Strategies for Change Management in Healthcare

Strategies for Change Management in Healthcare An Overview of Change by Management for Better Patient Care Smitha B. Vadakkan Registered nurses are on the front line in all the hospitals for early detection and prompt intervention when patients conditions deteriorate. So better patient outcomes and patient satisfaction are influenced by the number of registered nurses available to assess patients on an ongoing basis. So I like to select a change that management could undertake to improve patient care where I work is the staffing patterns. Adequate nursing care delivered directly depends on the nurse patient ratio. Change can be planned and managed, or it can occur haphazardly (Grohar-Murray Langan, 2011). Nursing is in the middle of so many revolutionary changes. To bring changes to the workplace depends on nurse’s attitude to adapt the change and the learning options and the support from the management. One of the theoretical perspective for the change is the learning dimensions. Continual learning is needed for an accelerated change and it provides ongoing learning of employees. Ongoing learning improves adaptation, resilience, and the hardiness of employees, which in turn result in desired responses to accelerated change (Grohar-Murray Langan, 2011). Skills that are needed to augment this change are systems thinking, personal proficiency, team learning, shared vision and use of information technology increases the access to needed knowledge. Normative-reeducative strategy is the most appropriate for nursing because it is the most likely to advance the profession. It is the strategy employed throughout nursing today to incorporate the latest informatics technology into everyday practice (Grohar-Murray Langan, 2011). In this strategy the members of the system work out programs of change under their own direction. Definition of the change problem includes the probability that shifts in attitudes, values, norms, and relationships between players in the system and between the system and its external environment (Miles, 2007). There is a mutual collaboration between the members and the management in the development of the final strategy. There are external and internal factors that influence change in nursing. The internal factors include the patient acuity levels, staff- patient ratio, treatment modules, and the use of modern technologies in nursing. External factors include social and economic factors that influence how nursing is practiced. Nurses are socialized in a unique way during their education and experience in practice and therefore prepared like no other group to monitor nursing practice (Grohar-Murray Langan, 2011). Nursing strength is found stronger when there is a collaborative effort of nurses in four different roles such as practitioners, educators, researchers, and managers. To have a better change in safe staffing the nurse managers should understand the external and internal factors and make changes which can bring better patient outcomes. Planned change is a better option in safe staffing. When there is a change to be made in the workplace, it is always good to include the nurses and other health care professionals in the unit for opinions and recommendations. The nurses in the unit better know how is the patient acuity level of the unit, how many assisted personnel working on the unit, which shift is the busiest, how can the structure of the unit to be modified for easy access of supplies etc.. There are many ways of implementing change. However, planned change, which is a purposeful, calculated and collaborative effort to bring about improvements with the assistance of a change agent, is commonly adopted in nursing (Roussel 2006). So the nurse manager should ask the nurses for recommendations how safe staffing can be implemented in the unit. Nurse manager with the help of the nurses in the unit can work out safe staffing by not giving two or more people vacation or holidays at the same time or balancing the schedule without giving more people off on the same day, not allowing the same person for more than two overtimes in one month, leaving the person for burnout, if the unit really needs more nurses, the nurse manager has to plan and explain the reasons and submit to the management. The safety of the patient is everyones responsibility. Once a decision has been reached to implement a change, time must be allowed for the sequence of stages designed to reduce resistance and maintain support from others (Grohar-Murray Langan, 2011). According to Kurt Lewin model of implementing change, there are three stages which are unfreezing, moving, refreezing. During unfreezing, more information and time is needed for the change. The people who are going to be affected are motivated for the change because of the benefits and the people who gave the ideas for the change are commented for their participation. By moving, the second stage of the change process is like a vacuum. This transitional stage when everyone is expected of the change when the old is gone and the new is not in place yet. The third stage of the change process is refreezing. Ongoing monitoring for continued quality must follow refreezing, because it provides valuable information about the ongoing effectiveness of the change (Grohar-Murray Langan, 2011). In the unionized city hospital, everything goes with seniority. When the senior nurses enjoy more vacation and holidays and leaving the younger nurses to work which results in more sick calls and also bad retention of the staff which compromises safe patient care and patient outcomes. Even the overtime is given according to the seniority where some older nurses are happy to do more overtimes by taking easy assignments and leaving the heavier assignments for younger nurses which also results in burnout and poor staff retention. The nurse manager should collect ideas from the nurses for the change and should update the management of what is going on in the unit and the need for hiring new nurses if the unit needs for safe staffing. During the unfreezing stage the staff in the unit should be notified of the equal rights for everyone and the management should be notified about the need to hire more RNs. All the nurses should be motivated for the change. During the moving process, it is h ard for the adjustment to the change for the senior nurses who is the majority in the unit. The nurse manager should make fair schedules and assignments and make everybody comply with the change. During refreezing stage the nurse manger should continue to make the best schedules and should check for the effectiveness of the staff and the patient outcomes. The characteristics and qualities of change agents include experience, success, being respected, leadership skills, and management competencies (Grohar-Murray Langan, 2011). Change is a long process and is difficult to achieve. The nurse manager who is the change agent should be calm, positive, optimistic, enthusiastic and able to spend enough time in correcting the problem. The nurse manager’s initial responsibility is to establish a plan of action. The nurse manager should inform her staff and management the reason for a change and should be able to show in measurable terms. The nurse manager should notify all the nurses and the management about the modified vacation time, schedules and the overtimes for safe staffing. The nurse manager should plan for each stage of implementation and should anticipate accommodating any new information and change. Not everybody will be satisfied with the schedule or there may be unexpected staff emergencies or sickness so the nurse manager should be able to get the cooperation of all the staff to perform her duties and should give enough time for the change. According to Lewin’s field theory, there are two opposing forces, the driving force and the restraining force in response to a change. Driving forces generate planned change and restraining forces generate resistance to change (Grohar-Murray Langan, 2011). The nurse manager by all means has to decrease the resistance to the change so the drive can be increased. The most important element in reducing the resistance is establishing trust by giving explanations, requesting input, acknowledging concerns, making changes in small doses, offering to assist, explaining benefits, and acknowledging success (Grohar-Murray Langan, 2011). The nurse manager has to explain to the senior nurses and the union representatives and the management, the need for safe staffing by balancing the schedules and assignments to avoid unnecessary vacation time for more than two people at a time during the busiest season, to reduce burnout and overtimes and to improve retention. Staff retention saves lots of money for the management and it improves better patient outcomes. The nurse manager should succeed in the way she/he explain the need for safe staffing, which can decrease falls, medication errors, pressure ulcers, decrease hospital stays, infections and death. Human behavior and interaction is far too complex to be able to gain total support for a change (Grohar-Murray Langan, 2011). There will be some resistance even with the best explanations given by the nurse manager, but in the long run it will be reduced and can get full support from everybody. The plan for evaluation is consistent with the overall change design, with outcomes being measured against the criteria found in the statements of purpose and objectives for change (Grohar-Murray Langan, 2011). The nurse manager should evaluate the changes. The evaluation of safe staffing can be seen with improved patient and staff satisfaction, better patient outcomes, decrease falls, pressure ulcers and infection rates, decrease sick calls, decrease employee turnover, good feedbacks by the patients and the employees. By interpreting the role of evaluation and the outcomes of changes, the nurse manager can improve and make better plans and modifications. References Grohar-Murray, M. E., Langan, J. (2011). Leadership and management in nursing (4th ed., p. 250-256). Upper Saddle River, NJ: Pearson Health Science. Miles, M. (2007).An overview of strategies for planned change in human systems. Retrieved from http://www.innovation.cc/scholarly-style/classic-theories.pdf Roussel, L (2006) Management and Leadership for Nurse Administrators. Fourth edition. Jones and Barlett, London.

