Implementing Change With an Interprofessional Approach Presentation: NUR 514 Assignment

Successful change is one of the biggest challenges that modern organizations face. A strategic necessity for change is always needed in this fast-changing world. Besides, if things are not done differently, organizations are unlikely to succeed or last. I will start by describing the background of a situation in my current healthcare organization where change did not go as planned, including the rationale and the purposed goals of the change. In addition, I will identify the key interprofessional stakeholders, both internal and external, that should be involved in change efforts. I will then identify an appropriate change theory or model and discuss how it can be used to achieve results. I will also outline a plan that I would adopt to utilize the change in the healthcare organization. Lastly, I will discuss the impact on the organization if the change initiative would be unsuccessful again, and the potential steps the interprofessional team should take if the change is ineffective.

Any organization cannot function without change. Change enables health organizations to implement interventions that help them succeed in the market and compete. Change also enables health organizations to more effectively respond to and adapt to emerging market needs. Health organizations must embrace the use of a change model to guide the process in order to successfully implement change. Change models serve as benchmarks for evaluating the success of the change process and the necessary improvement interventions. The evaluation is the final step in the change implementation process, and it determines whether or not the change was successful in facilitating the desired success.

Also Read: NUR 514 The Evolution of Nursing Informatics Presentation Assignment

Brainstorming Questions

1.Do you remember the 3 C’s of change leadership?

2.What are the three key steps of leading the process of strategic change?

3.What are the crucial qualities of leading people?

4.How have you ever affected positive change in your current or former organization?

5.How can you spur positive change on behalf of your organization?●

In a complex and fast-paced healthcare environment, change is inevitable and constant. The advanced practice nurse is required to lead and adapt to the constant changing environment while working with multidisciplinary teams. Imagine you are assigned by your director to work with a multidisciplinary team that is assisting with transition from the current paper record-based system to an electronic health record (EHR).

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Create a PowerPoint presentation (10-15 slides) in which you will assess the situation and the steps that should be taken to successfully implement the change. Be sure to include 100-250 word presenter’s notes per slide. Your presentation should address the following:

Implementing Change With an Interprofessional Approach Presentation NUR 514 Assignment Slayers

Describe the driving forces that relate to the need for implementing electronic health records.
Identify the key interprofessional stakeholders (both internal and external) that should be involved in change efforts.
Outline how you would initiate the change and be a change advocate. Utilizing change theory and innovative models of care, explain how you would provide a structure for the planned change to achieve successful implementation of the EHR.
Demonstrate how the change will affect current workflows. What revised workflow would you implement?
Identify resources (human, time, material, etc.) required for implementation.

Internal Inter-Professional Stakeholders

A number of internal inter-professional stakeholders could have been involved in the implementation of the change. One of them were the nurses. The nurses were the primary implementers of the change. It was therefore essential that training be provided to them on the ways of implementing the change. They could have also provided their insights into the ways in which the change could have been implemented efficiently. The other internal stakeholder that could have been involved in the implementation of the change were the nurse managers. The nurse managers could have worked with the other nurses in assessing the need for the change and ways of ensuring its success. The managers could have also used this opportunity to identify the behaviors and strategies that were needed for the success of the change initiative. The nurse managers could have also worked with the nurse leaders to ensure that the change initiative supported the vision of the hospital. They would have collaborated in exploring the most effective strategies that could have been used in implementing the change. The human resource manager could have assisted in performing needs assessment prior to the implementation of change. The information from need assessment could have been used to come up with appropriate goals for the implementation and training processes. Lastly, the finance manager could have assisted in the determination of whether the change initiative was financially sound or not. He could have assisted in exploring the most cost-effective ways of implementing the project.

Identify risks within the implementation plan. What are the impacts of the poor planning on cost, quality, and safety?
Identify potential barriers when implementing the change and discuss how you will handle resistance.

