Change management can face several challenges in the organizations and one of them is resistance. Stakeholders may not be willing to adapt to the new changes made and this may attract some resistance. In most cases, resistance is as a result of fear of the unknown, and mostly when people feel threatened by the proposed changes. Innovation, critical thinking and decision-making are at the center of making changes. When employees and the management are lead to innovative, there are chances that they will come up with new ideas that can lead to the need to make changes. To be a change agent in an organization, the leaders should use the right strategies that are suitable to achieve the changes with minimum resistance. Leaders should also ensure that the proposed changes are beneficial and in line with the mission and vision of the organization and that there is adequate communication. All stakeholders should also be involved. Transforming Healthcare at the Bedside is one of the changes that can be implemented to the healthcare centers to improve the quality of services offered.
Review of the Change
The proposed change is to improve the healthcare at the bedside. Between 2003 and 2008, an initiative called Transforming Care at the Bedside (TCAB) was initiated by the Robert Wood Johnson Foundation with the aim of generating and implementing ideas that can lead to better, more consistent, patient-centered and safe nursing practices. Since the launch of the campaign, many changes have been made to it and many states and hospitals have adopted it. By mid-2011, there were about 181 hospitals in seven regions across the United States were using TCAB to promote their services delivery. The demographics of the patients is changing fast and this leads to the need to have different approaches to delivering services. Some of the changes implemented in the healthcare industry are meant to increase the adaptability to these changes and the increased use of technology (Lavoie-Tremblay et al., 2017). The TCAB is a guide to the possible changes in healthcare that can be implemented to increase the efficacy of different departments.
The Context of the Change
The change will take place in the public healthcare emergency department and the wards. It will also be affected in the community health programs, whereby the patients will be given extra attention to minimize medical errors, reduce operational costs and improve the satisfaction of the patients. Research shows that improved healthcare services should be geared towards improved safety and satisfaction of the employees (Gandhi et al., 2018). The changes will affect a number of stakeholders and these include leaders, nurses, support staff and the patients. For the nurses, they will need to adopt the new operations which will include improved concern and patient-centered services delivery. They will be trained on how to ensure that they give the first priority to the patients and their services are satisfactory. The leadership will be affected in that they will need to offer moral support and allocate the required resources to make the change successful. The effect on the patients is that they will have different procedures to follow when they get served. For example, they will be required to provide their electronic health records to the nurses before they get treated.
Review of Literature
The review of the literature shows that the use of TCAB is an effective way of increasing the satisfaction of the nursing services. TCAB promotes the use of better bedside care that increases accuracy and minimizes chances of medical errors (Anderson, Malone, Shanahan & Manning, 2015). The challenges affecting the healthcare sector are usually related to poor communication, inadequate training and lack of concentration on the needs of the patients (La Frentz, Cavalier & Morse, 2016). Patient-centered care increases the focus on the exact needs of the patients and this leads the nurses into focusing on the different needs of the patients (Chiauzzi, Rodarte, & DasMahapatra, 2015). The use of TCAB cannot achieve all the goals of the organizations. Therefore, the healthcare organizations should combine it with other techniques to make sure they get the best out of it. For example, the use of electronic health records (EHR) is an effective way of increasing healthcare efficiency (Boonstra, Versluis & Vos, 2014). The combination will increase the success of the change.
The above research shows that the intended change or introduction of TCAB practices can be achieved if there is a well-designed plan. One of the plans to implement will be to ensure that all patients have electronic health records. The next step of the implementation process will be to offer training to the nurses and the support staff to make sure that they understand what TCAB means and the expected input from them. The third step will be to lobby for resources from the top management and to improve the communication process to make sure that all stakeholders are aware of the intended changes. Most of the intended changes fail due to poor communication and lack of support from the top management. In conclusion, the efforts of the stakeholders will help to achieve all the goals of the changes related to the use of TCAB in public and community health services.
Anderson, J., Malone, L., Shanahan, K., & Manning, J. (2015). Nursing bedside clinical handover-an integrated review of issues and tools. Journal of Clinical Nursing, 24(5-6), 662-671.
Boonstra, A., Versluis, A., & Vos, J. F. (2014). Implementing electronic health records in hospitals: a systematic literature review. BMC health services research, 14(1), 370.
Chiauzzi, E., Rodarte, C., & DasMahapatra, P. (2015). Patient-centered activity monitoring in the self-management of chronic health conditions. BMC Medicine, 13(1), 77.
Gandhi, T. K., Kaplan, G. S., Leape, L., Berwick, D. M., Edgman-Levitan, S., Edmondson, A., ... & Wachter, R. (2018). Transforming concepts in patient safety: a progress report. BMJ Qual Saf, 27(12), 1019-1026.
La Frentz, K., Cavalier, J., & Morse, R. (2016). Transforming Nurse Residency Skills Training Using Simulation: A Deliberate Practice Approach.
Lavoie-Tremblay, M., O'connor, P., Biron, A., Lavigne, G. L., Frechette, J., & Briand, A. (2017). The Effects of the Transforming Care at the Bedside Program on Perceived Team Effectiveness and Patient Outcomes. The health care manager, 36(1), 10-20.
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