Four West European Explores That Traveled to the New World.

*2. (a) Name four west European countries that explored the New World and name* one explorer who sailed for each country, (b) Of the four *explorers, named*, state the one you would most have liked to accompany. Discuss two reasons for your choices. Four west European explores that traveled to the New World. {draw:frame} {draw:frame} Christopher Columbus (c. 1451 – 5/20/1506 Jacques Cartier (12/31/1491 – 9/1/1557) {draw:frame} John Cabot_ (c. 1450 – c. 1498)_ Pedro Alvares Cabral_ (c. 1468 – c. 520)_ The race to find new spice and travel routes spurred a very exciting time in history which eventually lead to the founding and settling of New World. These discoveries lead us to settlement and establishment ofour own country. Although Norse explorer Erik the Red’s son,Leaf Ericson landed on what he called Vinland, now Newfoundland Canada, a little over a thousand years ago, Western European countries really made the push for colonization about five hun dred years later. These countries included Spain, Portugal, England, and France. Spain had many explorers and impacts in New World exploration. With a monarchy that was willing to finance and explore, Spain found riches in gold through South, Central, and North America. Of all Spain’s, and the world’ explorers, none are more famous than Christopher Columbus. Every generation of Americans knows he set sail in 1492, but I’m surprised how many don’t realize he landed in the Caribbean, and by mistake. Looking for a spice route to the Indies, Columbus and his crew named the local inhabits Indians because he thought wrongly of his location, and eventually started disease epidemics and slavery in the area. Giovanni Caboto was a Venetian explorer who sailed for England and thus became better known as John Cabot. On 5 March 1496, King Henry VII of England basically gave Cabot free license to do whatever he wanted under the English flag. On his second voyage in 1497 he ended up in upper north east Canada and is credited with being the first European since Erikson to reach North America. With Portugal’s impact in early navigation, thanks largelyto Prince Henry the Navigator and his navigational school, it’s natural that there would be an explorer who would have an impact on New World exploration. With explorers like Dias, Magellan (who sailed for Spain), and even Columbus who lived, married, and studied in Portugal, yet another name came about. Pedro Alvares Cabral was given the task to spread Christianity were ever he went, by force if necessary. With thirteen ships, he set sail on March 9th(my birthday) 1500. After some mishaps, he finally reached what is today modern day Brazil and making claim to the New World in the name of Portugal which would later lead to a dispute under the Treaty of Tordesilas. Jacques Cartier sailed for the French and claimed what is now Canada for France. Cartier not only sailed all the way to Gulf of Saint Lawrence and the Saint Lawrence River, but he was the first European to describe and map it. Of these four explorers I would choose Cabral to accompany. His voyage to Brazil was almost a world tour including Africa, India, and South America. I would prefer to stay in these regions and out of the northern colder regions as Cartier and Cabot explored.