Change Theory

PDSA theory could have been used
Provides understanding of systematic introduction of change
Implementation of change builds on the small successes in the organization
System checks used to promote continuous quality improvement in implementation of change

The PDSA change theory could have been used to implement the change. Planning, doing, studying, and acting are all part of the theory. This theory is used by change implementers to test the needed change by first developing a plan. The plan is implemented and tested to determine its efficacy. The research phase identifies the strengths and weaknesses of the interventions used. The study’s findings are used to implement the change. The theory provides a practical approach to implementing change in which successful tested interventions are used to implement the necessary change in the organization. Process checks are also used to eliminate flaws in the implementation process and strengthen the use of best practices in the process alone (Katzenbach et al., 2019).

Integrate 3-5 scholarly sources into your presentation.

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At the charge nurse level, organizational change is frequently experienced as a bystander. The shift is clear, but the stakeholders and model remain unknown. After being purchased by a multinational corporation, the transition from a nonprofit to a for-profit acute care hospital was difficult. The majority of the change was viewed negatively by nursing staff. There were layoffs, supply shifts, leadership voids, and protracted contract negotiations, all of which resulted in significant delays in step and other raises. If you asked the nursing staff how the transition went, they’d probably say, “not great, but we got through it.” Because the change plan was successful, you would get a different answer if you asked the primary stakeholders who were affected by it. Five years later, things are back to normal, with the announcement of a new hospital on the horizon

All of the area’s hospitals are now for-profit enterprises. This is a common occurrence in the United States, where hospitals are increasingly merging and healthcare costs are rising (Findlay, 2018). Approximately one out of every five hospitals was acquired or merged between 2013 and 2017. (Findlay, 2018). Mergers are almost always necessary for the survival of a hospital. The only way to keep up with changing technology, modern data management, and top clinical skill is to merge with large organizations (Findlay, 2018).

Nonetheless, at what cost to the communities served by these hospitals? You’d think that community services would suffer; however, a recent study found that nonprofit facilities spent slightly more on charity care, while for-profit hospitals with 300 beds or more spent more (Garber, 2020). According to the same study, the most significant variation in charity care spending occurred between states and had little bearing on whether the facilities were nonprofit or for-profit (Garber, 2020). Major organizational change is difficult, and some areas of nursing suffer; however, the larger picture indicates the need to survive.

10.0 %Language Use and Audience Awareness (includes sentence construction, word choice, etc.) 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. 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. Language is appropriate to the targeted audience for the most part. 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. 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.

5.0 %Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style) Sources are not documented. Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors. Sources are documented, as appropriate to assignment and style, although some formatting errors may be present. Sources are documented, as appropriate to assignment and style, and format is mostly correct. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

100 %Total Weightage

4 posts

Re: Topic 3 DQ 1
At the level of charge nurse, organizational change is often experienced as a bystander. The change is apparent; however, the stakeholders and model are a mystery. Being bought by a large organization and going from a nonprofit to a for-profit acute care hospital was a rough transition. From the viewpoint of the nursing staff, most of the change was not favorable. There was the loss of ancillary staff, changes to inferior supplies, gaps in leadership, and highly drawn-out contract negations resulting in significant delays in step and other raises. If you asked the nursing staff know how the change went, they would probably say, “not good, but we made it through.” If you asked the major stakeholders who influenced the change plan, their answer would be different because it was a success. Five years later and it is business as usual with talks of a new hospital on the horizon.
All the hospitals in the area are now for-profit facilities. This is a trend in the United States, hospitals are consolidating at an accelerating rate, and healthcare costs continue to rise (Findlay, 2018). From 2013 to 2017, nearly 1 in 5 hospitals were acquired or merged with another hospital (Findlay, 2018). In most cases, mergers are necessary for the survival of the hospital. To keep up with advancing technology, modern data management, and top clinical talent, merging with large corporations is the only option (Findlay, 2018).

