Planned Change in a Department or Unit - Research Paper

Introduction

In various healthcare organizations, change is commonly based on addressing emerging challenges in a given department or healthcare unit. The healthcare leaders have a role of developing as well as implementing profound change strategies which help in achieving the mission, vision, and importantly the goals and values of the healthcare organization.

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Moreover, the establishment of the key changes is generally based on theories and also frameworks which explain the processes to follow in ensuring the implementation of the strategies to address a specific change. Hence, this particular will focus on significant challenges that manifest at a given national hospital where there are challenges of patient monitor alarms which involve complaints and grievances among the patients based on the disturbances of these alarms. The planned change is based explicitly on the Kurt Lewin theory of change.

Problem Identification

Alarm Fatigue

I work at a national hospital assisting patients with various health problems to get adequate treatment. Even though, there has been a challenge in monitoring alarms which causes disturbances to the patients in their rooms. Patient monitoring alarm is necessary since there are situations where there are medical devices which are not necessary or times false in a situation which does not require monitoring (Graham 2010). Thus, reducing unnecessary alarms should be taken into consideration as this majorly minimizes the likelihood of alarm fatigue hence making it easier to translate the basic knowledge of the alarm-related problems. However, Alarm fatigue usually represents cases of sensory overload due to the increased number of nonactionable or false alarm signals which can greatly affect any of the healthcare institutions with the hospitalized patients (Cvach 2012).

Specific, Realistic Change That Could Be Made To Address The Issue

Since this desensitization can lead to longer response times as well as missing important alarms for the patients (Sendelbach 2013), in the healthcare unit where I work, one of the common, frequent devices that alarm is the physiological monitor.

Moreover, realistic change that could be made to address the issue of the alarm fatigue involves reducing the effect of the following contributors':

• The impact of the artifacts in the waveform;
• The alarm settings, delays as well as limits;
• Better ways of setting alarms based on the clinical population as opposed to individual patients;
• Educating patients.

The Effects of the Artifacts in the Waveform

The effects of the artifacts are majorly caused by the poor lead preparations and problems with the adhesive replacements as well as placements. Moreover, these artifacts can as well cause alarms highlighting system malfunctions known as the technical alarms, for example, leads off the alarm (Sendelbach 2012). Also, they can as well lead to alarms in cases where the monitor falsely perceives arrhythmias.

The Alarm Settings, Delays As Well As Limits

The national hospital especially the department where I work accepts the factory set defaults for the devices in areas including minimum and maximum heart rate and SPO2. However, these default settings may not necessarily meet workflow expectations when the baseline of your patient does not meet the normal healthy adult population (Sendelbach 2012). A cross-disciplinary team is supposed to prioritize the alarm parameters and also make decisions regarding the type of the alarm "visual vs. audio" that will take place for each alarm unit.

Better Ways of Setting Alarms Based On the Clinical Population As Opposed To Individual Patients

The default settings are more useful in cases where the patient first arrive in the department or unit. They can simply act as a safety net specifically detecting significant deviations from a common population of patients in the unit. However, there are recommendations for the alarms to configured for each patient own normal which will be implemented at a unit at which an action or the intervention will be highly required (Welch 2012).

Educating Patients

Patients should be educated on the need for the alarms in every healthcare unit, as well as the actions that should be carried out in case the alarm goes off. Also, the practices will include how the alarms may be interfering with the patient's sleep or rest. Also, the discussion of the alarms settings as well as changes to the settings should involve the patient's feedback, including the training for the patient so that they fully understand the rationale associated with the adjustments as well as what is likely to happen(Welch 2012).

Hence, I propose that in reducing as well as eliminating alarm fatigue will greatly help in improving the quality of the healthcare services and on the other hand, nurses will be better placed to meet the continuous patient needs (Welch 2012). Also, I propose adjusting monitor alarms as a viable change policy which will improve a lot the healthcare outcomes as well as helping in reducing the alarm fatigue.

How the Change Would Align With the Organization’s Mission, Vision, and Values as Well as Relevant Professional Standards

Mission

The national hospital mission statement is to listen and care specifically for the patients as well as the community around. Hence, the change with aligning with an organizational mission in ensuring that the patient fully listens to and cared for (Cummings 2016).Vision

The vision statement of the national hospital is to be a world-class patient-centered which specialized care hospitals. Hence, the change will aim at specializing in patients services for better care.

Core Values

The core values which are aligned with this change include the following; customer focus, accountability, security and safety, equity and equality and also professionalism and integrity (Cummings 2016). These core values will greatly help in monitoring alarm fatigue to help patients have a conducive environment for healthcare services.

A Change Model Or Strategy To Guide Your Planning For Implementing The Change.

