NUR 514 Week 3 Assignment Organizational Leadership and Informatics

NUR 514 Week 3 Assignment Organizational Leadership and Informatics

NUR 514 Week 3 Assignment Organizational Leadership and Informatics

  

As an advanced registered nurse, you will serve as a leader within your organization. Part of this role will entail being a change agent, and spurring positive change on behalf of patients, colleagues, and the industry.

Consider a situation you experienced previously where change did not go as planned in your health care organization. Create a 10-15-slide PowerPoint presentation in which you will assess the situation and the steps that should have been taken to successfully implement change.

Describe the background of the situation, including the rationale for and goal(s) of the change.

Identify the key interprofessional stakeholders (both internal and external) that should be involved in change efforts.

Discuss an appropriate change theory or model that could be used to achieve results.

Outline how you would initiate the change.

Describe the impact to the organization if the change initiative is unsuccessful again, and potential steps the interprofessional team could take if the change is unsuccessful.

Make sure to include slide notes of 100-250 words for each slide.

You are required to cite three to five sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

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The rapid pace of change in Canada’s health care system provides opportunities for nurse leaders to refine and advance their leadership and management skills for advancing change. Various forces that drive change in health care include rising costs of treatment, new technologies, advances in science, workforce shortages, and an aging population. Change initiatives must always be implemented for good reason within the context of advancing institutional goals and objectives. Balancing change is a key challenge within a patient- and family-centred model to provide safe and reliable patient care (Stefancyk, Hancock, & Meadows, 2013; Saskatchewan Ministry of Health, 2011).

9.1 THE NURSE LEADER AS CHANGE AGENT

Nurse leaders must ensure the day-to-day operation of their unit(s) in a rapidly evolving health care system. Nurse leaders are often called upon to be agents of change and are often responsible for the success of a project. Yet the literature suggests that leaders continue to struggle with change despite the frequency with which they are involved in leading change (Gilley, Gilley, & McMillan, 2009; Quinn, 2004). A change agent is an individual who has formal or informal legitimate power and whose purpose is to direct and guide change (Sullivan, 2012). This person identifies a vision and rationale for the change and is a role model for nurses and other health care personnel.

Nurse leaders’ behaviours influence staff actions that contribute to change (Drucker, 1999; Yukl, 2013). The significant number of changes that nurse leaders face require new ways of thinking about leading change and adapting to new ways of working. Moreover, leaders work closely with frontline care providers to identify necessary change in the workplace that would improve work processes and patient care. As such, nurse leaders must have the requisite skills for influencing human behaviour, including supervisory ability, intelligence, the need for achievement, decisiveness, and persistence to guide the process (Gilley et al., 2009). Effective change management requires the leader to be knowledgeable about the process, tools, and techniques required to improve outcomes (Shirey, 2013).

9.2 THEORIES AND MODELS OF CHANGE THEORIES

Knowledge of the science of change theory is critical to altering organizational systems. Being conversant with various change theories can provide a framework for implementing, managing, and evaluating change within the context of human behaviour. Change theories can be linear or non-linear; however, even linear theories do not unfold in a systematic and organized pattern. In the following section, we identify the role of leader and the typical pattern of events that occur in a change event.

Force Field Model and The Unfreezing-Change-Refreezing Model

Kurt Lewin (1951) is known as a pioneer in the study of group dynamics and organizational development. He theorized a three-stage model of change (unfreezing-change-refreezing model) in order to identify and examine the factors and forces that influence a situation. The theory requires leaders to reject prior knowledge and replace it with new information. It is based on the idea that if one can identify and determine the potency of forces, then it is possible to know the forces that need to be diminished or strengthened to bring about change (Burnes, 2004).

Lewin describes behaviour as “a dynamic balance of forces working in opposing directions” (cited in Shirey, 2013, p.1). The force field model is best applied to stable environments and he makes note of two types of forces: driving forces and restraining forces. Driving forces are those that push in a direction that causes the change to occur or that facilitate the change because they push a person in a desired direction. Restraining forces are those that counter the driving force and hinder the change because they push a person away from a desired direction. Finally, change can occur if the driving forces override or weaken the restraining forces.

This important force field model forms the foundation of Lewin’s three-stage theory on change (1951) (see Figure 9.2.1). Unfreezing is the first stage, which involves the process of finding a method to assist individuals in letting go of an old pattern of behaviour and facilitating individuals in overcoming resistance and group conformity (Kritsonis, 2005). In this stage, disequilibrium occurs to disrupt the system, making it possible to identify the driving forces for the change and the likely restraining forces against it. A successful change ultimately involves strengthening the driving forces and weakening the restraining forces (Shirey, 2013). This can be achieved by the use of three methods: (1) increase the driving forces that direct the behaviour away from the existing situation or equilibrium; (2) decrease the restraining forces that negatively affect the movement away from the current equilibrium; or (3) combine the first two methods.

The second stage, moving or change, involves the process of a change in thoughts, feelings, and/or behaviours. Lewin (1951) describes three actions that can assist in movement: (1) persuading others that the status quo is not beneficial and encouraging others to view a problem with a fresh perspective; (2) working with others to find new, relevant information that can help effect the desired change; and (3) connecting with powerful leaders who also support the change (Kristonis, 2005). This second stage is often the most difficult due to the fact that there is a level of uncertainty and fear associated with change (Shirey, 2013). Therefore, it is important to have a supportive team and clear communication in order to achieve the desired change.

Lastly, stage three, which Lewin called refreezing, involves establishing the change as a new habit. The third stage is necessary to ensure that the change implemented (in the second stage) will “stick” over time (Kristonis, 2005). Success at this stage will create a new equilibrium state known to be the new norm or higher level of performance expectation (Shirey, 2013).

Although Lewin’s model on change is well known and widely accepted in health care settings, it is often criticized for being too simplistic and linear. Change is often unpredictable and complex, and an effective leader must be aware of many change models.