Implementing Change With an Interprofessional Approach Presentation: NUR 514 Assignment

Implementing Change With an Interprofessional Approach Presentation: NUR 514 Assignment Details:

In a complex and fast-paced healthcare environment, change is inevitable and constant. The advanced practice nurse is required to lead and adapt to the constant changing environment while working with multidisciplinary teams. Imagine you are assigned by your director to work with a multidisciplinary team that is assisting with transition from the current paper record-based system to an electronic health record (EHR).

Create a PowerPoint presentation (10-15 slides) in which you will assess the situation and the steps that should be taken to successfully implement the change. Be sure to include 100-250 word presenter’s notes per slide. Your presentation should address the following:

Implementing Change With an Interprofessional Approach Presentation NUR 514 Assignment

  1. Describe the driving forces that relate to the need for implementing electronic health records.

  2. Identify the key interprofessional stakeholders (both internal and external) that should be involved in change efforts.

  3. Outline how you would initiate the change and be a change advocate. Utilizing change theory and innovative models of care, explain how you would provide a structure for the planned change to achieve successful implementation of the EHR.

  4. Demonstrate how the change will affect current workflows. What revised workflow would you implement?

  5. Identify resources (human, time, material, etc.) required for implementation.

Internal Inter-Professional Stakeholders

A number of internal inter-professional stakeholders could have been involved in the implementation of the change. One of them were the nurses. The nurses were the primary implementers of the change. It was therefore essential that training be provided to them on the ways of implementing the change. They could have also provided their insights into the ways in which the change could have been implemented efficiently. The other internal stakeholder that could have been involved in the implementation of the change were the nurse managers. The nurse managers could have worked with the other nurses in assessing the need for the change and ways of ensuring its success. The managers could have also used this opportunity to identify the behaviors and strategies that were needed for the success of the change initiative. The nurse managers could have also worked with the nurse leaders to ensure that the change initiative supported the vision of the hospital. They would have collaborated in exploring the most effective strategies that could have been used in implementing the change. The human resource manager could have assisted in performing needs assessment prior to the implementation of change. The information from need assessment could have been used to come up with appropriate goals for the implementation and training processes. Lastly, the finance manager could have assisted in the determination of whether the change initiative was financially sound or not. He could have assisted in exploring the most cost-effective ways of implementing the project.

  1. Identify risks within the implementation plan. What are the impacts of the poor planning on cost, quality, and safety?

  2. Identify potential barriers when implementing the change and discuss how you will handle resistance.

Integrate 3-5 scholarly sources into your presentation.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.
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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

4 posts
Re: Topic 3 DQ 1
At the level of charge nurse, organizational change is often experienced as a bystander. The change is apparent; however, the stakeholders and model are a mystery. Being bought by a large organization and going from a nonprofit to a for-profit acute care hospital was a rough transition. From the viewpoint of the nursing staff, most of the change was not favorable. There was the loss of ancillary staff, changes to inferior supplies, gaps in leadership, and highly drawn-out contract negations resulting in significant delays in step and other raises. If you asked the nursing staff know how the change went, they would probably say, “not good, but we made it through.” If you asked the major stakeholders who influenced the change plan, their answer would be different because it was a success. Five years later and it is business as usual with talks of a new hospital on the horizon.
All the hospitals in the area are now for-profit facilities. This is a trend in the United States, hospitals are consolidating at an accelerating rate, and healthcare costs continue to rise (Findlay, 2018). From 2013 to 2017, nearly 1 in 5 hospitals were acquired or merged with another hospital (Findlay, 2018). In most cases, mergers are necessary for the survival of the hospital. To keep up with advancing technology, modern data management, and top clinical talent, merging with large corporations is the only option (Findlay, 2018).
Nevertheless, at what cost to the communities these hospitals serve. You would think community services would suffer; however, a recent study showed only slightly higher spending in charity care for nonprofit facilities and showed higher charity care spending in for-profit hospitals with 300 beds or more (Garber, 2020). The same study showed that the most significant deviation in charity care spending was from state to state and had little bearing on whether the facilities were nonprofit or for-profit (Garber, 2020). Major organizational change is complex, and some areas of nursing suffer; however, the more significant picture points to the necessity to survive.Findlay, S. (2018, July 19). Can a Community Hospital Stick to its Mission When it Goes For-Profit? Retrieved from npr.org: http://npr.org/sections/health-shots/2018/canacommunityhospitalsticktoitsmissionwhenitgoesforprofitGarber, J. (2020, October 1). Nonprofit and for-profit hospitals provide similar levels of charity care, study finds. Retrieved from Lown Institute: https//lowninstitute.org/nonprofitandfor-profithospitalsprovidesimilarlevelsofcharitycare,studyfindsTopic 3 DQ 1 

How have you seen or experienced organizational change within an organization? Did it go well or not? Was there any correlation in how the organizations used stakeholders or change models?