Nevertheless, at what cost to the communities these hospitals serve. You would think community services would suffer; however, a recent study showed only slightly higher spending in charity care for nonprofit facilities and showed higher charity care spending in for-profit hospitals with 300 beds or more (Garber, 2020). The same study showed that the most significant deviation in charity care spending was from state to state and had little bearing on whether the facilities were nonprofit or for-profit (Garber, 2020). Major organizational change is complex, and some areas of nursing suffer; however, the more significant picture points to the necessity to survive.Findlay, S. (2018, July 19). Can a Community Hospital Stick to its Mission When it Goes For-Profit? Retrieved from npr.org: http://npr.org/sections/health-shots/2018/canacommunityhospitalsticktoitsmissionwhenitgoesforprofitGarber, J. (2020, October 1). Nonprofit and for-profit hospitals provide similar levels of charity care, study finds. Retrieved from Lown Institute: https//lowninstitute.org/nonprofitandfor-profithospitalsprovidesimilarlevelsofcharitycare,studyfindsTopic 3 DQ 1How have you seen or experienced organizational change within an organization? Did it go well or not? Was there any correlation in how the organizations used stakeholders or change models?

Re: Topic 3 DQ 1
At my previous job, the hospital policy on bloodwork/labs became a topic of interest for change. Between the lab directors and the medical directors, they decided to implement a trial that included changing how the patient labels were printed for the bloodwork. Originally, the labels included the patient’s name, date of birth, medical record number (MRN), the physician’s name in which the patient was admitted under, and the date that the patient was admitted. The proposed new labels would include the same information, but would also include the color of the tube that the bloodwork was to go in, as well as a barcode. Although the thought process was that the new labels would help the doctors, nurses and phlebotomists easily place the correct sample in the correct color tube top, the exact opposite occurred. The computer system became at fault as the barcodes were not matching all the patient information and tube top colors; labs and colors did not correlate with each other. For example, a CBC normally would be in a lavender tube top, yet the label would print mint green, which was meant for a BMP. This led to many errors after the blood was sent to the lab. Labs were not being run right away, including STAT labs, and some were even put in the wrong color tubes. Some lab results were not coming up for the correct patient as well. This was a MAJOR patient safety issue. Having the wrong lab results for the wrong patient is beyond dangerous, especially something as serious as a type and screen. Administration quickly found out about all of the errors in the first week that the new labels were roll ed out.

The new labels were put on hold, and we went back to the original labels which were working just fine to begin with. We were told that IT and the lab would be working to resolve the issues and that the new labels would be trialed again once it was deemed OK and safe to utilize. I have since left that position but when I left that job, the new labels still had not be re-instituted.After reading about the 8 Step Change Model, I do not feel that many of the steps were properly utilized. According to DeNisco & Barker (2016), when a change idea is proposed by administration, educational experience and data should be utilized to demonstrate why the change is necessary. A team vision should also be a part of the change process, as it will not only affect one group of people, and should be questioned and discussed before implementing the plan to do said change (DeNisco & Barker, 2016). I feel that when the idea of new lab labels was initiated, it came out of nowhere. The staff like myself who did the bloodwork and sent to the lab was not asked for our opinions and there was no discussion of the reasoning behind the new labels. I believe if administration had utilized the 8 Step Change Model and took the time to incorporate the IT team for the computer aspect of the labels, many patient errors could have been avoided.

WORD COUNT: 529ResourcesDeNisco, S. M., & Barker, A. M. (2016). Advanced practice nursing: Essential knowledge forthe profession (3rd ed.). Jones & Bartlett Learning.Topic 3 DQ 2You have been selected to serve on a community outreach committee within your state’s nursing organization. The committee includes registered nurses of different specialties. At your first meeting, it becomes evident that not everyone is in agreement with a recent position statement about the role of spiritual care, with some members arguing they will no longer support the committee if the position statement is not revised or reversed. As a nurse leader, how could you draw from change theory to address these concerns and encourage collaboration on the committee?Re: Topic 3 DQ 2
The change theory could be utilized to reformulate the position statement about the role of spiritual care. The leader should establish communication amongst all members that there is a need for change and that all participants must put aside their differences to collaborate to create a new position statement (DeNisco & Barker, 2016). The team needs to develop a plan of action that states the participants, the process, the expectations, and the outcome. The first stage is the assessment to identify the problem that needs to be changed (Weberg et al., 2019). Research may be necessary to design the position statement. Clinical or relevant expertise may be used. The team may need to review the old statement to assess what the conflict is about. The next step is team reflection (Weberg et al., 2019). The team gathers together to develop ideas on what should be incorporated in the position statement and why. The leader guides the team toward a positive outcome. The leader maintains the direction of the collaborative effort. In the third step, the ideas are organized and categorized into a plan to be implemented. The leader may have to assist team members in their resistance to change in the position statement.

