Planned Change in the Rehabilitation Unit

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Introduction

Change is an integral part of an effective nursing organization. To make a transition to the desired point and improve the performance of a department or a unit, it is essential to consider the organizational change options. This paper will present several steps to identify, evaluate, and implement change in the rehabilitation unit.

Identification of a Problem

A range of problems marks the rehabilitation unit of the given organization. First, the process of rolling out Meditech and computerized physician order entries (CPOE) causes many difficulties in the work of the staff primarily because of the lack of engagement and awareness of new technology. Among other issues, there are staff grid issues, high fall protocol on every patient, etc. Since the first problem seems to be the most critical in the given situation, this paper will propose a change regarding Meditech and CPOE.

Addressing the Issue

Meditech and CPOE allow entering medical data and orders via computers, making treatment more transparent and organized. To ensure patient safety and satisfaction, it is important to design a clear decision-making mechanism and engage physicians (Radley et al., 2013; Simon et al., 2013). In other words, comprehensible and achievable goals regarding the work with the mentioned innovative methods are established. This realistic approach based on leadership and interdisciplinary collaboration is likely to result in setting clear guidelines and regulations as well as staff awareness.

Aligning the Change to the Mission, Vision, and Values of the Organization, and Relevant Professional Standards

The mission statement of the given organization is to serve humanity to honor God by providing cost-effective and outstanding health care available to all. To support this balance between cost and quality, it is essential to adhere to continuous quality improvement. Therefore, the suggested change aligns well with this mission. Khanna and Yen (2014) state that CPOE aims at setting standardized order sets and clinical alerts in terms of quality and safety.

The above statement corresponds to the organization’s vision that is formulated as follows: to provide world-class care. The goals accepted by the organization – strengthening community health and promoting health awareness – are also in line with the assumed solution. Professional standards that align with the potential change, patient-oriented care, knowledge-based practice, and professional responsibility should be noted.

Change Model or Strategy

Transformation is always a multi-faceted process, as various aspects are to be taken into account. Kotter’s change management model seems to be relevant to introduce change at the given rehabilitation unit. This model focuses on the change of the organizational context and several consecutive stages. In particular, the following points are discussed by the scholar: create a sense of urgency, build a guiding coalition, form a strategic vision and initiatives, list a volunteer army, enable action by removing barriers, generate short-term wins, sustain acceleration, and institute change (Klein, 2013). The rationale for selecting this model can be identified in the following manner: a rather detailed method of preparing and implementing change based on staff engagement, motivation, and leadership.

Steps to Facilitate Change

Creating an achievable action plan requires considering all the stages of Kotter’s change management model. It is suggested to organize change in three phases. The first step will include three first stages and create a climate for change. Establishing proper relationships between team members and stating the goals, the leader will create a sense of urgency and illuminate the purpose of transformation (Ip et al., 2012). Such strategies as the video presentation, statistics, and interdisciplinary collaboration will contribute to accomplishing the first phase.

In terms of phase two that includes three next stages, it is important to communicate mission, vision, and values aligned with Meditech and CPOE. This will be initiated via open dialogue, collective meetings, timely feedback, and the distribution of frequently asked questions. Moreover, the mentioned steps will allow ensuring staff involvement and inducing their motivation to participate in change.

The last phase focusing on sustaining acceleration and producing more change, will require training and the resolution of unexpected problems. It may turn out that, for example, some employees are still not involved in change or resist it. According to Klein (2013), “the creation of a safety committee, identification of employees who are safety stars, and performing weekly safety huddles on the frontline will also help establish and maintain a commitment to the culture of safety” (p. 9). In this case, it is critical to pay attention to every team member and address the existing challenges.

Skills and Characteristics of Change Agent who will Initiate and Manage the Change

The unit leader, along with nursing managers, will be assigned the role of initiators of the described change. The skills of creative thinking and decision-making, communication, and collaboration are required to transform the rehab unit’s current organizational context and create a new culture. As for characteristics, change agents will need commitment, integrity, positive attitude, openness, and creativity.

Conclusion

To conclude, it should be emphasized that the rehabilitation unit encounters problems with the successful use of Meditech and CPOE. It was suggested that the implementation of Kotter’s change management model would be useful in addressing the identified problem. The key change actors, skills, and characteristics were also provided as a part of the action plan.

References

Ip, I. K., Schneider, L. I., Hanson, R., Marchello, D., Hultman, P., Viera, M.,… Seltzer, S. E. (2012). Adoption and meaningful use of computerized physician order entry with an integrated clinical decision support system for radiology: Ten-year analysis in an urban teaching hospital. Journal of the American College of Radiology, 9(2), 129-136.

Khanna, R., & Yen, T. (2014). Computerized physician order entry: Promise, perils, and experience. The Neurohospitalist, 4(1), 26-33.

Klein, L. (2013). Implementing an advanced computerized provider order entry system to the neonatal intensive care using Kotter’s change management model. Canadian Journal of Nursing Informatics, 8(1), 1-11.

Radley, D. C., Wasserman, M. R., Olsho, L. E., Shoemaker, S. J., Spranca, M. D., & Bradshaw, B. (2013). Reduction in medication errors in hospitals due to adoption of computerized provider order entry systems. Journal of the American Medical Informatics Association, 20(3), 470-476.

Simon, S. R., Keohane, C. A., Amato, M., Coffey, M., Cadet, B., Zimlichman, E., & Bates, D. W. (2013). Lessons learned from implementation of computerized provider order entry in 5 community hospitals: A qualitative study. BMC Medical Informatics and Decision Making, 13(1), 67-77.

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