HOW HAVE YOU SEEN OR EXPERIENCED ORGANIZATIONAL CHANGE WITHIN AN ORGANIZATION? NUR 514

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?

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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.

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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/canacommunityhospitalsticktoitsmissionwhenitgoesforprofit

Garber, 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,studyfinds

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.

HOW HAVE YOU SEEN OR EXPERIENCED ORGANIZATIONAL CHANGE WITHIN AN ORGANIZATION? NUR 514 References

Nielsen, P., Albertsen, K., & Meng, A. (2020, September). Impacts of organizational change on senior employees. In The Nordic Working Life Conference, Aalborg. https://vbn.aau.dk/en/publications/organisatoriske-forandringers-betydning-for-seniorer

DeNisco, S. M., & Barker, A. M. (2016). Advanced practice nursing: Essential knowledge for

the profession (3rd ed.). Jones & Bartlett Learning.

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 rolled 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.

Resources

DeNisco, S. M., & Barker, A. M. (2016). Advanced practice nursing: Essential knowledge for

the profession (3rd ed.). Jones & Bartlett Learning.

A wide variety of organizational change models can be utilized to structure a business and, in turn, influence its operations and results. Models can be used to direct health promotion and disease prevention initiatives. These frameworks can describe and predict how people’s health-related habits change over time.

Lewin’s Change Theory is a three-step model based on the premise that behavior is a dynamic balance of forces working in opposition. To facilitate change by pushing employees in the desired direction and inhibiting forces hamper change because they make employees in the opposite direction. Lewin’s three-stage change framework can be used as one of the change models. This model is a three-step procedure for analyzing the organizational environment’s change process and devising strategies for challenging the status quo in order to create meaningful transformation. The paradigm suggests that group actions will dictate how an individual responds to the proposed change. Leaders, it follows, need to see members’ actions as a barometer of how their teams feel about the proposed transformation if they want to see any real results (Hussain et al., 2018). The model’s three steps of transformation are unfreezing, change process, and refreezing. When unfreezing a company, it is important to communicate with employees about the upcoming changes and gain their buy-in and support. The second step is to put the plan into action through communication and strong leadership. The third phase, “refreezing,” is when the modified elements of the organization’s culture are fully embedded through persistent application and, if necessary, course corrections.

Stakeholder management is a powerful tool used by successful people to get the support of others. Stakeholder management is an essential skill that can help save your projects from failure. Your projects have staunch advocates in the form of stakeholders, who may also act as roadblocks. Therefore, it is essential to identify your stakeholders and quickly gain their support.