Implementing Change With an Interprofessional Approach Presentation
Presentation Objectives Notes
This presentation will provide an example of a case from my experience where change failed to achieve outcomes, explain the role of advanced registered nurses as change agents, propose a theory to implement the change, describe the process of initiating change as an advanced registered nurse, and describe additional factors that drive organizational change.
Change Incident in My Organization
Covid 19 impacted all areas of healthcare delivery. During the peak of the COVID-19 pandemic, the director of nursing at my organization wanted to achieve a sustainable nurse-patient ratio at any given time by increasing the number of shifts in a day to three so that nurses would work for 8 hours in a shift as opposed to the previous day/night shifts. Some nurses from my unit were moved to the emergency area and isolation units. Therefore, the workforce in my unit went down. The need for this change caused various instabilities, and the outcomes were not as expected.
Incident Goals and Outcomes
Of the seven nurses left in the unit, two resigned, and the, therefore, director of nursing started a recruitment process to bring in more nurses. The goals of this change were to minimize the impact of the pandemic on human resources in various units and reduce the burden of care on remaining nurses.
However, none of these goals were achieved, and the recruitment was a salvage process to maintain healthcare safety and quality. The director of nursing communicated the change three days before effecting it. This meant that nurses of all cadres had to adjust to the change in less than 72 hours. The assumption was that all nurses were aware of the pandemic and were ready for the change.
Implications of the Practice Change
This change had ethical, legal, economic, and political implications. Ethically, patient safety risks rose because of nurse burnout, stress, and increased workload. Even though no harm was intended with the change, upon achieving stability, some patients were discharged to reduce workload and create more attention to the unstable patients.
Legally, some patients threatened the organization litigation during the two weeks when nurse recruitment was conducted, citing neglect as their main reason for dissatisfaction. Politically, the organization’s top administration made new policies that triage patients and only admit those in critical conditions. Economically, this change meant that nurses would have overtime allowances, which were not accounted for in the new policies. Nurse pay remained the same, but the duration between shifts was reduced.
Advanced Registered Nurse Role as Change Agent
Advanced registered nurses have critical roles in steering for change. These roles can be achieved through nursing leadership and management. Advanced registered nurses should act as leaders to junior nurses and guide the behavioral aspect of change. This can include acting as role models to junior stakeholders in the process of change.
Advanced registered nurses as change agents should uphold the standards of professional practice and standards of professional performance to effect change. These standards of professional performance include but are not limited to ethics, education, evidence-based practice and research, nursing communication, leadership and collaboration, and environmental health. According to the American Nurses Association, standards of practice are nursing assessment, diagnosis, implementation, and evaluation – basically, the nursing process.
According to Weberg et al. (2018), nurses can act as change agents by embracing the role of the professional in the political and social fora to influence change. Through nursing advocacy, nurses can uphold the nursing profession in change discussions at the top administration forums. This advocacy must include upholding the standards of nursing practice mentioned in the previous slide.
Addressing patient and professional advocacy requires the nurses’ commitment to addressing personal, individual, and population interests in such collaborations. Without publicity, advanced registered nurses must act as change agents quietly on in a normative way without direct public involvement. In this case, an advanced registered nurse ought to advocate for other nurses to find an amicable solution without abrupt shift length change.
Interprofessional Stakeholders
In this scenario, various stakeholders, both internal and external, were important in effecting the change. The key stakeholders in this change are the nurse leaders and the chief nursing officer. Alongside being the initiators of change, these nurse leaders are also the change agents. Advanced registered nurses are also important stakeholders as key change agents. Informaticists and technologists are also critical internal stakeholders in tracking change using data and information for evaluation purposes.
External stakeholders will include state policymakers and the state board of nursing. The State board of nursing is important in this change because they regulate professional practice standards and scope and would therefore be kept abreast with matters pertaining to patient safety and quality.
Appropriate Change Theory
The planned change model by Lippitt, Watson, and Westley (1958) would be more appropriate for this change. The planned change theory focuses on managing processes and facilitating these processes. The planned change model expanded Lewin’s three-step model into a five-step model for change management.
The planned change model starts with a diagnosis of the problem and is followed by assessing the system’s motivation and capacity for change, assessing change agents’ resources and motivation, setting objectives and strategies, defanging the change agents’ role, and maintaining and finally terminating this change.
Thus change theory focuses more on the change agent’s role and readiness for change as opposed to other theories that focus on the processes and systems. Due to the involvement of personnel and human resource, I believe the change agent will have essential in providing leadership and collaborative strategies to maintain the change.
