Change Implementation in Nursing Leadership and Management
Outline of Steps
During the implementation of the new change, different steps were taken to encourage involvement and feedback from the administration, nurses, and other important stakeholders. In the first step, the suggested change was written down and sent to the administration for approval. The draft explained how using the SBAR method could make communication better in the facility and how the SBAR checklist could help make sure the plan worked. The second step was to make the SBAR checklist, making sure to include all parts of the situation, background, evaluation, and suggestion. To improve efficiency, the checklist took into account what was done in the emergency room and the unit where patients were admitted.
Clinical nurse educators are important people who help healthcare organizations use evidence-based methods. In the third step, the suggested SBAR checklist was given to the nurse educator to be reviewed and approved. The nurse educator helped rework a few parts of the suggested checklist, and a final draft was made that included everything to do with communication between the two departments. The next step was to figure out who the key stakeholders were, what their jobs were, and how they would be educated about the new change before it was put into place. The nurses, doctors, hospital staff, and patients were the most important people in the project.
During change implementation in healthcare groups, education and training are very important because they prepare employees for the new change. The fifth step was to work with the nurse educator to come up with educational parts about SBAR communication for each stakeholder. The nurses and doctors were told about the new plan and how important it was in the emergency room and the unit where new patients are admitted. The charge nurses were also shown how to collect the SBAR forms on a regular basis, file them, and send the weekly reports to the implementation team. The final step was to give the nurse managers the final draft of the SBAR checklist and start the test. During the four weeks, the charge nurses and the nurse educator kept an eye on the communication process and put the finished checklists into a file that was given to the implementation team every week. Also, key stakeholders met once a week to talk about the new change and look for problems and review how it was going.
Talk about the changes
The first plan was to teach ED and admitting unit workers about the importance of SBAR communication through education and training. But the nurse educator thought about bringing in outside partners to talk about communication and how it affects patient satisfaction. Together with the hospital’s management, the nurse trainer was able to get board members from the CMS to talk to the staff about how communication affects HCAHPS scores. Second, it was hard to find time for staff education because the nurses and doctors worked different shifts. So that every person could learn, sessions were recorded and put on online groups so that people could easily find the information they needed. There was also a need to make an extra education program for people who worked the night shift and found it hard to learn and train during the day. Also, an extra week was added to the program to make sure that all events, including the new ones, were included.
Talk about the problems
Healthcare groups face many challenges when they try to put big change plans into action. But knowing about these problems gives you a strong foundation for managing change well. The first problem was that the hospital administration didn’t want to accept the plan. Other ways to improve quality were probably given more attention, which slowed down the project’s recognition. But it was easy to show the administration how important the new change was to the two departments and the company as a whole.
The second problem was that the nursing team and the doctors didn’t want to use the SBAR checklist. The new schedule was different from the one that had been used before, and it had extra parts that, according to the nurses and doctors, made it harder to use. The team also said that the busy nature of the ER and the hospital admitting unit made it hard to get all the information needed for the tool in as little time as possible. Lastly, the delay in staff education and training made time a problem during the new change’s execution. Since outside educators were now involved, more time was also needed to talk about how important the new change was to the group and to the patients/families.
Getting Past Problems
The first problem was that the administration didn’t want to go along with the plan because they were already working on other hospital projects. I talked to the nurse trainer because I thought he could help get the administration on board with the new change. I talked about the mistakes that were made in the ER because of a lack of communication and how the new change was backed by evidence and would make patients happier. I also asked the research team to look into the positive effects of SBAR communication in the ER and how focusing on this area could help the organization. In the end, the managers were happy with the plan and understood how important the new change was to make patients happier and improve the organization’s performance.
The second problem was that the nursing and doctor teams didn’t like how complicated the new SBAR tool was. To get around this problem, the education and training program taught employees how important each part was. The staff could see that using the new plan could possibly cut down on mistakes in the emergency room through the inpatient admitting unit. The charge nurses for the two areas were also told to be strict with staff members who didn’t follow the rules when the new change was made.
The third barrier was that there wasn’t enough time to adopt the new change, especially during training and education. To get around this problem, online learning and sharing of materials were made available so that workers could listen to and watch all training sessions when it was convenient for them. The second method was to give education and training to people who worked at night because they couldn’t get training during the day. The program also had an extra week added to make sure that staff got all the education and training they needed. Also, weekly meetings were moved to the weekends when there wasn’t enough time to talk about how the new change was going.
