LDR 615 Benchmark – Change Initiative: Implementation, Evaluation, and Sustainability Essay
LDR 615 Benchmark – Change Initiative: Implementation, Evaluation, and Sustainability Essay
LDR 615 Benchmark – Change Initiative: Implementation, Evaluation, and Sustainability Essay
Change Initiative: Implementation, Evaluation and Sustainability
Change Initiative: Implementation, Evaluation and Sustainability
Nurses and other healthcare providers play an essential role in promoting optimum health outcomes for the populations they care. They adopt evidence-based interventions that address current and emerging needs in healthcare. Part of the nurses’ role in healthcare entails the analysis of the healthcare environment to identify opportunities for change and improve the performance of their organizations. Safety and quality issues in nursing and healthcare threaten the realization of the desired care outcomes. Therefore, the purpose of this paper is to analyze the issue of medication errors in my practice site and utilization of the developed theory to propose approaches to address it.
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Issues in the Area and Outcomes
The practice site is a hospital that provides general and specialized care for diverse patient populations. The organization leads in the region in the provision of high-quality, safe and efficient care. Despite its reputation, the hospital has witnessed a rise in the medication error rate above the quarterly benchmark data. Medication errors comprise a safety issue in nursing and healthcare. Medication errors are largely defined as preventable events that increases the risk of harm or inappropriate medication use(Escrivá Gracia et al., 2019). Medication errors occur when the medication is under the care or handle of a healthcare provider or patients.
The rise in medication errors have had negative outcomes on patients and the organization. Some of the patients have suffered unintended harm because of the errors. Issues such as drug interactions and adverse drug reaction cause unintended harm to the affected patients. Medication errors have also increased costs that patients incur. The harm from medication errors results in increased length of hospital stay and complex care, hence, high costs of care. Medication errors have also increased resource utilization in the organization. The hospital uses most of its resources to manage preventable harm to the patients, hence, a decline in its performance(Alghamdi et al., 2019; Thomas et al., 2019). Therefore, change initiatives to address the issue of medication errors should be implemented.
External and or Internal Driving Forces
Medication errors arise from some internal driving force. One of them is nursing shortage. The shortage of nurses increases the workload, occupational stress, and burnout among the few nurses. Increased workload and burnout are crucial predictors of medication errors in nursing. The other internal driving force is the number of medications. The risk of a medication error increases when a patient is on multi-drug therapy. Dual therapy also predisposes patients to committing the errors if they have low level of understanding about the use of the medications. The other internal driving force contributing to medication errors is the lack of medication administration protocols. Examples include nurses being non-adherent to the use of the five rights of medication administration and double checking to minimize the risk of medication errors(Alghamdi et al., 2019; Escrivá Gracia et al., 2019; Thomas et al., 2019). The additional internal driving forces include the lack of teamwork, organizational culture, and lack of competency among staff on the use of technologies for medication processes. Medication errors affect patients, nurses, physicians, and pharmacists.
Stakeholders Involved
A change initiative to address the issue of medication should be adopted. The change initiative will involve several stakeholders. They will include nurses, nurse leaders, nurse managers, physicians, and pharmacists. The proposed change entails training the stakeholders about the best practices for the prevention and minimization of medication errors. The proposed change will affect the stakeholders. The change will require the adoption of new behaviors among the healthcare providers(Escrivá Gracia et al., 2019). They will also have to engage in continuous improvement initiatives in the practice site to ensure the adoption of best practices to prevent and minimize medication errors.
Role and Responsibility as a Change Leader
I will play several roles as a change leader. One of the roles is assessing readiness for change among the stakeholders. Informed assessment data should inform the implementation of the proposed change. Change leaders utilize interventions such as administering staff surveys and interviewing them to determine the readiness for change and needs. The other role is communicating the need for change. The adopters of change should be made away of why the existing system and processes should change. They should be provided with accurate information about the negative effect of the current situation and need for change.The other role as a change leader is managing change. The risk of resistance to change among the adopters is high. As a result, I will adopt interventions such as staff training and their active involvement to facilitate their readiness of change(Dang et al., 2021). The additional roles include communicating plans for change, keeping track of change initiatives, and connecting change initiative to strategy.