Applying the Theory
In my organization’s case, the change problem was well-defined and pushed by external factors. Applying the change theory would have ethical, legal, social, and economic implications for the system and employees. Ethically, planned change will result in organizational cultural erosion and cultural reinvention. This can include the erosion of preexisting culturally and ethically sensitive practices while focusing on one goal for change.
Legally, planning this change would mean that some nurses would work out of their professional scope to fill in the deficit left by departing nurses. Economic efficiency would be compromised with the new rearrangements in the planned change. Planned change takes time, and immediate short-term productivity may be compromised due to adjustments for acclimatizing to the change. Politically, planned change may reduce the clinical autonomy in the postimplementation phase, thus diminishing independent decision-making.
Initiating Change as an Advanced Registered Nurse
Active change management starts when the change agent acknowledges the need for change and understands the problem behind the change. As a change agent and an advanced registered nurse, initiating change in my organization would involve some preliminary strategies to increase the chances of successful outcomes. Before initiating change, I would understand the organization’s level of interest in the change, identify possible participation barriers and plan for them, and assess the need and readiness of the organization’s executive leadership.
The actual process of initiation of change will include informing all stakeholders of the need for change and the roles they will play I n the change process. This will increase participation and stakeholder engagement during the change. This will also prepare them for the change and anticipated outcomes.
Impacts on the Organization
An unsuccessful change initiative would create organizational chaos. Complex environments account for chaos during the change process and postimplementation. The confusion resulting from change failure can impact the processes of care delivery. Healthcare quality and patient safety will suffer the consequences of unsuccessful outcomes if change did not plan for such eventualities.
According to Weberg et al. (2018), change cannot be controlled but can be only facilitated. Change doesn’t need to become chaotic. Even with strategic planning that aims at reducing the chaos of change, failure can still occur. According to Denisco (2019), complexity science requires understanding change as a systemic process means that in cases of eventualities or failure from change processes.
In cases of this failure, I will improve interdisciplinary collaboration to ensure that even small parts of the organization that are easily ignored will be incorporated into the final outcomes of change. This would include collaborating with the frontline nurses to understand their input in the change process and come up with the best strategies to effect change.
Additional Factors Driving Organizational Change
Strategic planning for change intends to improve outcomes. However, it cannot include all possible outcomes of the change. The changing environment is continually changing. Therefore, change needs to adapt to this complexity. A change leader must take into account various factors that drive additional change, such as ethics, legal considerations, stakeholder, nursing leadership and management, and most importantly, technology.
Technology has become so vital that most care processes move from paper and people-oriented care delivery to technology-assisted care delivery. This change comes with the need for human adaptation to use such technology to improve care efficiency. Evidence-based practice is important in the dynamic environment because quality care requires constant exposure and utilization of the best available and current evidence for effective care delivery.
References
Denisco, S. M. (2019). Advanced practice nursing: Essential knowledge for the profession: Essential knowledge for the profession (4th ed.). Jones & Bartlett.
Harrison, R., Fischer, S., Walpola, R. L., Chauhan, A., Babalola, T., Mears, S., & Le-Dao, H. (2021). Where do models for change management, improvement and implementation meet? A systematic review of the applications of change management models in healthcare. Journal of Healthcare Leadership, 13, 85–108. https://doi.org/10.2147/JHL.S289176
Udod, S. A., & Wagner, J. (2018). Common change theories and application to different nursing situations. In Leadership and Influencing Change in Nursing. University of Regina Press.
Weberg, D., Mangold, K., Porter-O’Grady, T., & Malloch, K. (2018). Leadership In Nursing Practice (3rd ed.). Jones and Bartlett.
NUR514 Topic 3 Assignment Implementing Change With an Interprofessional Approach Presentation Instructions
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. Implementing Change With an Interprofessional Approach Presentation
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 Implementing Change With an Interprofessional Approach Presentation:
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.
Outline the advanced registered nurse\’s role as change agent within the interprofessional and dynamic health care environment.
Identify the key interprofessional stakeholders (both internal and external) that should be involved in change efforts.
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.
As an advanced registered nurse, outline how you would initiate the change.
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.
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 Implementing Change With an Interprofessional Approach Presentation assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.
Rubric Criteria
Description of Situation, Rationale for Change and Goal
7.5 points
Criteria Description
Description of Situation, Rationale for Change and Goal
- 5: Excellent
7.5 points
A comprehensive description of the background of the situation, including the rationale for change and the goal or goals of change, is thoroughly developed with supporting details. The ethical, social, legal, economic, and political implications of practice change are clearly considered in the response.
- 4: Good
6.9 points
A description of the background of the situation, including the rationale for change and the goal or goals of change, is provided and well developed. Overall, the ethical, social, legal, economic, and political implications of practice change are considered in the response. Implementing Change With an Interprofessional Approach Presentation
- 3: Satisfactory
6.6 points
A description of the background of the situation, including the rationale for change and goal or the goals of change, is generally presented. Some aspects of the ethical, social, legal, economic, and political implications of practice change are considered in the response.