Identifying Relationships Between Professionals
Modern healthcare is like a team sport, with a group of pros working together to give patients good care. This practice is thought to make it easier for healthcare teams to share info and talk to each other. New evidence shows that effective collaboration encourages each discipline, as well as the patient and their families, to take an active role in patient care. During the new change’s introduction, the nurses, doctors, IT (information technology), and administrators worked together as an interprofessional team to make sure the project went well.
Talking about relationships
Nurses make up the largest group of health care workers in healthcare groups, which makes them very important when making changes. During patient care, it was up to the nurses in the emergency room and the hospital admissions unit to talk to the doctors. Using the SBAR method, the team communicated well with the doctors and told them about anything that didn’t go as planned. Also, nurses and other parties worked well together to make sure the plan was carried out correctly, which led to good results.
During the project’s implementation, the physician team was an important stakeholder because they actively used the SBAR method when taking care of patients. The team worked with the nurses and the management to make sure the plan was followed and to fix any problems they saw. The doctors were involved in teaching, and their professional relationships with the nurses made it easy for them to talk to each other during the implementation phase.
Part of putting the project into action was using technology, which was handled by the IT team. The IT team made sure that all training and education events had visual tools to help people understand. Second, the movies were shared in groups so that both day-shift and night-shift workers could see the same information. On the other hand, the government worked with the nurses, doctors, and other stakeholders to make sure the program was a success. Good ties between these teams helped them deal with problems like time and resistance in the best way possible.
Chapter 4: Things to think about after the final project
Talk about what went well
The group was able to implement SBAR communication because people worked together and the administration helped. By making it easier for nurses and other healthcare providers to talk to each other, the new approach helped teamwork and collaboration between different professions a lot. The nurses, doctors, IT team, and management all worked together to make sure that the plan for implementing SBAR communication was followed. The joint practice also made it easy to get past obstacles like time and resistance.
The project showed how evidence-based methods can be used to improve the quality of healthcare and the performance of organizations. For example, the SBAR routine made sure that healthcare teams were held accountable when they shared information. As a result of the implementation, the ER and the area for admitting inpatients made fewer communication mistakes, which made a big difference in how happy patients were. Because of better communication, the performance of each section got a lot better. For example, patient satisfaction rates went up because there were fewer mistakes and services were given more quickly in the ER.
How Past Projects’ Successes Will Help Plan Future Ones
The fact that this project was a success shows that using evidence-based practices can change the way healthcare groups provide care. Using evidence-based methods is seen as a way for nurses to learn more about what they do and for patients to be more involved in their own health care. For future projects to be successful, it will be important to make changes that are backed by proof. The success of the project also shows that professionals from different fields can work together to improve care. Multiple healthcare teams should be involved in future projects to encourage teamwork and reach goals faster. The success of this project also shows that hurdles in healthcare shouldn’t stop people from using practices that have been proven to work.
Things that didn’t go as planned
Evidence-based practices can be hard to put into place because of problems like company culture and lack of support. When the ER started using SBAR communication, the nurses and doctors didn’t like the change very much. This made it take longer for the change to be adopted and accepted. The new checklist seemed to be more detailed than the one that had been used before, and it became hard to cover all of the needed points when communicating. At first, it was hard to get help from the administration because they were busy with other projects in the facility. I had to go out of my way to get the clinical nurse educator and the research team involved to show the institution’s administration how important the project was. Because of the different shifts, it was also hard to find time for the staff in the ER, which made it hard to educate and train them.
Understanding What Did Not Go Well
Understanding what didn’t go well has helped me understand how important it is to get ready for a project early on. Early planning can help make sure that there is enough help for projects before they start and that they stay on schedule. When I introduce projects to institutional managers in the future, I will make sure to use people with power and influence. I think this practice will help get people to agree with the idea because influential leaders are behind it. Also, I will need to make project proposals early so I have enough time to do study and present facts before other stakeholders. Time management is another thing I’ll need to work on in the future to make sure that every step is done in the time allowed.