Leadership Theory
I will adopt participative leadership theory when implementing the proposed change. Participative leadership theory recognizes the need for leaders seeking input from the followers before implementing an initiative. Leaders encourage followers to express their insights into how to implement the change and best strategies to achieve the desired outcomes. Participative theory will promote stakeholder empowerment and ownership of the change initiative(Dang et al., 2021; Nilsen et al., 2020). I will retain the right to enable the followers to give input about the change.
Change Agents and their Roles
The change agents for the proposed change will be varied. They will include nurse leaders, nurse managers, a physician and pharmacist. Nurse leaders will lobby for the resources needed for the change. They will also provide supervisory roles in the change implementation process. They will provide insights into best practices that can be adopted to achieve the desired project outcomes. Nurse managers will work closely with the nurses in the implementation of change. They will provide the supervisory role and obtain feedback from the nurses on how the change outcomes can be improved further. The physician and pharmacist will be involved in the development of change strategies that will meet the needs of other physicians and pharmacists. They must be involved in the process since they prescribe and dispense drugs. Therefore, their role contributes to the medication errors in nursing and healthcare.
Utilization of the Change Model
The developed model is applicable for use in the proposed change. The model has steps that include needs assessment, planning, implementation, monitoring, evaluation and communicating findings. The model is relevant to my organization because of some reasons. First, it supports continuous improvement of systems and processes. The systematic and interdependence of the steps imply that its use enable the adoption of best practices only in the implementation of change(Bonawitz et al., 2020). The relevance to the organization is also attributed to the fact that the model supports efficiency by assessing the need of a change in addressing the organization’s needs before its adoption.
The developed model has a range of strategic aspects. One of them is the identification of the relevance of the change in the needs analysis stage. The needs analysis also ensures the alignment of change with the organization’s vision and mission. The other strategic aspect is the development of goals, objectives, and strategies in the planning phase. The stakeholders that include nurses, physicians, and pharmacists use the assessment data to develop a plan of action. The other strategic aspects include training, open communication seeking and communicating feedback in the implementation, monitoring, and evaluation stages(Heinen et al., 2019). The change stakeholders that include nurses, physicians, and pharmacists will undertake these roles.
Potential Barriers to Change and How to Overcome Them
The implementation of the change may face some barriers. One of them is inadequate support from the hospital. Inadequate support may arise from competing needs in an organization that affect resource use and allocation. This barrier will be addressed by aligning the aims of the change with the organization’s mission. Aligning will enhance the need and relevance of the proposed change. The other potential barrier is resistance from the staff. The staff may not be willing to adopt the change. This may arise from factors such as fear of the unknown impact of the change, lack of knowledge and skills related to the change(Dang et al., 2021). Strategies such as training and education, active stakeholder participation, open communication, and rewarding performance will be adopted to address this barrier.
Evaluation Methods
Outcome and process measures will be used to evaluate the change. Outcome measures provide insights into the effectiveness of the adopted interventions in achieving the set results in the change initiative. Process measures evaluate the effectiveness of the strategies that were used to implement the project. Outcome measures will include the rates of medication errors, costs of care, length of hospital stay, and harms due to medication errors following the implementation of change. The data on these measures will be obtained before and after the change and analyzed to have a clear understanding of the impact of the change on clinical outcomes. Process measures will include staff perceptions about the effectiveness of training, engagement strategies, resources management, and teamwork approaches that were used in the project implementation(Jeffries, 2022). Surveys and interviews will be conducted among the staff to obtain information about their subjective experiences with the change.
Strategies to Anchor Change or Support Continuous Change
It is important to support continuous change to enhance safety and quality in the practice site. One of the strategies that should be considered to achieve this objective is the provision of regular training and education to the staff. Regular training and education would empower them with the competencies needed to support the use of best practices to minimize and prevent medication errors. The other strategy is regular assessment and providing feedback(Moran et al., 2023). The assessment data will inform continuous improvements in the organization’s systems and processes.
How the Plan Supports the Organizational Mission/Goal
The change plan supports the organizational mission of promoting safety and quality in the patient care processes. The reduction and prevention of medication errors eliminate any risk of unintended patient harm, hence, safety and quality. The change also aligns with the organization’s goal of implementing initiatives that contribute to evidence-based practice. The proposed change will improve the existing systems and processes, which will form part of the evidence-based strategies in the organization.
Conclusion
The issue identified in the practice site is medication errors. Several internal factors contribute to the problem. The developed change model is relevant to the organization. The model will inform the strategies that will be adopted to achieve the desired change outcomes. Stakeholders will be actively involved to ensure sustainable change.
