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Health care management can be seen as the optimization of internal and external processes within the institution. The effective manager affects the levels of income and expenses, administers the work of the personnel, and ensures the implementation of organizational objectives (DeWit & Kumagai, 2014). Moreover, successful managers know the ways to influence employee teams through the application of diverse leadership styles. It should be noted that any management process takes place in particular political, social, and economic conditions; the changes in these conditions entail alterations in the management style as well. In this regard, managers must adapt their strategies to introduce the changes in a proper way (Media-Partners, n.d.).
The manager may apply reinforcement and incentive methods, regulate the performance of the employees through communication strategies and motivation, utilize the techniques to optimize the work processes, and increase the responsibility of the staff through the corresponding initiatives. The practicum change is concerned with strategies to prevent pressure ulcers occur in intermediate patients at Kendall Regional Medical Center (KRMC), and it is essential to consider all the possible aspects of its implementation to ensure that the management staff will be able to execute the change in the most effective way.
Abstract
Pressure ulcer (also referred to as pressure/bedsore, and decubitus ulcer) is an area of locally damaged tissue formed by unrelieved pressure. As a rule, it locates over a bony prominence (DeWit & Kumagai, 2014). Such ulcers may cause ischemia, necrosis, and cell death. Risk groups include patients of various backgrounds with varied health status. For instance, patients suffering from serious diseases or those having spinal cord injuries are among the representatives of the risk group. Moreover, patients, whose mobility is impaired, rather frequently develop pressure ulcers. The people who wear prostheses or a plaster cast and completely paralyzed individuals fall in the risk group as well.
It should be mentioned that patients with obesity or some other nutrition problems might also develop the disease (DeWit & Kumagai, 2014). Apart from that, older adults and pregnant women should be aware of the possibility to develop pressure ulcers due to decreased mobility and other health-related issues. In general, pressure ulcers can be caused by improper posture, which aggravates pressure on bones or some unsuitable equipment. It is assumed that the creation of a team of qualified specialists (staff nurses, nurse managers, nutritionists, pharmacists, physicians, and senior leader) that will have the necessary knowledge and expertise would allow furnishing more effective care and achieve better nursing and patient outcomes.
However, the successful implementation of the proposed change requires effective coordination and collaboration of the key stakeholders that include both the patients, their families, and the nursing team (DeWit & Kumagai, 2014). The core of the negotiation plan lies in a well-trained and equipped team and the active engagement of the stakeholders to achieve the desired outcome, which is the reduced occurrence of pressure ulcers.
Audience
It is assumed that the leadership of the KRMC is the main audience of the practicum project since it is the leading agent in the change management. The hospital leadership is liable for regulating the organizational and policy issues and administering the action plan for the staff, which is essential for the successful improvement of care provision in the center (Media-Partners, n.d.). The leadership is to eliminate the individualistic behaviors of the employees to ensure that the key stakeholders can collaborate efficiently. Regarding the negotiation plan, communication within the hospital must be organized in an orderly manner to facilitate the effective execution of the change management.
The Problem
The success of change management directly depends on several external and internal factors. Thus, it is important to mitigate the possible barriers to the change in project implementation. Some of the barriers are related to patients. For instance, they should be knowledgeable of the risks of impaired mobility, and they should be informed about the preventive measures in due time. Further, the health care team should collect information about the patients condition related to pressure ulcers within the first 8 hours of his/her hospitalization to be able to eliminate the risk factors (Frontera, Silver, & Rizzo, 2014). Also, the team of specialists is to obviate the extrinsic factors that can cause pressure ulcers. Thus, the prevention of the disease requires effective communication skills of all the employees, the timely care provision and preventive measures, the specific training, expertise, and coordination of the nursing staff. The active collaboration and sharing of knowledge should be encouraged to achieve better patient results.
Change Theory
The objective of the change theory is to manage the implementation of the change project to prevent pressure ulcers in KRMCs patients. In this relation, the concept of Lean focuses on the patients as a Quality Improvement Tool. This approach will allow assessing the needs of patients and determine the value (Scully & Wilson, 2014). The theory implies the elimination of non-value-added activities, which means avoiding the redundant actions that do not result in effective disease prevention. Moreover, the application of modern technologies will ensure the reduction in manual labor and eliminate wastes in the process. Most importantly, the Lean concept focuses on systematic improvement of care provision and preventive measures, which denotes the identification of root causes to prevent problems in perspective.