Explaining how the gap was closed
Communication is a key tool that helps to provide good care, which makes patients happy. This part is emphasized and backed by research because it reduces mistakes and helps healthcare providers and patients get along better (Wang et al., 2017). In my company, bad communication during handoffs from the emergency room to the inpatient admissions unit led to bad care coordination, more medical mistakes, and unhappy patients. There was a gap between how nurses reported cases and how they talked to doctors, especially during situations. To fill this gap, a change in behavior that was based on evidence and used an SBAR checklist was suggested.
The SBAR checklist was suggested as a way to improve communication because it gave multiple healthcare teams a chance to be involved. The approach helped nurses and doctors talk to each other better, which led to collaborative care that helped patients do better. The other thing that was improved was the way that detailed information about a patient’s past was shared during communication, which helped to guide care for the patient. For example, the checklist made sure that important patient information like drug history, allergies, and pain rating were included in SBAR communication. By using the checklist, nurses and doctors in the two different areas made sure to talk about medication, which cut down on mistakes. This result is in line with evidence-based practice, which strongly shows that SBAR communication lowers mistakes and makes patients happier. Lastly, the checklist helped with patient-centered care by letting the patient be a part of the conversation and letting the family ask questions or suggest changes during care.
Helping with the Plan
Projects can be hard to keep going if clear goals aren’t set and enough help isn’t given. For example, money problems can make it hard to support a project even when the giver isn’t there. This is called “pragmatic sustainability.” To make sure that the new change is accepted, the ER and admitting unit charge nurses will give regular updates on contact and check in on the change every so often. Second, the departments will keep using the schedule for a few more weeks, until the staff can talk about all the details without referring to the list. As part of the long-term plan for survival, the unit will come up with rules for how to communicate using SBAR. For example, if someone is found to be taking short cuts when sharing patient information, they can be punished.
Resources for Post-Implementation
As part of the project’s ongoing support, meeting rooms will be needed for continuing education and training of new workers. As a short-term plan for survival, weekly reports on the strategy will need to be talked about. The IT staff will keep telling healthcare providers about the results of SBAR communication. Financial help will be needed to make sure that checklists are available in the rooms and to help new staff get trained and educated.
Chapter 5: Thinking
During the change, nurses with a master’s degree should use study and practices that have been proven to work. (Moss et al., 2016) One of the program outcomes says that a nurse with a master’s degree should use the results of applied research in the practice setting by navigating and combining care services across healthcare systems. Research was used to find that SBAR communication is an evidence-based way to improve communication in healthcare, and this result was built on that. The second program outcome was interprofessional collaboration. A nurse with a master’s degree should see the creation of interprofessional teams that communicate, coordinate, work together, and consult with other health professionals to promote a culture of excellence (Moss et al., 2016). To make sure the new change worked, the nurses, doctors, the IT team, and the managers had to work together. The multidisciplinary method also made sure that the patient was the main focus, which helped make patients happier.
Evidence-based practice (EBP) is now generally seen as the best way to improve the health of patients and the quality of healthcare. Communication in healthcare is one of the practices that need to be changed with the help of EBPs, because problems with communication lead to mistakes and bad results for patients. In the organization’s emergency room, there was a problem with dialogue that needed to be looked into and fixed in order to help patients. The problem was that the nursing and physician teams in the emergency and hospital admitting units didn’t share information about patients well when they switched over. The suggested solution to improve communication in these departments was to make an SBAR handover checklist that nurses could use to talk to each other better. The first plan was to make the checklist, send it to the clinical nurse educator, and make changes to the things that were on the final draft of the SBAR checklist. The second step was to teach and train the staff from the two units about SBAR communication, how to use the tool, and why the project was important to patients and the company. The process of putting the SBAR communication checklist into place took five weeks, and the results showed that it was an important tool for improving dialogue between nurses and other members of healthcare teams.
Moss, E., Seifert, P. C., & O’Sullivan, A. (2016). Registered nurses as interprofessional collaborative partners: Creating value-based outcomes. OJIN: The Online Journal of Issues in Nursing, 21(3). DOI:10.3912/OJIN.Vol21No03Man04
Wang, Y. Y., Wan, Q. Q., Lin, F., Zhou, W. J., & Shang, S. M. (2017). Interventions to improve communication between nurses and physicians in the intensive care unit: An integrative literature review. International Journal of Nursing Sciences, 5(1), 81–88. https://doi.org/10.1016/j.ijnss.2017.09.007
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