References
Alghamdi, A. A., Keers, R. N., Sutherland, A., & Ashcroft, D. M. (2019). Prevalence and Nature of Medication Errors and Preventable Adverse Drug Events in Paediatric and Neonatal Intensive Care Settings: A Systematic Review. Drug Safety, 42(12), 1423–1436. https://doi.org/10.1007/s40264-019-00856-9
Bonawitz, K., Wetmore, M., Heisler, M., Dalton, V. K., Damschroder, L. J., Forman, J., Allan, K. R., & Moniz, M. H. (2020). Champions in context: Which attributes matter for change efforts in healthcare? Implementation Science, 15(1), 62. https://doi.org/10.1186/s13012-020-01024-9
Dang, D., Dearholt, S. L., Bissett, K., Ascenzi, J., & Whalen, M. (2021). Johns Hopkins Evidence-Based Practice for Nurses and Healthcare Professionals: Model and Guidelines, Fourth Edition. Sigma Theta Tau.
Escrivá Gracia, J., Brage Serrano, R., & Fernández Garrido, J. (2019). Medication errors and drug knowledge gaps among critical-care nurses: A mixed multi-method study. BMC Health Services Research, 19(1), 640. https://doi.org/10.1186/s12913-019-4481-7
Heinen, M., van Oostveen, C., Peters, J., Vermeulen, H., & Huis, A. (2019). An integrative review of leadership competencies and attributes in advanced nursing practice. Journal of Advanced Nursing, 75(11), 2378–2392. https://doi.org/10.1111/jan.14092
Jeffries, P. (2022). Clinical Simulations in Nursing Education: Advanced Concepts, Trends, and Opportunities. Lippincott Williams & Wilkins.
Moran, K. J., Burson, R., & Conrad, D. (2023). The Doctor of Nursing Practice Project: A Framework for Success. Jones & Bartlett Learning.
Nilsen, P., Seing, I., Ericsson, C., Birken, S. A., &Schildmeijer, K. (2020). Characteristics of successful changes in health care organizations: An interview study with physicians, registered nurses and assistant nurses. BMC Health Services Research, 20(1), 147. https://doi.org/10.1186/s12913-020-4999-8
Thomas, B., Paudyal, V., MacLure, K., Pallivalapila, A., McLay, J., El Kassem, W., Al Hail, M., & Stewart, D. (2019). Medication errors in hospitals in the Middle East: A systematic review of prevalence, nature, severity and contributory factors. European Journal of Clinical Pharmacology, 75(9), 1269–1282. https://doi.org/10.1007/s00228-019-02689-y
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Assessment Description
You will utilize your change model for this assignment. Review the feedback submitted by your instructor on your previous change model assignment. Make any changes or modifications necessary for the submission of this assignment.
Evaluate the performance of your organization or department. Identify an area that would significantly benefit from initiating a change. Write a paper (1,500-1,750 words) in which you describe the particular area you propose to address through a change initiative. Include the following for your company:
Discuss the issues in this area and the current outcomes as a result of the issues.
Describe the external and/or internal driving forces, contributing issues, and the people affected.
Evaluate the stakeholders involved and discuss how they will be affected by your change initiative.
Clarify your role and responsibility as a change leader. Discuss the leadership theory (or theories) you will use to guide the change process.
Discuss the change agents you need to recruit in order to successfully implement your change. Describe the roles of these change agents.
Utilize your change model to develop strategies: (a) Explain the relevance of this model to your organization; and (b) Present the strategic aspects using your model. Be sure to clearly define the purpose of each aspect, the people involved, and the actions that need to be taken.
Identify, or predict, the potential barriers to change. Discuss possible ways to overcome these obstacles, including methods for dealing with emerging or unforeseen circumstances that could impede implementation.
Describe the evaluation methods you will use to determine the level of success of your change initiative. Discuss what metrics or measureable determinates you will use.
Propose strategies to anchor change or support continuous change.
Establish how your change plan supports the organizational mission/goal, genuinely addresses stakeholder concerns, and will serve as an equitable contribution for the community or society overall.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Benchmark Information
This benchmark assignment assesses the following programmatic competencies:
MSL, MBA, MSL in Leadership with an Emphasis in Homeland Security and Emergency Management 1.5
Demonstrate flexibility and adaptability in response to changing or unknown circumstances.