There may need to be further assessment and revision of the position statement in order to create a final statement that everyone agrees upon. The ideas proposed by DeNisco & Barker (2016) and Weberg et al. (2019) suggest that the team identify and recognize ways to work together in an established document that defines those terms to be able to agree and prepare a new position statement reflective of the ideas of all participants. When there is disagreement, the leader may need to step in to drive the conversation in a rational and logical manner towards consensus. A compromise may be necessary. A calm temperament is needed for heated debate.ReferencesDeNisco, S. M., & Barker, A. M. (2016). Advanced practice nursing: Essential knowledge for the profession (3rd ed.). Jones & Bartlett Learning. https://www.gcumedia.com/digital-resources/jones-and-bartlett/2016/advanced-practice-nursing_essential-knowledge-for-the-profession_3e.phpWeberg, D., Mangold, K., Porter-O’Grady, T., & Malloch, K. (2019). Leadership in nursing practice: Changing the landscape of health care (3rd ed.). Jones & Bartlett Learning. https://www.gcumedia.com/digital-resources/jones-and-bartlett/2018/leadership-in-nursing-practice_changing-the-landscape-of-healthcare_3e.phpObjectives:

Discuss the advanced registered nurse’s role as change agent within the interprofessional health care
Analyze factors driving organizational change within health care organizations, including stakeholders and
Evaluate change theories and collaborative models for promoting successful
Evaluate the ethical, social, legal, economic, and political implications of practice

Study Materials

How have you seen or experienced organizational change within an organization? Did it go well or not? Was there any correlation in how the organizations used stakeholders or change models?

RESPOND HERE (150 WORDS, 2 REFERENCES)

This is insightful, Marion; organizational change can sometimes become sudden due to the lack of involvement of some professionals in the change process. In most cases, charge nurses are left out in the decision-making processes, a scenario that makes it so hard for them to realize that the change process has been initiated (Nielsen et al., 2020). The change from profit to a non-profit organization can prove to be a challenge for most healthcare workers due to the changes in the roles for nurses that ought to be implemented. Given the increase in demand for effective healthcare care services, the change processes are always dynamic; this is a trend in the United States, hospitals are consolidating at an accelerating rate, and healthcare costs continue to rise (DeNisco et al., 2016). Sometimes, when organizational changes are implemented, nurses, particularly charge nurses, experience challenges in the process of transition. Therefore, there is the need to involve nurses in the decision-making processes geared towards implementing changes in the healthcare systems.

APA Writing Checklist

Use this document as a checklist for each paper you will write throughout your GCU graduate program. Follow specific instructions indicated in the assignment and use this checklist to help ensure correct grammar and APA formatting. Refer to the APA resources available in the GCU Library and Student Success Center.

☐ APA paper template (located in the Student Success Center/Writing Center) is utilized for the correct format of the paper. APA style is applied, and format is correct throughout.

☐ The title page is present. APA format is applied correctly. There are no errors.

☐ The introduction is present. APA format is applied correctly. There are no errors.

☐ Topic is well defined.

☐ Strong thesis statement is included in the introduction of the paper.

☐ The thesis statement is consistently threaded throughout the paper and included in the conclusion.