- 2: Less Than Satisfactory
6 points
A description of the background of the situation, including the rationale for change and the goal or goals of change, is present, but it lacks detail or is incomplete.
- 1: Unsatisfactory
0 points
A description of the background of the situation, including the rationale for change and the goal or goals of change, is not included.
Advanced Registered Nurse Role as Change Agent
7.5 points
Criteria Description
Advanced Registered Nurse Role as Change Agent
- 5: Excellent
7.5 points
The role of the advanced registered nurse as a change agent is clearly discussed. Supporting detail and rationale are provided.
- 4: Good
6.9 points
The role of the advanced registered nurse as a change agent is discussed. Minor detail or rationale is needed for clarity or accuracy.
- 3: Satisfactory
6.6 points
The role of the advanced registered nurse as a change agent is summarized. Information or supporting rationale is needed. Implementing Change With an Interprofessional Approach Presentation
- 2: Less Than Satisfactory
6 points
The role of the advanced registered nurse as a change agent is only partially discussed.
- 1: Unsatisfactory
0 points
The role of the advanced registered nurse as a change agent is omitted.
Key Internal and External Interprofessional Stakeholders That Should Be Involved in Change Efforts
7.5 points
Criteria Description
Key Internal and External Interprofessional Stakeholders That Should Be Involved in Change Efforts
- 5: Excellent
7.5 points
A comprehensive discussion of the key internal and external interprofessional stakeholders that should be involved in change efforts is thoroughly developed with supporting details.
- 4: Good
6.9 points
The key internal and external interprofessional stakeholders that should be involved in change efforts are discussed. Minor detail or rationale is needed for clarity or accuracy.
- 3: Satisfactory
6.6 points
The key internal and external interprofessional stakeholders that should be involved in change efforts are summarized. Information or supporting rationale is needed.
- 2: Less Than Satisfactory
6 points
The key internal and external interprofessional stakeholders that should be involved in change efforts are only partially discussed.
- 1: Unsatisfactory
0 points
The key internal and external interprofessional stakeholders that should be involved in change efforts are not included.
Appropriate Change Theory or Model That Could Be Used to Achieve Results
15 points
Criteria Description
Appropriate Change Theory or Model That Could Be Used to Achieve Results
- 5: Excellent
15 points
A comprehensive discussion of an appropriate change theory or model that could be used to achieve results is thoroughly developed with supporting details. The ethical, social, legal, economic, and political implications of applying the change management strategies to practice change are considered in the response. Implementing Change With an Interprofessional Approach Presentation
- 4: Good
13.8 points
A discussion of an appropriate change theory or model that could be used to achieve results is clearly provided and well developed. Overall, the ethical, social, legal, economic, and political implications of applying the change management strategies to practice change are considered in the response.
- 3: Satisfactory
13.2 points
A discussion of an appropriate change theory or model that could be used to achieve results is presented. Some aspects of the ethical, social, legal, economic, and political implications of applying the change management strategies to practice change are considered in the response.
- 2: Less Than Satisfactory
12 points
A discussion of an appropriate change theory or model that could be used to achieve results is present, but it lacks detail or is incomplete.
- 1: Unsatisfactory
0 points
A discussion of an appropriate change theory or model that could be used to achieve results is not included.
Outline for Initiating Change as Advanced Registered Nurse
15 points
Criteria Description
Outline for Initiating Change as Advanced Registered Nurse
- 5: Excellent
15 points
A comprehensive outline for initiating change as an advanced registered nurse is thoroughly developed with supporting details.
- 4: Good
13.8 points
An outline for initiating change as an advanced registered nurse is clearly provided and well developed. Minor detail or rationale is needed for clarity or accuracy.
- 3: Satisfactory
13.2 points
A general outline for initiating change as an advanced registered nurse is present. Information or supporting rationale is needed. Implementing Change With an Interprofessional Approach Presentation
- 2: Less Than Satisfactory
12 points
An outline for initiating change as an advanced registered nurse is present, but it lacks detail or is incomplete.
- 1: Unsatisfactory
0 points
An outline for initiating change as an advanced registered nurse is not included.
Impact to the Organization
7.5 points
Criteria Description
Impact to the Organization if the Change Initiative Is Unsuccessful Again and Potential Steps the Interprofessional Team Could Take
- 5: Excellent
7.5 points
The impact to the organization if the change initiative is unsuccessful again, and potential steps the interprofessional team could take, is thoroughly discussed and includes supporting details.
