DQ1
Consider an organization in your field or industry. Describe the essential systems necessary to facilitate continuous change without compromising quality or causing burnout among employees. Describe three factors to consider when making sure that the changes made become permanently imbedded in the organization's culture.
DQ2
What is your reaction to change in your personal history? What personal tools do you implement to help yourself navigate change?
Melissa response to DQ1
Change in any industry is inevitable and essential. In the healthcare industry, especially in the hospital setting, change can affect lives and health outcomes of patients and their families. Hospitals take pride in practicing evidence-based practice (EBP), but often this requires huge system or process changes for those already at high-risk of burnout. Leadership teams can help facilitate continuous change by following the see-feel-change and 8 steps ideas of Kotter and Cohen (2002). By initially appealing to emotion and following through with the steps from creating a guiding team, to creating vision and leading with employee empowerment leadership can create a better change situation that will relieve some of the distress of change.
To truly complete cycle of change the new behavior and vison must be imbedded in the “new” culture of the organization. Strategic hiring and orientation of new hires that includes the vision and desired culture is an essential way to introduce new individuals to the organization’s culture (Kotter & Cohen, 2002). In my department, we talk about our culture during the interview process in an attempt not only to introduce it to potential new hires, but to make those that may not agree aware of the expectations before they accept a position. Another strategy is to promote those who not only have the skill for a position but are also great spokespeople and role models of the “new norms” (Kotter & Cohen, 2002). Finally, leadership should be constantly relying on the power of emotion (Kotter & Cohen, 2002). People can lose site of the “why” of change easily in the day-to-day and get discouraged. Reminding them of the goal, especially in areas of high turn-over can increase the success of the change initiative.
Michael DQ1
When implementing a process of continual change in an organization, it is essential that key measures be taken to prevent compromising quality or causing burnout among employees. Change is most effective when leaders work with the team to define the change, provide support during the change, coach and mentor employees through the change, and reward team accomplishments (Kotter, 2002). Additionally, collaborating with and involving employees on how to best implement the change and how to continually improve results after the change, makes it easier for employees to accept change.
Three key factors to consider when making sure that changes that are made are permanently embedded in the organization’s culture are (1) engaging employees and demonstrating the need for change, (2) having effective leadership, to include putting those in support of the change into influential and visible positions (3) continually supporting the change to help new culture grow; not giving up on the 8-step change process until the change processes roots are deep. Although each step is equally important, the last step is especially important to not only influence the initial change, but to make it stick long term and transition from “the change” to the new norm, or a true shift in culture.
Christine DQ2
My reaction differs to change and depends on the change initiative. I understand change is a constant, especially in healthcare and I typically try to keep an open mind about it. I support change if there is a reason for it and or if it improves a process. As I get older, I think there may be a time that I can no longer be a bedside RN, because of change, hence the MSN. I want to have options and not feel as though I am stuck.
One recent example of change at my hospital was the use of Cyclers for CAPD patients. Thankfully my unit typically sees HD patients. However, for the one CAPD patient we see, there is always a delay of care because of the new cyclers. What I found out this week though, was the new cyclers were returned and we received new-new cyclers. Not one RN or Manger had been trained on the new equipment. It took three educators and five nurses and two phone calls to the equipment call center to program the machine. The patient was hooked up 4.5 hours later. It was embarrassing. The idea of this cycler was to have dialysis run at night for a long length of time allowing ‘freedom’ during the day and benefiting kidney function. So this change was a good idea with a failure in communication.
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