☐ Paragraph development: Each paragraph has an introductory statement, two or three sentences as the body of the paragraph, and a transition sentence to facilitate the flow of information. The sections of the main body are organized to reflect the main points of the author. APA format is applied correctly. There are no errors.

☐ All sources are cited. APA style and format are correctly applied and are free from error.

☐ Sources are completely and correctly documented on a References page, as appropriate to assignment and APA style, and format is free of error.

Scholarly Resources: Scholarly resources are written with a focus on a specific subject discipline and usually written by an expert in the same subject field. Scholarly resources are written for an academic audience.

Examples of Scholarly Resources include: Academic journals, books written by experts in a field, and formally published encyclopedias and dictionaries.

Peer-Reviewed Journals: Peer-reviewed journals are evaluated prior to publication by experts in the journal’s subject discipline. This process ensures that the articles published within the journal are academically rigorous and meet the required expectations of an article in that subject discipline.

Empirical Journal Article: This type of scholarly resource is a subset of scholarly articles that reports the original finding of an observational or experimental research study. Common aspects found within an empirical article include: literature review, methodology, results, and discussion.

Adapted from “Evaluating Resources: Defining Scholarly Resources,” located in Research Guides in the GCU Library.

☐ The writer is clearly in command of standard, written, academic English. Utilize writing resources such as Grammarly, LopesWrite report, and ThinkingStorm to check your writing.

Participation for MSN

Threaded Discussion Guiding Principles

The ideas and beliefs underpinning the threaded discussions (TDs) guide students through engaging dialogues as they achieve the desired learning outcomes/competencies associated with their course in a manner that empowers them to organize, integrate, apply and critically appraise their knowledge to their selected field of practice. The use of TDs provides students with opportunities to contribute level-appropriate knowledge and experience to the topic in a safe, caring, and fluid environment that models professional and social interaction. The TD’s ebb and flow is based upon the composition of student and faculty interaction in the quest for relevant scholarship. Participation in the TDs generates opportunities for students to actively engage in the written ideas of others by carefully reading, researching, reflecting, and responding to the contributions of their peers and course faculty. TDs foster the development of members into a community of learners as they share ideas and inquiries, consider perspectives that may be different from their own, and integrate knowledge from other disciplines.

Participation Guidelines

Each weekly threaded discussion is worth up to 25 points. Students must post a minimum of two times in each graded thread. The two posts in each individual thread must be on separate days. The student must provide an answer to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week. If the student does not provide an answer to each graded thread topic (not a response to a student peer) before the Wednesday deadline, 5 points are deducted for each discussion thread in which late entry occurs (up to a 10-point deduction for that week). Subsequent posts, including essential responses to peers, must occur by the Sunday deadline, 11:59 p.m. MT of each week.

Direct Quotes

Good writing calls for the limited use of direct quotes. Direct quotes in Threaded Discussions are to be limited to one short quotation (not to exceed 15 words). The quote must add substantively to the discussion. Points will be deducted under the Grammar, Syntax, APA category.

