Governing entities

:What internal and external governing entities (individuals, groups) must approve the
change prior to implementation?

Is an IRB required? Why or why not?

Approximately how long will it take to gain approval to implement your plan?

Implementing Change

Governing entities
Different governing entities work in partnership with co-regulators in inspecting,
investigating, and taking enforcement action where necessary. These entities are responsible for
regulating various aspects within the healthcare sector. Some have specific legislative powers
that puts in them in a position to respond to patient or service user complaints or incidents
(Carlson et al., 2015). Before my project of educating nurses on delivery of quality care to
diabetic patients is implemented, some governing entities, both external and internal, should
approve it.
External Governing Entities

(i) General Medical Council

This organization plays a crucial role of ensuring clinical settings maintain professional
standards. According to Wood et al, it serves to improve the care of patients, use an inspection
framework in standardizing independent healthcare services, and reduce healthcare associated
infection risk to patients (Wood et al., 2013).

(ii) Care Quality Commission (CQC)

This is an independent body that regulates the quality as well as safety of care delivery. It
uses information from a wide range of sources to analyze the outcomes of people who have

received medical attention. Since my project will be on improve the outcomes of diabetic
patients, approval from this commission will be quite significant.

(iii) Professional Bodies such as Nursing Association and Diabetic
These organizations ensure that there is proper maintenance of standards by health and
social care professionals. They accomplish similar duties for various professions across the
country. Their main functions include; setting and maintaining standards for education, training,
and conduct (Harvey Wallace et al., 2014). This is a very powerful body which should approve
my project before it progresses.
Internal Entities
They include;

(i) Top Level Management in the hospital such as the Chief Medical Officer
(ii) Chief Hospital Nutritionist
(iii) Chief Nursing Officer

These are very important officials in any hospital. Changes that my affect the nature of
activities conducted in the hospital should be approved by these individuals. For instance, the
CMO is quite important because my project will need some funding which requires his/her
approval, the nutritionist will also be at the center of my project since he/she will go through the
proposed interventions and ensure that they are in line with the needs of diabetic patients. Since
this project will heavily entail execution of the proposed changes by the nurses, the Chief
Nursing Officer should also approve the project and ensure that it does not infringe the welfare
of the nurses.

Is an IRB Required?
Yes. My project will need an IRB to ensure that the safety and well-being of the patients
is maintained, ensure that my project contains only ethical and scientifically effective research
prior to implementation, and lastly to solve concerns from the general public regarding the
responsible conduct of the project.
Approximately how long will it take to gain approval for implementation of the plan?

The approximated approval time for this project is about one month. This will be suitable
because new nurses will be joining the hospital for practice and I would like them to be leading
ambassadors of this change.
Aspects that may be of concern to the governing entities
One of the major concerns that may arise is employee resistance. Usually employees tend
to oppose change citing reasons that the change may affect their familiarity by changing their
expectations and roles in the hospital (Hon, Bloom & Crant, 2014). The governing entities would
therefore question what plan I have in place in case such an instance arises.
The other concern will be on finance. The governing entities would like to know my
budget and ensure that the allocation will not disrupt major activities of the institution.
Project Planning. They will also like to know how the project is going to be executed. For
instance, the project will involve education of some nurses. The entities would not like this
training to be conducted at times when some of this nurses should be attending to patients.



Carlson, V., Chilton, M. J., Corso, L. C., & Beitsch, L. M. (2015). Defining the Functions of
Public Health Governance. American journal of public health, 105(S2), S159-S166.
Harvey Wallace, D., Tilson, H., Carlson, M. V. P., & Valasek, M. T. (2014). Instrumental roles
of governance in accreditation: responsibilities of public health governing entities.
Journal of public health management and practice: JPHMP, 20(1), 61.
Hon, A. H., Bloom, M., & Crant, J. M. (2014). Overcoming resistance to change and enhancing
creative performance. Journal of Management, 40(3), 919-941.
Wood, D., Wood, A., Fleming, D., Macrobin, D., Thomson, D. A. S., Hargrave, M., … &
Apjohn, S. D. C. (2013). General Medical Council.