discusion board response post

Change and Innovation
Each and every one of us is directly affected by the decisions made by the leadership teams at our places of employment. Being able to identify the key nuances related to leadership style can mean the difference between promoting change and innovation within our workplace and stagnation. The purpose of this discussion is to understand the significance behind effectively managing change and innovation as essential leadership competency. In addition, two supporting examples will highlight how change has been either successfully or unsuccessfully managed in my workplace to analyze if my organization could have approached change differently.
Adequately understanding and managing change and innovation is an essential leadership competency in order to successfully implement change, regardless of what the adjustment may entail. Although change and innovation can accompany one another, the process of change is associated with an alteration of an existing condition whereas innovation is related to a state of originality (Huber, 2014). As such, leaders must possess the necessary skillsets to pioneer change and innovation, while being change agents within their departments that can foresee and address potential emotional responses. Therefore, by involving team engagement into a practice management initiative, the likelihood of change being successful rises. The ability to adjust one’s leadership approach to various situations is a primary determinant of success (Gillam & Siriwardena, 2013).
As a charge nurse in my department, I have observed and participated in various changes where the innovation/goal was identified, followed by getting the “buy-in” from all affected parties. This process is taken to help ensure a smooth rollout plan within a certain timeframe, where change results were measured and evaluated for effectiveness or necessary additional modifications. An example of an unsuccessful change was to shift our previous Pre-Admission Testing (PAT) process, where 100% of surgical patient history and physicals (H&Ps) used to be conducted onsite to having the surgeons and/or medical managers do the H&Ps. The goal was to quickly decrease NP full-time expenditures and onsite resources to increase profit utilization. However, approximately two years later, we have not been able to reach our goal due to lack of surgeon and/or medical manager compliance and continue to require NP’s to perform H&Ps. Although Lewin’s Change Theory was applied, the third stage, “refreezing”, was unsuccessful because the new changes were never fully integrated and stabilized. In response, I believe that this change could have been successful if the second phase, “moving”, encompassing planning and implementing had included surgeon and/or medical management participation (Huber, 2014).
On the other hand, an example of successful change was to use the 3M Povidone Iodine nasal swabs in the preoperative area on high risk surgical patients to decrease surgical site infections (SSI) and increase patient compliance with the prophylaxis prep being done the day of surgery by the nursing staff. Fellow staff members were educated on the identified problem, increased SSI, and the plan to address the problem, using the nasal swabs in the preoperative area on the day of surgery, as well as the rationale supporting this change. As a result of initiating this change, the number of SSI infections has decreased in relation to high risk surgeries like open heart, joint replacement, spine and colorectal procedures. I believe this change incorporated all three elements of Lewin’s Change Process; unfreezing, moving and refreezing, as demonstrated by its successful outcome (Huber, 2014).
In summary, leadership competency is essential in order to effectively manage change in the workplace. Subsequently, today’s healthcare necessitates the need for professionals to work together among disciples to tackles complex problems and institute fresh practices, processes and workflows (Wojciechowski et al., 2016). By effectively managing change and innovation, healthcare leaders at my workplace ensure best practice and optimal patient outcomes are the overall goal.
Gillam, S., & Siriwardena, A. N. (2013). Leadership and management for quality. Quality In Primary Care, 21(4), 253-259.
Huber, D. L. (2014). Leadership and nursing care management (5th ed.). St. Louis, MO: Elsevier/Mosby.
Wojciechowski, E., Pearsall, T., Murphy, P., & French, E. (2016). A Case Review: Integrating Lewin’s Theory with Lean’s System Approach for Change. Online Journal Of Issues In Nursing, 21(2), 1. doi:10.3912/OJIN.Vol21No02Man04
Change and Innovation
The purpose of this first discussion post will be to discuss effective management skills, leadership competency and how to handle change within the work place. In nursing you are always in a management/leadership role whether by choice or not. Even a floor nurse is a direct leader/manager to their patient care technicians. I, myself love working as a floor nurse and have never had a desire to become a nurse manager however I can appreciate that any even the floor nurse must have qualities of leadership at times. There is a difference between management and leadership although many can confuse the two for being the same. Leaders want to motivate others for example whereas managers hope that people only complete the task at hand (Ellis & Abbott, 2013). Leadership competency must be utilized within nursing so that we can adopt newer and better ways of providing healthcare and continuing to make a difference within the lives of our patients while hopefully making the job run more smoothly and effectively.
Understanding change within nursing is a must as healthcare is always changing and evolving with new methods, techniques and research. If you think back to thirty or forty years ago I think we can all imagine how much procedures and medicine has changed for the better. There are many different leadership styles that can be utilized to help motivate change and the nurse must look at what the goal is to be able to decide what leadership style will best suit helping others reach the goals (Huber, 2013). I will provide a few examples of change within my workplace.
One example of a change at my workplace that happened within this past year was our way of communication within the staff. We used to utilize a walkie talkie system for communication between the nurses and the techs however we have changed over to an internal cell phone system called the SARA through status solutions. The administration did a poor job of executing the change as they never consulted the nurses or the techs on what they needed the system to be able to do so that made for some frustration for staff at the time of implementation. After the training on the new system took place there was a period of unfreezing where many problems were identified and brought to the attention of administration when in turn did answer and fix the said concerns. One way my company could have done the cell phone change differently would have been to go to the moving phase of the change theory to talk to the nurses and the techs to assess what they need the cell phone system to be able to do to make their work and tasks more effective.
The facility I work at is not a specialty facility for Alzheimer’s/dementia however we do try to do what we can to assure that residents can stay in their “home” for as long as physically possible. For a few of our residents we had an issue with them wandering mainly at night time and during the night is a skeleton crew so that became an issue with not knowing when they were wandering. Anyone who has dementia is at a risk for wandering and can easily become lost or unsure of why they wandered out to begin with (“Alzheimer’s association, n.d.). One of my fellow nurses worked in a facility that utilized “silent” door alarms and it would allow the resident to come and go but the silent alarm would go directly to the cell phone of the techs so they would know the resident was wandering out of their room and therefore go check on them. I would say that the change started in the unfreezing stage as the techs and the nurses were the ones to recognize the need for a solution to the wandering residents and were ready for the change process to happen. The door alarms have worked out wonderfully as they have gave the staff more peace of mind on the confused residents and helped to utilize resident safety, the reception has been 100% positive.
Ellis, P., & Abbott, J. (2013). Leadership and management skills in health care. Nurse Prescribing, 11(5), 251–254. doi:10.12968/npre.2013.11.5.251
Huber, D. L. (2013). Leadership and nursing care management (5th ed.). United States: Saunders/Elsevier
Alzheimer’s association. Retrieved September 28, 2016, from http://www.alz.org/care/alzheimers-dementia-wandering.asp

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