Application: Planned Change in a Department or Unit
Health care organizations are continuously immersed in change from the emergence of new
policies, to promote quality care and improve patient safety to keeping pace with the rapid
growth in knowledge and best practices. Establishing a solid framework for planning and
implementing change is a wise move, as it provides a foundation for the extensive
coordination that will be needed to successfully facilitate the change.
For this Assignment, you propose a change at the department or unit level and develop a
plan for guiding the change effort.
Review Chapter 8 in the course text. Focus on Kurt Lewin’s change theory, and contrast it
with other classic change models and strategies.
Reflect on problems, inefficiencies, and critical issues within a specific department, unit, or
area in your organization or one with which you are familiar. Select one issue as a focal
point for this assignment, and consider a change that could be made to address the issue.
Think about how the change would align with the organization’s mission, vision, and values
as well as relevant professional standards.
Using one of the change models or strategies discussed in Chapter 8, begin formulating a
plan for implementing the change within the department/unit. Outline the steps that you
and/or others should follow to facilitate the change effort. Align these steps to the change
model or strategy you selected.
Determine who should be involved in initiating and managing the change. Consider the
skills and characteristics that are necessary to facilitate this change effort.
Write a 2-3-page paper that addresses the following:
Identify a problem, inefficiency, or issue within a specific department/unit.
Describe a specific, realistic change that could be made to address the issue.
Summarize how the change would align with the organization’s mission, vision, and values
as well as relevant professional standards.
Identify a change model or strategy to guide your planning for implementing the change.
Provide a rationale for your selection.
Outline the steps that you and/or others would follow to facilitate the change. Align these
steps to your selected change model or strategy.
Explain who would be involved in initiating and managing this change. Describe the skills
and characteristics that would be necessary to facilitate the change effort
BOOK: Marquis, B. L., & Huston, C. J. (2012). Leadership roles and management
functions in nursing: Theory and application (Laureate Education, Inc., custom ed.).
Philadelphia, PA: Lippincott, Williams & Wilkins.
Application: Planned Change in Nursing
Healthcare providers are facing increased pressure from need to improve patient care,
nursing staff shortages, outdated technologies, and increased responsibility in shared governance.
APPLICATION: PLANNED CHANGE IN NURSING 2
According to existing research, patient care which the main objective of nursing is being
overlooked due to routine activities like documentation and administering medication that are
least beneficial to patients.
Ineffective and inefficient communication systems are a hindrance to patient care. They
are time consuming hence requiring nurses to conduct more managerial work which overtakes
the patient care role which is most vital (Marquis & Huston, 2012).
Communication between team members or inter-departments in a hospital otherwise
referred to as care coordination is important to improve patient health. However, these nursing
activities are done at the nurse station which increases distance between nurses and patients. This
is attributed to traditional institutional processes and old technologies that have made
communication difficult. Increased abandonment of patients by nurses due to this inefficiency
requires that the entire communication system in a hospital be well analyzed and necessary
Efficient nursing communication requires giving correct information to the right person
in the correct format and at the right time and location. Nurses need mobile communication
devices that enable communication from any location. These devices should filter information
and ensure correct information goes to right person which will eventually eliminate time wastage
by nurses. Mobile communication will ensure that clear directions on particular patient care are
followed to ensure effectiveness in patient care.
APPLICATION: PLANNED CHANGE IN NURSING 3
Connectivity is necessary in efficient communication. Various clinical systems need to be
connected to ensure automation of care coordination, elimination of duplication, and
Advanced technologies required for this include core communications, workflow
applications and solutions, and clinical mobility technology (Marquis & Huston, 2012). Core
communications is the basic technology required for hospitals to operate smoothly. It includes
basic applications like electronic badge readers, networking to connect all computers, telephone
service, and wireless internet access for staff and patients. Workflow applications and solutions
utilize connectivity and networking of core communications in synchronizing various hospital
processes. They automate processes by eliminating manual tasks and paperwork. Clinical
mobility technologies are devices that connect people and equipments together hence eliminating
time spent moving to nurse stations to access telephone services.
Hospital mission and vision are mostly to improve patient care for the health of patients.
Values of hospitals are based on beneficence, privacy, respect, dignity, information sharing,
participation and collaboration. This change in communication systems to embrace advanced
technology is clearly enhancing the mission, vision, and values of hospitals (Marquis & Huston,
2012). Incorporating core communications, workflow applications and solutions, and clinical
mobility technologies in hospital systems increases the time nurses spend with patients hence
improve patient care significantly. Continuous information sharing between departments fosters
participation and collaboration of all necessary parties for the benefit of a patient. Patient privacy
is stricter since all information on patients in saved in computers which are safe. Therefore
change in communication systems is in line with values and principles of hospitals.
APPLICATION: PLANNED CHANGE IN NURSING 4
The three-step model by Lewin utilizes concepts of unfreezing, movement, and
refreezing. It is all about driving and restraining forces working at eliminating and replacing
some practices hence necessitating change. Unfreezing requires increasing driving force that
necessitate change and decreasing restraining force that hinder it. It will therefore require finding
ways of making it possible to let go of old communication systems and embracing advanced
technology and communication systems (Marquis & Huston, 2012). Movement will involve
change in communication systems to the planned and efficient one to ensure vital goals of
hospitals is fulfilled. Refreezing entails establishing change as the new habit. This will ensure
that core communications, workflow applications and solutions, and clinical mobility
technologies are accepted as the standard communication systems.
Processes in initiating and managing change
Implementing the change will require analyzing hospitals and its need for communication
and technology systems change. Shared vision and common direction should be created amongst
patients, nurses, administrators and other stakeholders (Marquis & Huston, 2012). Comparison
with the existing institutional processes and communications systems made hence creating a
sense of urgency for its implementation. Development of an implementation plan to present to
concerned authorities. Communicating and involve other nurses in reinforcing the necessity of
advanced technology and communication systems to the hospital. If administrators are convinced
then it will require institutionalizing change.
APPLICATION: PLANNED CHANGE IN NURSING 5
Lewin’s planned approach is suitable for this case. Change process is indefinitely
continuous with modifications that require implementation till desired results are achieved.
Therefore any necessary change in whichever nursing department requires analysis to ensure the
correct change model and strategies are chosen to implement it.
APPLICATION: PLANNED CHANGE IN NURSING 6
Marquis, B. L., & Huston, C. J. (2012). Leadership roles and management functions in nursing:
Theory and application (Laureate Education, Inc., custom ed.). Philadelphia, PA:
Lippincott, Williams & Wilkins.