Planned Change in a Department or Unit

Planned Change in a Department or Unit

Every company and organization goes through seasons of change.  Depending on how the change is presented to the staff members can make a big impact on how successful the change will be.  Leadership plays a critical role when an organization goes through a period of change. “The key aspects of the leadership role involves influencing group activities and coping with change,” (Al-Sawai, 2013, para.1).  In this paper, a problem within my organization will be explained, a solution to the problem will be identified, how the change plays into the organizations mission, and strategy for implementation of the change.

Organizational Inefficiency

It is important in a health care facility to provide quality services to all seeking help.  One aspect of providing quality care is timely service.  My organization has been struggling with extended wait times in the emergency department.  This started with long wait times to get to a room, and then an additional wait before the doctor would see them, followed by more waiting for results and treatment options.  In this regard, we were failing out patients and our satisfaction surveys were a clear indication of this.

Addressing the Inefficiency

By recognizing there is a problem allows an organization to fix it.  By receiving the overwhelming negative surveys in regards to patient wait times; it was clear something needed to be addressed.  The first step in addressing this concern was to start from the beginning of the patient experience.  By decreasing the wait time from the patient check in time to getting them to a treatment room works to address the first delay in care.  One way to decrease the time from check in to arrival in treatment rooms is to not complete an entire triage before going to a room.  This can be referred to as “pull-until-full.”  The means pulling patients from triage back to an open room as long as one is available.  When the triage nurse only is checking in the patient and gathering limited information, and assigning them to a room decreases their wait time in the waiting room.

Improvement Regarding the Mission, Values, and Goals

The mission where I work is to, “improve the health of those we serve,” (Ohio Health, 2016, para. 4).  The vision is, “where people want to work, where physicians want to practice and, most importantly, where patients want to go when they need healthcare services,” (Ohio Health, 2016, para. 5).  The values are, “compassion, excellence, stewardship, and integrity,” (Ohio Health, 2016, para. 7).  By making a change to decrease a patient’s wait time will give the patient a feeling that we are concerned about their complaint and want to address it timely.  This provides compassion, excellence, and will increase the likelihood that they will want to come back to our facility to receive care at another time. 32% of all emergency room visits having a wait time of only 15 minutes to be initially seen (Centers for Disease Control and Prevention, 2017, para. 1).  The time aspect of a patient visit is a necessary area to keep reviewing to try and find ways to improve on patient care.  With improved patient care, this will allow for increased patient satisfaction, and improved patient survey scores.

Kurt Lewin’s Change Model

Kurt Lewin lived from 1890-1947, and is known as the father of psychology (Nursing Theories, 2011, p. 1).  Kurt Lewin theorized a three-stage model of change that is known as the unfreezing-change-refreeze model that requires prior learning to be rejected and replaced (Nursing Theories, 2011, p. 1).  This model can be used to help address my organizations inefficiency in a simple no-nonsense approach.  By making the same tasks (getting patients checked in and to a treatment room) easier, will be a change that is accepted easily by staff members.  Unfreezing is where the company is letting go of previous way of doing something that is not working correctly (delayed times to get patients to a room).  Change is where the company is finding a better way of doing the task (pull-until-full).  Refreeze is where the organization is setting this new action as a standard for quality care to be carried out daily.

Steps to Facilitate the Change

The first step is to alter how the triage nurse checks a patient in (unfreeze).  Rather than obtaining a big picture view for their visit, this nurse is looking for the basic complaint to get their visit started.  Second, the nurse or aide will pull the patient into a triage room and obtain vital signs.  This is still an important step so the patient is placed in the correct bed assignment for the best care.  Third, the patient’s vital signs are entered and the patient is then moved directly to a treatment room (change).  Fourth step is for the assigned nurse to greet the patient and initiate the full triage and assessment.  When using this method daily, it will decrease wait time within the emergency department and provide faster treatment for patients (refreeze).

Managing the Change

Initially the data needs collected to see what the actual wait times are for patients and not just going off the patient complaints/surveys.  Management would then have to step in, announce the concern and discuss possible solutions to the problem.  By taking the employees thoughts and ideas into consideration, it will allow for the employees to feel heard and have a more positive attitude to accept and continue with the changed process (Marquis & Huston, 2015).  Management needs to thoroughly explain the selected process, educate on the change, and make it known ahead of time before the change is to be initiated.  Then it is up to the staff to implement the changes and continue to working in the new way.  Management then needs to collect data to track if the new method is working to decrease patient wait times and if it has any impact on our customer surveys.

In conclusion, organizations have to adjust to change often.  The changes that are made can have either a positive or negative effect on the company, the employees, and the patients.  When a problem arises, making sure the problem is solved correctly is imperative.  By utilizing open communication and educating staff on not only what needs changed but the reasoning behind the change helps keep everyone on the same page.  This will allow for an easier transition while keeping a more positive atmosphere among the unit/facility.

References

Al-Sawai, A. (2013). Leadership of healthcare professionals: Where do we stand?. OMAN Medical Journal, 28, 285-287. http://dx.doi.org/10.5001/omj.2013.79

Centers for Disease Control and Prevention. (2017). Emergency department visits. Retrieved from https://www.cdc.gov/nchs/fastats/emergency-department.htm

Marquis, B. L., & Huston, C. J. (2015). Organizational structure. In Leadership roles and mzanagement functions in nursing: Theory and application (8th ed., pp. 260-286). Philadelphia, PA: Wolters Kluwer.

Nursing Theories. (2011). Change Theory: Kurt Lewin. Retrieved from http://www.currentnursing.com/nursing_theory/change_theory.html

Ohio Health. (2016). About Us. Retrieved from www.ohiohealth.com/about-us/