Mexicans on the Usa Essay

By the late 19th and early 20th centuries, Mexican American migrant workers played an increasingly important role in the growing American economy, an estimated 11. 7 million unauthorized immigrants were living in the U. S. in March 2012, and American people want to solve this problem. In this essay am going to answer this question Should North American Companies hire illegal immigrants? I will answer this by looking at the advantages and disadvantages of hiring illegal immigrants. People in the USA don’t want that illegal aliens work in their country because they use the jobs that Americans can work in, they are angry because they are illegal and just legal people deserve to work in the USA. Illegal aliens (Mexican Workers) are a benefit to the USA companies because they work more time for less pay and they do the hard works that Americans will do for less time and more money. Mexican immigrants are vital to the U. S. economy, contributing about 4 % to GDP. Mexican Workers are not respecting the USA law and The Authorities can?t do anything this create a big problem between the USA communities and the government because they say that the illegal aliens are invading them This is called ? La Reconquista?. Mexican Illegals go only to find work and do it because they are force to do that, they have a family in very bad conditions that it’s believing that his familiar that pass the border could get a work and send them money so they cans survive. Mexicans Pass the border illegally because they don? t have money to buy a Visa even a Mexican passport so they go and work hard to get a better life that they couldn?t get at their country. The USA families are worried of their families because they can? t be relaxed just because some illegal people are in the street breaking the law, they are annoyed of Mexican illegal in every corner of their town, they have to take care of their children because they are dangerous. Mexicans just try to get a job and live better they are trying to became part of the community but the USA people are acting on a racist way, They don? t want to even see Mexicans and know them. There are been attacks to Mexican from the Americans sometimes they were close to kill them. A good example is that on a Mexican restaurant the employees have to use a t-shirt that says how to catch an illegal Mexican. Mexican illegal are increasing USA population and that is not a real problem but when there is more people, they use more services as foo health care, etc. The USA citizens that pay taxes make these services happen, if there are more people to serve the taxes will be more expensive and illegal Mexicans don? t pay these services. Mexicans help the community they buil houses, clean the streets and fix the public places such as gardens and parks.

Understanding Morality in Henrik Ibsens The Dolls...

Morality Introduction Morality is defined as a recognition or belief that explains why some behaviors are bad or good. In simple words, morality refers to values relating to the distinction between wrong and right or good and bad. Few morals are easily accepted and are only questioned by some fringes of society who might disagree with such morals. These individuals on the fringes can be bad or good. The ones who reject socially accepted moral does not necessarily mean that they are good persons. Thus, one can say that each individual has morals that are different from each other (Joseph). Referring to morality from an individual point of view, each person has strong beliefs about what is wrong and what is right. Moreover, morals differ from person to person and may be due to difference in culture. Morality also results from basic human emotions i.e. love, hate, honesty, greed, sins etc (Psychology Today). This paper discusses the notion that truly moral people are not only those who follow rules, laws and norms, these society norms and laws are very flexible and change with time. Such people do whatever they wish to do without the fear of being criticized. The essay is based on The Doll House play by Henrik Ibsen. However, other similar stories that support thesis statement include; The story of an Hour by Kate Chopin and The Stranger by Albert Camus. Thesis Statement The thesis statement is that, moral people are not the people who follow rules, laws andShow MoreRelatedIbsen11859 Words   |  48 PagesForshey 1 Running head: IBSEN’S FEMALE CHARACTERS Ibsen’s Female Characters in Captivity: An Exploration of Literature and Performance Christina Kelley Forshey A Senior Thesis submitted in partial fulfillment of the requirements for graduation in the Honors Program Liberty University Fall 2008 Forshey 2 Acceptance of Senior Honors Thesis This Senior Honors Thesis is accepted in partial fulfillment of the requirements for graduation from the Honors Program of Liberty University. ______________________________Read MoreA Doll House by Henrik Ibsen7379 Words   |  30 PagesMa. Jennifer S. Yap Dr. Sherwin Perlas World Literature January 14, 2012 A Doll House by Henrik Ibsen Translated by Rolf Fjelde I. Introduction During the late nineteenth century, women were enslaved in their gender roles and certain restrictions were enforced on them by a male dominant culture. Every woman was raised believing that they had neither self-control nor self-government but that they must yield to the control of a stronger gender. John Stuart Mill wrote in his essay, â€Å"The Subjection