Grading Rubric Guidelines

Performance Category	10	9	8	4	0
Scholarliness Demonstrates achievement of scholarly inquiry for professional and academic decisions.	Provides relevant evidence of scholarly inquiry clearly stating how the evidence informed or changed professional or academic decisions Evaluates literature resources to develop a comprehensive analysis or synthesis. Uses valid, relevant, and reliable outside sources to contribute to the threaded discussion	Provides relevant evidence of scholarly inquiry but does not clearly state how the evidence informed or changed professional or academic decisions. Evaluates information from source(s) to develop a coherent analysis or synthesis. Uses some valid, relevant, reliable outside sources to contribute to the threaded discussion.	Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions. Information is taken from source(s) with some interpretation/evaluation, but not enough to develop a coherent analysis or synthesis. Little valid, relevant, or reliable outside sources are used to contribute to the threaded discussion. Demonstrates little or no understanding of the topic.	Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions. Information is taken from source(s) without any interpretation/evaluation. The posting uses information that is not valid, relevant, or reliable	No evidence of the use of scholarly inquiry to inform or change professional or academic decisions. Information is not valid, relevant, or reliable
Performance Category	10	9	8	4	0
Application of Course Knowledge – Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings and relate them to real-life professional situations	Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources; Applies concepts to personal experience in the professional setting and or relevant application to real life.	Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources. Applies concepts to personal experience in their professional setting and or relevant application to real life Interactions with classmates are relevant to the discussion topic but do not make direct reference to lesson content	Posts are generally on topic but do not build knowledge by incorporating concepts and principles from the lesson. Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life Does not demonstrate a solid understanding of the principles and concepts presented in the lesson	Posts do not adequately address the question posed either by the discussion prompt or the instructor’s launch post. Posts are superficial and do not reflect an understanding of the lesson content Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life	Posts are not related to the topics provided by the discussion prompt or by the instructor; attempts by the instructor to redirect the student are ignored No discussion of lesson concepts to personal experience in the professional setting and or relevant application to real life
Performance Category	5	4	3	2	0
Interactive Dialogue Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days. (5 points possible per graded thread)	Exceeds minimum post requirements Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts three or more times in each graded thread, over three separate days. Replies to a post posed by faculty and to a peer Summarizes what was learned from the lesson, readings, and other student posts for the week.	Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days Replies to a question posed by a peer Summarizes what was learned from the lesson, readings, and other student posts for the week.	Meets expectations of 2 posts on 2 different days. The main post is not made by the Wednesday deadline Does not reply to a question posed by a peer or faculty	Has only one post for the week Discussion posts contain few, if any, new ideas or applications; often are a rehashing or summary of other students’ comments	Does not post to the thread No connections are made to the topic
	Minus 1 Point	Minus 2 Point	Minus 3 Point	Minus 4 Point	Minus 5 Point
Grammar, Syntax, APA Note: if there are only a few errors in these criteria, please note this for the student in as an area for improvement. If the student does not make the needed corrections in upcoming weeks, then points should be deducted. Points deducted for improper grammar, syntax and APA style of writing. The source of information is the APA Manual 6th Edition	2-3 errors in APA format. Written responses have 2-3 grammatical, spelling, and punctuation errors. Writing style is generally clear, focused, and facilitates communication.	4-5 errors in APA format. Writing responses have 4-5 grammatical, spelling and punctuation errors. Writing style is somewhat focused.	6-7 errors in APA format. Writing responses have 6-7 grammatical, spelling and punctuation errors. Writing style is slightly focused making discussion difficult to understand.	8-10 errors in APA format. Writing responses have 8-10 grammatical, spelling and punctuation errors. Writing style is not focused, making discussion difficult to understand.	Post contains greater than 10 errors in APA format. Written responses have more than 10 grammatical, spelling and punctuation errors. Writing style does not facilitate communication. The student continues to make repeated mistakes in any of the above areas after written correction by the instructor
	0 points lost				-5 points lost
Total Participation Requirements per discussion thread	The student answers the threaded discussion question or topic on one day and posts a second response on another day.				The student does not meet the minimum requirement of two postings on two different days
Early Participation Requirement per discussion thread	The student must provide a substantive answer to the graded discussion question(s) or topic(s), posted by the course instructor (not a response to a peer), by Wednesday, 11:59 p.m. MT of each week.				The student does not meet the requirement of a substantive response to the stated question or topic by Wednesday at 11:59 pm MT.

NOTE: To receive credit for a week’s discussion, students may begin posting no earlier than the Sunday immediately before each week opens. Unless otherwise specified, access to most weeks begins on Sunday at 12:01 a.m. MT, and that week’s assignments are due by the next Sunday by 11:59 p.m. MT. Week 8 opens at 12:01 a.m. MT Sunday and closes at 11:59 p.m. MT Wednesday. Any assignments and all discussion requirements must be completed by 11:59 p.m. MT Wednesday of the eighth week.

Implementing Change With an Interprofessional Approach Presentation: NUR 514 Assignment