MSL, MSL in Leadership and Homeland Security and Emergency Mgmnt 3.5; MBA and MSN Leadership in Health Care Systems 6.2; MBA and MSL 6.5
Develop strategy for implementing and managing change within an organization.
Benchmark – Change Initiative: Implementation, Evaluation, and Sustainability – Rubric
LISTGRID
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Rubric Criteria
Total250 points
Criterion
1. Unsatisfactory
2. Less than Satisfactory
3. Satisfactory4. Good
5. Excellent
The Need for Change
The Need for Change
0 points
The need for change including specifying the issue and the current outcomes resulting from the issue is not discussed.
18.5 points
The need for change including specifying the issue and the current outcomes resulting from the issue is discussed, but discussion is incomplete or inaccurate.
19.75 points
The need for change including specifying the issue and the current outcomes resulting from the issue is included, but discussion is cursory and lacking in depth.
21.75 points
The need for change including specifying the issue and the current outcomes resulting from the issue is discussed, including all necessary elements.
25 pointsThe need for change including specifying the issue and the current outcomes resulting from the issue is thoroughly discussed with rich detail, including all necessary elements.
Driving Forces
Driving Forces
0 points
Description of internal and/or external driving forces, contributing issues, and people affected is not included.
9.25 points
Description of internal and/or external driving forces, contributing issues, and people affected is incomplete or inaccurate.
9.88 points
Description of internal and/or external driving forces, contributing issues, and people affected is included, but discussion is cursory and lacking in depth.
10.88 points
Description of internal and/or external driving forces, contributing issues, and people affected is discussed, including all necessary elements.
12.5 points
Description of internal and/or external driving forces, contributing issues, and people affected is thoroughly discussed with rich detail, including all necessary elements.
Stakeholder Evaluation
Stakeholder Evaluation
0 points
Evaluation of stakeholders and how they will be affected by the change initiative is not included.
9.25 points
Evaluation of stakeholders and how they will be affected by the change initiative is incomplete or inaccurate.
9.88 points
Evaluation of stakeholders and how they will be affected by the change initiative is included, but discussion is cursory and lacking in depth.
10.88 points
Evaluation of stakeholders and how they will be affected by the change initiative is discussed, including all necessary elements.
12.5 points
Evaluation of stakeholders and how they will be affected by the change initiative is thoroughly discussed with rich detail, including all necessary elements.
The Role of the Leader in the Change Initiative
The Role of the Leader in the Change Initiative
0 points
The role of the leader in the change initiative is not addressed.
18.5 points
The role of the leader in the change initiative is present, but it is incomplete or inaccurate.
19.75 points
The role of the leader in the change initiative is presented, but it is cursory and lacking in depth.
21.75 points
The role of the leader in the change initiative is presented and includes discussion of all necessary elements.
25 points
The role of the leader in the change initiative is thoroughly presented with rich detail and includes discussion of all necessary elements.
Change Agents and Roles
Change Agents and Roles
0 points
Discussion of necessary change agents and their respective roles in implementing change is not included.
18.5 points
Discussion of necessary change agents and their respective roles in implementing change is incomplete or inaccurate.
19.75 points
Discussion of necessary change agents and their respective roles in implementing change is included, but discussion is cursory and lacking in depth.
21.75 points
Discussion of necessary change agents and their respective roles in implementing change is discussed, including all necessary elements.
25 points
Discussion of necessary change agents and their respective roles in implementing change is thoroughly discussed with rich detail, including all necessary elements.
Application of the Change Model to Develop Strategies (B)
Application of the Change Model to Develop Strategies Develop strategy for implementing and managing change within an organization. (C 3.5, 6.5)
0 points
The change model is not applied to develop strategies.
18.5 points
The change model is applied, but the resulting strategies are incomplete or inaccurate.
19.75 points
The change model is applied, but the resulting strategies are cursory and lacking in depth.
21.75 points
The change model is thoroughly applied and the resulting strategies include all necessary elements.
25 points
The change model is thoroughly applied with rich detail and the resulting strategies include all necessary elements.
Overcoming Barriers to Change (B)
Overcoming Barriers to Change Demonstrate flexibility and adaptability in response to changing or unknown circumstances. (C 1.5)
0 points
Overcoming barriers to change is not addressed.
18.5 points
Overcoming barriers to change is presented, but it is incomplete or inaccurate.
19.75 points
Overcoming barriers to change is presented, but it is cursory and lacking in depth.