Proposed Change Strategies
The proposed change project is aimed at creating a team of qualified specialists (staff nurses, nurse managers, nutritionists, pharmacists, physicians, and senior leaders) and providing protective devices to ensure comfortable positioning and protection from the external risks (Sarasua et al., 2011). The employees will be involved in educational programs oriented at training them in the use of the technologies for prevention purposes. It is planned to conduct an in-depth study of the state of the environment, objectives, and developed project methods and adopt solutions for efficient use of available resources in the organization. An essential part of the strategy is changing the organizational culture of the KRMC.
Stakeholders
The key stakeholders include both the patients and the KRMC team. The prevention of pressure ulcers should start with patients and their family members to ensure that patients themselves take preventive measures. In the case of paralyzed patients, the family should be liable for the implementation of preventive care. Further on, the team is one of the main stakeholders. The staff nurses, nurse managers, nutritionists, pharmacists, and physicians are involved in care provision for the patients, and they should be trained in effective practices including manual labor and modern technology. The team is responsible for monitoring the patients health status in terms of immobility, poor nutrition, dehydration, and so on. Consequently, proper training is necessary to ensure that the care provider is initiated within a reasonably short period. The team should be coordinated properly to avoid producing wastes in the process of furnishing aid.
Change Process
The process of change will be based on a new approach to the management of the organization focused on quality improvement. The quality change will be achieved through the involvement of all personnel members as well as the key stakeholders. The principle of staff involvement will provide a permanent joint work of all employees of the organization to achieve the project objective, which is the prevention of the pressure ulcer (Sarasua et al., 2011). The involvement of staff can be reached after the employees will gain insights into the project and after the leadership will create the necessary working and educational environment.
Since the organization is composed of various specialized units, which have a vertical management hierarchy, these units will be connected through associated processes, which will provide the horizontal interaction. Thus, the processes will become part of the general processes of the organization. The practice of individual units will be integrated into larger ones throughout the center, and that will allow reaching the main strategic aim (Perry, Potter, & Ostendorf, 2015). Also, continuous permanent improvement will be conducted to enable the center to apply both analytical and creative methods of quality improvement. Also, during the change project, effective communication will play a significant role in maintaining motivation and awareness of employees at all levels of management. The communication on the changes must become a part of daily activities. Consequently, KRMC will promote the change project as a part of its formal and informal organizational culture through the application of the official policies and procedures.
Communication Plan and Negotiation Strategies
As stated earlier, effective communication and negotiation strategies are integral to successful change management. It is planned to provide informational and educational support to all the key stakeholders. The strategy envisages staff education on aspects of the project through mass communications and facilitation of their trust in the consistency of management actions. The internal network will allow two-way communication. For instance, meetings of managers with the personnel and coaching groups would enable exchanging ideas and sharing the knowledge on the preventive strategies (Scully & Wilson, 2014). Thus, the employees will receive the necessary information and will be able to ask questions or express their perceptions and suggestions.
Additionally, the plan includes collective group settings (personnel consulting) to gather the staff views and perceptions. Employee participation is indeed crucial for the center as it is a way to encourage them to make suggestions often in conjunction with introducing relevant policies and guidelines to educate the stakeholders about the implemented change. Finally, yet importantly, groups of workers, along with line managers will be able to examine thoroughly and develop ideas and processes related to the proposed project as well as to solve the emerging problems.
Conclusion
Pressure ulcers are an issue of paramount importance as they are associated with the risk of death if not addressed timely. The application of educational strategies for the key stakeholders as well as the introduction of modern technologies will facilitate the effective prevention of possible complications. The KRMCs management has an important task to implement the change bearing in mind that the success of the project depends on numerous factors and forces that may interfere with its implementation. For that reason, the management must apply leadership to facilitate the change for achieving better patient outcomes.
References
DeWit, S., & Kumagai, C. (2014). Medical-surgical nursing. New York, NY: Elsevier.
Frontera, W., Silver, J., & Rizzo, T. (2014). Essentials of physical medicine and rehabilitation. New York, NY: Elsevier.
Media-Partners. (n.d.). What a manger should say [Video file]. Web.
Perry, A., Potter, P., & Ostendorf, W. (2015). Nursing interventions & clinical skills. New York, NY: Elsevier.
Sarasua, J., Lopez, S., Viejo, M., Basterrechea, M., RodrÃguez, A., Gutiérrez, A.,&Hernández, O. (2011). Treatment of pressure ulcers with autologous bone marrow nuclear cells in patients with spinal cord injury. The Journal of Spinal Cord Medicine, 34(3), 301-307.
Scully, N., & Wilson, D. (2014). Clinical cases. New York, NY: Elsevier.
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