Re: Topic 3 DQ 1
At my previous job, the hospital policy on bloodwork/labs became a topic of interest for change. Between the lab directors and the medical directors, they decided to implement a trial that included changing how the patient labels were printed for the bloodwork. Originally, the labels included the patient’s name, date of birth, medical record number (MRN), the physician’s name in which the patient was admitted under, and the date that the patient was admitted. The proposed new labels would include the same information, but would also include the color of the tube that the bloodwork was to go in, as well as a barcode.

Although the thought process was that the new labels would help the doctors, nurses and phlebotomists easily place the correct sample in the correct color tube top, the exact opposite occurred. The computer system became at fault as the barcodes were not matching all the patient information and tube top colors; labs and colors did not correlate with each other. For example, a CBC normally would be in a lavender tube top, yet the label would print mint green, which was meant for a BMP. This led to many errors after the blood was sent to the lab. Labs were not being run right away, including STAT labs, and some were even put in the wrong color tubes. Some lab results were not coming up for the correct patient as well. This was a MAJOR patient safety issue. Having the wrong lab results for the wrong patient is beyond dangerous, especially something as serious as a type and screen.

Administration quickly found out about all of the errors in the first week that the new labels were rolled out. The new labels were put on hold, and we went back to the original labels which were working just fine to begin with. We were told that IT and the lab would be working to resolve the issues and that the new labels would be trialed again once it was deemed OK and safe to utilize. I have since left that position but when I left that job, the new labels still had not be re-instituted.

After reading about the 8 Step Change Model, I do not feel that many of the steps were properly utilized. According to DeNisco & Barker (2016), when a change idea is proposed by administration, educational experience and data should be utilized to demonstrate why the change is necessary. A team vision should also be a part of the change process, as it will not only affect one group of people, and should be questioned and discussed before implementing the plan to do said change (DeNisco & Barker, 2016). I feel that when the idea of new lab labels was initiated, it came out of nowhere. The staff like myself who did the bloodwork and sent to the lab was not asked for our opinions and there was no discussion of the reasoning behind the new labels. I believe if administration had utilized the 8 Step Change Model and took the time to incorporate the IT team for the computer aspect of the labels, many patient errors could have been avoided.

WORD COUNT: 529

Resources

DeNisco, S. M., & Barker, A. M. (2016). Advanced practice nursing: Essential knowledge for

the profession (3rd ed.). Jones & Bartlett Learning.

Topic 3 DQ 2

You have been selected to serve on a community outreach committee within your state’s nursing organization. The committee includes registered nurses of different specialties. At your first meeting, it becomes evident that not everyone is in agreement with a recent position statement about the role of spiritual care, with some members arguing they will no longer support the committee if the position statement is not revised or reversed. As a nurse leader, how could you draw from change theory to address these concerns and encourage collaboration on the committee?

Re: Topic 3 DQ 2
The change theory could be utilized to reformulate the position statement about the role of spiritual care. The leader should establish communication amongst all members that there is a need for change and that all participants must put aside their differences to collaborate to create a new position statement (DeNisco & Barker, 2016). The team needs to develop a plan of action that states the participants, the process, the expectations, and the outcome. The first stage is the assessment to identify the problem that needs to be changed (Weberg et al., 2019). Research may be necessary to design the position statement. Clinical or relevant expertise may be used. The team may need to review the old statement to assess what the conflict is about. The next step is team reflection (Weberg et al., 2019). The team gathers together to develop ideas on what should be incorporated in the position statement and why. The leader guides the team toward a positive outcome. The leader maintains the direction of the collaborative effort. In the third step, the ideas are organized and categorized into a plan to be implemented. The leader may have to assist team members in their resistance to change in the position statement. There may need to be further assessment and revision of the position statement in order to create a final statement that everyone agrees upon. The ideas proposed by DeNisco & Barker (2016) and Weberg et al. (2019) suggest that the team identify and recognize ways to work together in an established document that defines those terms to be able to agree and prepare a new position statement reflective of the ideas of all participants. When there is disagreement, the leader may need to step in to drive the conversation in a rational and logical manner towards consensus. A compromise may be necessary. A calm temperament is needed for heated debate.

 

 

References

DeNisco, S. M., & Barker, A. M. (2016). Advanced practice nursing: Essential knowledge for the profession (3rd ed.). Jones & Bartlett Learning. https://www.gcumedia.com/digital-resources/jones-and-bartlett/2016/advanced-practice-nursing_essential-knowledge-for-the-profession_3e.php

Weberg, D., Mangold, K., Porter-O’Grady, T., & Malloch, K. (2019). Leadership in nursing practice: Changing the landscape of health care (3rd ed.). Jones & Bartlett Learning. https://www.gcumedia.com/digital-resources/jones-and-bartlett/2018/leadership-in-nursing-practice_changing-the-landscape-of-healthcare_3e.php

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