To kick off any successful change process, one must start understanding the reasons as to why the given change must take place. Hence, as Kurt Lewins states it motivation for change must be ensured before change can occur (Cummings 2016).

Unfreeze Strategy

The next stage of change is ensuring that the national hospital accepts that change is necessary. The unfreeze strategy will involve breaking down the existing status quo of fatigue alarms before the healthcare unit can build up a new way of operating (Cummings 2016).

Change Strategy

Immediately after the uncertainty in the unfreezing stage, the change stage is where the organization starts to resolve the uncertainty and also look for the new ways of doing things, for instance, monitoring the fatigue alarms (Cummings 2016). The national hospital will start to believe as well as acting in new ways that specifically supports the new direction.

Refreeze Strategy

As a result of changes taking shape and patients have embraced the new ways of working; the institution is ready to refreeze since the outwards signs of refreezing are such stable and needs to help patients (Sutherland 2013). The refreeze strategy will ensure that the changes put in place to monitor fatigue alarms are used all the time.

Rationale for Selection

The unfreeze strategy will majorly help in determining the need for change, understanding why the change has to take place also it will help in ensuring there is support from the senior management of the national hospital (Sutherland 2013). The change strategy stage will help in communication often as well as explaining exactly how the changes will affect everyone as well as involving patients in the process. Moreover, refreeze strategy stage will help in developing ways to sustain change as well as ensuring leadership support.

Outline the Steps That You and Others Would Follow To Facilitate the Change

For one to follow and facilitate the required changes in the health unit, one has to:

• Create problems awareness;
• Create change/move;
• Refreezing.

Align These Steps With Changing Strategies

In creating awareness in the institution like a national hospital, it's possible for patients to let go of the old patterns and also to undo the current ways; for instance, changing the status quo. However, in changing/ moving will help in seeking alternatives as well as demonstrating the benefits of a change in monitoring fatigue alarms (Kazmi 2013). Moreover, refreezing will help to integrate and also stabilize the new changes implemented by the institution.

Who Will Be Involved in Initiating and Managing the Change in National Hospitals?

The head departments, as well as the top management, are the key individual who will be involved effectively in the initiating and also managing the changes in the healthcare unit. It's because the individuals can manage change which involves handling the complexity of the work in the unit. It's also about evaluating, planning, tactics, strategies as well as implementing operations.

Skills and Characteristics Necessary to Facilitate the Change Effort

Persuasive

The skill helps a leader to be persuasive and also aid in facilitating changes in the department. Also, by being persuasive as well as a charismatic leader helps in making change easier for the patients (Puccio 2010).

Confidence

In the healthcare department, the patient may question the abilities of the head of the department as well as the top manager; also there may be such question such as how monitoring the fatigue alarm would affect the future patients in the hospitals (Cummings 2014).

Communication

Change in an institution like a hospital can cause patients to become concerned hence; a manager who shut herself/himself in the office while change is being implemented is irrelevant to the entire institution (Cummings 2014). Moreover, communicating before, during and also after the change process is essential in making sure that change causes minimal disruption as possible.

References

Cummings, S., Bridgman, T., & Brown, K. G. (2016). Unfreezing change as three steps: Rethinking Kurt Lewin's legacy for change management. Human relations, 69(1), 33-60.Cummings, T. G., & Worley, C. G. (2014). Organization development and change. Cengage Learning.

Cvach, M. (2012). Monitor alarm fatigue: an integrative review. Biomedical instrumentation & technology, 46(4), 268-277.Graham, K. C., & Cvach, M. (2010). Monitor alarm fatigue: standardizing the use of physiological monitors and decreasing nuisance alarms. American Journal of Critical Care, 19(1), 28-34.

Kazmi, S. A. Z., & Naarananoja, M. (2013, January). Comparative approaches of key change management models-a fine assortment to pick from as per situational needs!. In International Conference on Business Strategy and Organizational Behaviour (BizStrategy). Proceedings (p. 217). Global Science and Technology Forum.

Puccio, G. J., Mance, M., & Murdock, M. C. (2010). Creative leadership: Skills that drive change. Sage Publications.

Sendelbach, S. (2012). Alarm fatigue. Nursing Clinics, 47(3), 375-382.Sendelbach, S., & Funk, M. (2013). Alarm fatigue: a patient safety concern. AACN advanced critical care, 24(4), 378-386.

Sutherland, K. (2013). Applying Lewin's change management theory to the implementation of bar-coded medication administration. Canadian Journal of Nursing Informatics, 8(1-2).

Welch, J. (2012). Alarm fatigue hazards: the sirens are calling. Patient Saf Qual Healthc, 9(3), 26-33.