21.75 points
Overcoming barriers to change is presented and includes discussion of all necessary elements.
25 points
Overcoming barriers to change is thoroughly presented with rich detail and includes discussion of all necessary elements.
Evaluation Methods
Evaluation Methods
0 points
Evaluation methods for determining the success of the change initiative are not included.
18.5 points
Evaluation methods for determining the success of the change initiative are incomplete or inaccurate.
19.75 points
Evaluation methods for determining the success of the change initiative are included but lack specific metrics or measurable determinants and relevant details.
21.75 points
Evaluation methods for determining the success of the change initiative are complete and include specific metrics or measurable determinants and relevant details.
25 points
Evaluation methods for determining the success of the change initiative are extremely thorough with specific metrics or measurable determinants clearly defined and numerous relevant details.
Strategies for Sustaining Change
Strategies for Sustaining Change
0 points
Strategies for sustaining change are not addressed.
9.25 points
Strategies for sustaining change are incomplete or inaccurate.
9.88 points
Strategies for sustaining change are presented, but discussion is cursory and lacking in depth.
10.88 points
Strategies for sustaining change are complete and include discussion of all necessary elements.
12.5 points
Strategies for sustaining change are thoroughly presented with rich detail and include discussion of all necessary elements.
Overall Effectiveness of Change Plan
Overall Effectiveness of Change Plan
0 points
Discussion of how the change plan supports the organizational mission and goals, addresses stakeholder concerns, and contributes to the community of society is not included.
9.25 points
Discussion of how the change plan supports the organizational mission and goals, addresses stakeholder concerns, and contributes to the community of society is incomplete or inaccurate.
9.88 points
Discussion of how the change plan supports the organizational mission and goals, addresses stakeholder concerns, and contributes to the community of society is cursory and lacking in depth.
10.88 points
Discussion of how the change plan supports the organizational mission and goals, addresses stakeholder concerns, and contributes to the community of society is presented and includes discussion of all necessary elements.
12.5 points
Discussion of how the change plan supports the organizational mission and goals, addresses stakeholder concerns, and contributes to the community of society is thoroughly presented with rich detail and includes discussion of all necessary elements.
Thesis Development and Purpose
Thesis Development and Purpose
0 points
Paper lacks any discernible overall purpose or organizing claim.
5.55 points
Thesis is insufficiently developed or vague. Purpose is not clear.
5.93 points
Thesis is apparent and appropriate to purpose.
6.53 points
Thesis is clear and forecasts the development of the paper. Thesis is descriptive and reflective of the arguments and appropriate to the purpose.
7.5 points
Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.
Argument Logic and Construction
Argument Logic and Construction
0 points
Statement of purpose is not justified by the conclusion. The conclusion does not support the claim made. Argument is incoherent and uses noncredible sources.
9.25 points
Sufficient justification of claims is lacking. Argument lacks consistent unity. There are obvious flaws in the logic. Some sources have questionable credibility.
9.88 points
Argument is orderly, but may have a few inconsistencies. The argument presents minimal justification of claims. Argument logically, but not thoroughly, supports the purpose. Sources used are credible. Introduction and conclusion bracket the thesis.
10.88 points
Argument shows logical progressions. Techniques of argumentation are evident. There is a smooth progression of claims from introduction to conclusion. Most sources are authoritative.
12.5 points
Clear and convincing argument that presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.
Mechanics of Writing (includes spelling, punctuation, grammar, and language use)
Mechanics of Writing (includes spelling, punctuation, grammar, and language use)
0 points
Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is employed.
9.25 points
Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.
9.88 points
Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.
10.88 points
Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.
12.5 points
The writer is clearly in command of standard, written, academic English.
Paper Format (use of appropriate style for the major and assignment)
Paper Format (use of appropriate style for the major and assignment)
0 points
Template is not used appropriately or documentation format is rarely followed correctly.
3.7 points
Appropriate template is used, but some elements are missing or mistaken. A lack of control with formatting is apparent.
3.95 points
Appropriate template is used. Formatting is correct, although some minor errors may be present.
4.35 points
Appropriate template is fully used. There are virtually no errors in formatting style.
5 points
All format elements are correct.
Documentation of Sources
Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)
0 points
Sources are not documented.
9.25 points
Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.
9.88 points
Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.
10.88 points
Sources are documented, as appropriate to assignment and style, and format is mostly correct.
12.5 points
Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.
