrimental to the health of the patient.

3. A Summary Of How The Change Would Align With The Organization’s Mission, Vision, And Values As Well As Relevant Professional Standards

The mission of this organization is to provide quality healthcare to the patient at low costs. In this regard, the organization emphasizes on the quality of services that are offered to the patients that are admitted to the hospital. Their vision is to become a leader in the provision of quality healthcare services. As such, this will start when the internal processes of the organization are well aligned with the mission and vision of the organization. The change that I meant to improve on the dissemination of hand-off information between nurses in the oncological department and another department is properly in line with the objectives of the healthcare organization. Specifically, the change will improve on the quality of the healthcare in the oncological department. Additionally, the nurses, patients and their families will be satisfied with the implementation of this plan (Laureate Education, 2012g). This will, in turn, put the facility in good light and hence become a leader in providing quality healthcare. The values of work discipline and respect that the organization stands for will be effected when the proposed change is implemented as information will be shared that is vital for the success of the organization. Professional standards require that information should be disseminated to healthcare providers so that errors in diagnosis are reduced. As such, the change is crucial to fulfilling all those requirements.

4. A Change Model or Strategy to Guide My Planning For Implementing the Change

Kurt Lewin’s change theory will guide my planning for implementing the change in the ineffectiveness of the hand-off communication among nurses in the oncological department. His approach involves three steps that are involved in planning for change. Specifically, the three phases are unfreezing, change and freezing level (Shirey, 2013). The first step, which is unfreezing, starts with the mover of the modification explaining and indeed showing to the healthcare organization that there is an importance for change. This, therefore, prepares the persons who are probably going to be affected by the proposed change. Notably, according to Shirey (2013), change will alter the status quo. Therefore, it is important for the nurses in the department to prepare for the change instead of ambushing them. Additionally, the unfreezing stage is critical in showing the nurses that the traditional way of giving hand-off information cannot continue. The second phase is that of change. In this point, Lewin states that this stage the member of the organization will resolve that they have to change and hence change that uncertainty (Mitchell, 2013). The management of the effects of the modification is done at this stage. The third and the final stage is the one of freezing. In this step, the nurses will be able to internalize the changes and, make them part of their programs.  I chose this model because it aligns very well with the plan of implementation that I have, as the steps involved are practical.

5. The Steps That I and/or Others Would Follow To Facilitate the Change.

The steps that I would follow to facilitate the implementation of my plan follows the model that has been set out by Lewin. In this regard, I would start by showing the unit managers why there is a need for a change in the way that hand on information is disseminated from one nurse to the other. In this regard, I would invoke the records of the many misdiagnoses that have been done due to the inefficient hand-off communication. This will convince them that change is inevitable and that they have to embrace it. In the second step, which Lewin terms as change, I will start to array the fears that nurses might have on the effects of the proposed amendment. In this regard, I will explain to them why they need to embrace the change and how it will help them as well as the patients. I will proceed to implement the plan by ensuring the preparation of those standard forms and initiating the training of the nurses on how to provide hand-off information. In the final step, freezing, I will ensure that all the nurses fill those forms on a daily basis so that it becomes part of their program. I will also thank the nurses for embracing the change and encourage them to make it part of their daily routine.

6. People Involved In Initiating And Managing This Change, And The Skills And Characteristics That Would Be Necessary To Facilitate The Change Effort

The completely oncological department would be involved in the proposed amendment. In this regard, the Unit Manager, Unit Director, and the Departmental Manager will form part of the planned change. Additionally the nurses and other medical personnel in the department will be involved so that the proposed change is embraced by every member of the staff. The initiation of this change would come from the Unit Manager upon receiving this information. The management would be in the realm of the Departmental Manager that would ensure that the requirements of the proposed change are followed. The nurses are the most affected by the change as they are the ones who would be required to undergo training and fill the standard forms. Moreover, the Unit Director will facilitate in the training of the nurses on the formulation of a right hand-off communication. Leadership skills, which include those of cooperation, inclusiveness, and respect for one another, will be required. Additionally, the managers will need to lead from the front in the facilitation of the change effort. This will ensure that the implementation of the change is efficient and convenient to all.