- 4: Good
6.9 points
The impact to the organization if the change initiative is unsuccessful again, and potential steps the interprofessional team could take, is discussed. Minor detail or rationale is needed for clarity or accuracy.
- 3: Satisfactory
6.6 points
The impact to the organization if the change initiative is unsuccessful again, and potential steps the interprofessional team could take, is summarized. Information or supporting rationale is needed.
- 2: Less Than Satisfactory
6 points
The impact to the organization if the change initiative is unsuccessful again, and potential steps the interprofessional team could take, is only partially described. Implementing Change With an Interprofessional Approach Presentation
- 1: Unsatisfactory
0 points
The impact to the organization if the change initiative is unsuccessful again, and potential steps the interprofessional team could take, is not included.
Additional Factors Driving Organizational Change and Advanced Registered Nurse as Change Agent
7.5 points
Criteria Description
Additional Factors Driving Organizational Change and Advanced Registered Nurse as Change Agent
- 5: Excellent
7.5 points
Additional factors driving upcoming organizational change for the organization and the advanced registered nurse role as change agent are thoroughly discussed. The narrative is well-developed and supported.
- 4: Good
6.9 points
Additional factors driving upcoming organizational change for the organization and the advanced registered nurse role as change agent are discussed. Minor detail or rationale is needed for clarity or accuracy.
- 3: Satisfactory
6.6 points
Additional factors driving upcoming organizational change for the organization and the advanced registered nurse role as change agent are summarized. Information or supporting rationale is needed.
- 2: Less Than Satisfactory
6 points
Additional factors driving upcoming organizational change for the organization and the advanced registered nurse role as change agent are only partially discussed. Implementing Change With an Interprofessional Approach Presentation
- 1: Unsatisfactory
0 points
Additional factors driving upcoming organizational change for the organization and the advanced registered nurse role as change agent are not discussed.
Presentation of Content
37.5 points
Criteria Description
Presentation of Content
- 5: Excellent
37.5 points
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.
- 4: Good
34.5 points
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.
- 3: Satisfactory
33 points
The presentation slides are generally competent, but ideas may show some inconsistency in organization or in their relationships to each other.
- 2: Less Than Satisfactory
30 points
The content is vague in conveying a point of view and does not create a strong sense of purpose. Includes some persuasive information. Implementing Change With an Interprofessional Approach Presentation
- 1: Unsatisfactory
0 points
The content lacks a clear point of view and logical sequence of information. Includes little persuasive information. Sequencing of ideas is unclear.
Layout
15 points
Criteria Description
Layout
- 5: Excellent
15 points
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. Implementing Change With an Interprofessional Approach Presentation
- 4: Good
13.8 points
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.
- 3: Satisfactory
13.2 points
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.
- 2: Less Than Satisfactory
12 points
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.
- 1: Unsatisfactory
0 points
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. Implementing Change With an Interprofessional Approach Presentation
Language Use and Audience Awareness (includes sentence construction, word choice, etc.)
15 points
Criteria Description
Language Use and Audience Awareness (includes sentence construction, word choice, etc.) Implementing Change With an Interprofessional Approach Presentation
- 5: Excellent
15 points
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.
- 4: Good
13.8 points
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.
- 3: Satisfactory
13.2 points
Language is appropriate to the targeted audience for the most part.
- 2: Less Than Satisfactory
12 points
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.
- 1: Unsatisfactory
0 points
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.
Mechanics of Writing (includes spelling, punctuation, grammar, language use)
7.5 points
Criteria Description
Mechanics of Writing (includes spelling, punctuation, grammar, language use)
- 5: Excellent
7.5 points
Writer is clearly in control of standard, written, academic English.
- 4: Good
6.9 points
Slides are largely free of mechanical errors, although a few may be present.
- 3: Satisfactory
6.6 points
Some mechanical errors or typos are present, but they are not overly distracting to the reader.
- 2: Less Than Satisfactory
6 points
Frequent and repetitive mechanical errors distract the reader. Implementing Change With an Interprofessional Approach Presentation
- 1: Unsatisfactory
0 points
Slide errors are pervasive enough that they impede communication of meaning.
Documentation of Sources
7.5 points
Criteria Description
Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style) Implementing Change With an Interprofessional Approach Presentation
- 5: Excellent
7.5 points
Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.
- 4: Good
6.9 points
Sources are documented, as appropriate to assignment and style, and format is mostly correct.
- 3: Satisfactory
6.6 points
Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.
- 2: Less Than Satisfactory
6 points
Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors. Implementing Change With an Interprofessional Approach Presentation
- 1: Unsatisfactory
0 points
Sources are not documented.
Also Read NUR514 Topic 4: Nurse Leadership And Health Care Policy And Advocacy