Article Review Example on Effective Change Management

Introduction

The article, “Effective Change Management within an Australian Community Palliative Care Service,” describes a process of change management in a palliative care service where prescribing emergency subcutaneous medication for all patients admitted is changed in favor of prescribing “anticipatory medication” with clear guidelines for usage. This paper analyses the change management as described by the article.

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Australian Community Palliative Care

According to the article, the Australian Community palliative care had a standard practice where all patients admitted for care were given an emergency subcutaneous medication. This practice had not received systematic evaluation and, therefore, was relying on anecdotal evidence. The method of prescribing emergency medication lacked any scientific evidence, and therefore there was no proper rationale for the practice. There were no evidence-based procedures, even though palliative care is becoming important due to increased demand. The new practice has clear criteria for who qualifies for the emergency medication, clearly defined processes of the provision of the medication, and guidelines for prescribing the medication. The change in practice was to ensure that each individual patient received care according to their individual needs, thus giving the patients control of the symptoms of their illness. The change in emergency medication practice improved service provision and consumer satisfaction (Dredge et al. 2017).

Managing Emergency Medication

The article also describes the process of managing emergency medication practice change. For a successful transition, those involved need time to adjust to the loss of the old method and accept the new procedures. The use of systematic and evidence-based improvements improves the chances of successful change. People tend to resist changes, as seen in the article, where staff were reluctant and were concerned that the new procedure would compromise patient care. The article describes ways of effectively managing change and leadership styles for effective change.

The article offers insights palliative caregivers, those managing change in similar settings and palliative care recipients. The article describes how change was managed to enable smooth service delivery and consumer satisfaction. Many people are involved in the growth and its management. For a chance to be effective, those involved should have a common aim and understanding. Change management requires the identification of the values and motivations of the individuals involved. All those involved in the change are guided by a framework.

In the case described by the article, a working group was formed to implement the change in practice. The group consisted of a palliative care medicine specialist, the community palliative registrar, palliative nurses, and the clinical director of palliative care (Dredge et al. 2017). The working group developed the processes to be followed in the new practice, the guidelines for prescribing emergency medicine, and the criteria for identifying patients who qualify to receive the emergency medication. As seen to manage change in a similar setting effectively, nurses, allied health, and medical team members have to be involved. This article, therefore, serves as a guide for implementing and effectively managing change to those who work in similar settings. Palliative care is increasingly becoming important due to the large aging population; a lack of scientific evidence-based procedures indicates that the field is likely to experiences a lot of changes to ensure that the increased demand for the care is met with effective practices.

Pressure From Changes

Many healthcare organizations are undergoing change due to pressure from changes, both internal and external to the organization. There are rapid changes in the healthcare environment. To be able to deal with rapid changes, nurse managers should be able to identify changing trends and respond by implementing effective changes(Shanley, 2007). Some of these changes affect palliative care. An increase in the aging population places a strain in palliative care; therefore, it requires changes in practices in order to cope with the increase in demand and in the complexity of individual cases.

In many healthcare organizations, patient care is provided by intuition based practices. Changes in healthcare and the growth of integrated delivery systems have intensified, therefore encouraging practitioners to change old ways. During these changes, current practices are questioned, and better evidence-based practices are sought. Critical thinking skills and evidence-based procedures are essential for maximizing the quality and lowering the cost of care(Rosswurm, &Larrabee, 1999). In the case described by the article, the change is implemented from an intuitive, historical practice without any scientific evidence to an evidence-based procedure. Improving the quality of care requires a change of methods to practices based on sound scientific evidence. The article shows the process of change and how it is controlled as well as challenges facing the process, such as the unwillingness of the participants to change or undertake education programs.

Changes can occur in many levels of intensity and urgency making it difficult to relate theory to the practice of managing change. The articles show an example of the application of change management theory. The change management practices employed in this case can be applied in other adaptations of different levels and magnitudes. Frameworks applied in the case, such as the Plan-Do-Study-Act (PDSA) and Working Together Change Framework (WTCF), can be used by nurses to create a platform for implement change in their practice (Dredge et al. 2017). As observed in the case identifying the values of the individual team members and what motivates them is crucial in effective change management.

I think what I found surprising is that there are healthcare procedures practiced which lack sound scientific evidence. In palliative care, all patients admitted were given emergency subcutaneous medication without any evidence-based reason. This indiscriminate administration of medication can result in an increase in disease resistance to medication and addictions. (Porter & Grills, 2016).

Conclusion

The article describes the change management in a community palliative care service. The change was from prescribing emergency subcutaneous medication to evidence-based practice with a clear criterion for who qualifies to get the emergency medication. Change management is essential to ensure an effective change. The article describes how change was managed to enable smooth service delivery and consumer satisfaction. Many people are involved in the growth and its management. Nurses, allied health, and medical team members have to be involved. This article, therefore, serves as a guide for implementing and effectively managing change to those who work in similar settings. The change management practices employed in this case can be applied in other adaptations of different levels and magnitudes.

References

Dredge, A., Oates, L., Gregory, H., & King, S. (2017). Effective change management within an Australian community palliative care service. British Journal of Community Nursing, 22(11), 536-541.

Porter, G., & Grills, N. (2016). Medication misuse in India: a major public health issue in India. Journal of Public Health, 38(2).

Rosswurm, M. A., &Larrabee, J. H. (1999). A model for change to evidencebased practice. Image: The Journal of Nursing Scholarship, 31(4), 317-322.

Shanley, C. (2007). Management of change for nurses: lessons from the discipline of organizational studies. Journal of nursing management, 15(5), 538-546.