Length: 1,500 words
Aim: This assessment provides the student the opportunity to apply and evaluate leadership styles in a scenario involving a change process. Scenario
A recent state-wide quality improvement project has shown that an electronic medical record system improves communication between health care providers and many aspects the individual patient's care. In order to share this knowledge, the state organisation has shared the results on a quality improvement website. The Local Health District that you work for has recently had some critical incidents where communication has been cited as a root cause. These critical incidents occur in the context of a general increase of minor communication incidents over the last three years.
The Local Health district's executive team including the senior Nurse Leaders have reviewed the information on the state's quality improvement website.
The Nurse Leader of the two hundred bed hospital you work in calls the Nurse Unit Managers for a meeting and advises of the general trending increase in communication errors. The Nurse Leader advises that the computer hardware and systems will be available for installation in two months and that there is an expectation that all wards will have adopted the electronic medical record system within six months. Discuss how an effective Nurse Unit Manager would lead this change to address this important patient safety issue. The essay will need to:
— Discuss reasons, using support from the literature, to adopt the fully electronic medication system — Use Lewin's model to outline a plan of change that includes milestones and timeframes — Choose and apply a leadership style to the plan of change. — Critically evaluate the choice and compare with at least one other leadership style — Describe two aspects of potential resistance and discuss how the resistance might be addressed.
Every nurse should abide by the code of conduct of nursing to ensure they are emphasizing on workplace values and principles, thereby creating efficient communication with patients as well. A code of conduct allows guidance in the nursing profession by preventing incompetent behaviour from providing a remarkable nursing performance. The role of the nurse leader here is to ensure everyone in the team is well versed in their responsibilities and duties to provide quality service to the patients. It is the responsibility of the nurses to keep the value of ethics very high and maintain them throughout their service. Apart from serving their professional duties, they have to be morally into this as well. The nurses should be very well aware of the changing times and importance of adaptability to changes. Everybody has a different approach to handling change. Therefore it can be categorized in various types such as the incremental change, organizational change, strategic change, behavioural change, cultural change, and last but not the least transformational change.
The electronic health record system is a part of the electronic medication system, which has an impact on the practice of primary care. It is incredibly beneficial in improving the quality of care, improving health outcomes, and reduction of costs. (Huang et al., 2018) The fully electronic medical system today has become a most used practice to record patient history, their present medical status, and any other information that involves them. It helps to provide applications that use economic, health, social, environmental, and behavioural data to foster better communication and to act upon the intricate healthcare details to offer medication. Hardware became extremely reasonable, compact, and powerful by the year 1992, which led to the use of computers, internet, and local area networks to provide quick and hassle-free access to medical information. (Evans, 2016) It is now a more significant part of the medical world. Still, more remarkable advancement would lead to fully adopting it as a practice to meet the standards of compliance and information security.
The characteristics of implementing an electronic medical record were to facilitate clarification, discussion, and open-ended questions with the patient that involved allowing the patient family to look at the shared screen and maintaining eye contact while communicating with them. (Alkureishi et al., 2016) It acted as a reference point for educating the patients and their families about certain things like the test results and adopting a dynamic role in encouraging questions and clarifying information for the patients. The way the electronic health record works and international personal health records are being used will allow the health care workers to understand the importance of shared health data leading to advanced care coordination with the patient family. (Osman, 2020) This ultimately results in saving valuable time and the need to make perfect decisions.
Lewin’s model of change is the ideal plan that should be incorporated in today’s nursing in every health care facility. Kurt Lewin was known for developing a change model where three steps were followed by unfreezing, changing, and refreezing. ("Lewin's 3-Stage Model of Change: Unfreezing, Changing & Refreezing", 2020) The change model was a straightforward model for understanding the process of change in perception wherever it was necessary, followed by the development of new levels of behaviour as the new norm. The leadership style that is appropriate for this plan of change is transformational leadership. It has become a highly practised leadership style across several industries and has a significant impact on the nursing industry as well. It is a component of the full range leadership model which was proposed in the year 1985 by Bass. (Giddens, 2018) Transformational leadership is known for the ability to create, inspire, and encourage others to focus on relationship building. The characteristics of this leadership style are to make the change by concentrating on the value of relationship building with people.
Transformational change is a way to meet new demands with radical breakthroughs in the behaviour and beliefs over some time. In this case, the lack of communication by the nurses over three years has led to change. If we compare transformational change with organizational change, it is all about centralization and decentralization. There are structural changes in the way the nursing staff has been functioning, which are brought about by systems and processes changes through operational methods such as technology. Over here, the system change would imply upgrading the hospital's electronic system with electronic data interchange, chain automation, enterprise resource planning, and most importantly, through customer relationship management, also known as CRM. Once there are technological changes that further need to be maintained, it would bring about a specific behavioural change amongst them further with the effect of transformational change initially. Transformational leaders do not necessarily lead their team from the front as the responsibilities are delegated amongst their team members. ("Leadership styles: Understanding and using the right one for your situation – Informa Australia", 2020)
The other form of change is the strategic change which involves long term organizational issues such as dealing with the implementation of the change and the aim of the change. It is to determine the purpose and the mission of the organization by studying the corporate philosophy, and one of the popular methods that the nurse leader should carry out is the SWOT analysis which stands for strength, weakness, opportunities, and threats analysis. The nurse leader should address patient safety issues by following a transformational leadership style where the four factors comprise of motivation through arising inspiration amongst the nurses, influencing them through idealized behaviour, and bringing about intellectual stimulation to facilitate individualized consideration amongst them. The nurses should be more proactive and must focus on relationship-oriented behaviour. This automatically will improve them nursing performance and will allow smooth functioning of work without any errors whatsoever. The nursing leader in such a situation becomes the role model who develops and builds trust amongst the team members by a shared vision of interests. It is the responsibility of the nurse leaders to help others gain the confidence to carry out effective means of communication amongst them and the patient family.
The connection between nursing leadership and patient safety is an essential aspect of fostering a safety culture. The factors that lead to such a culture is due to supportive nurse leadership, orientation program, adequate proper training, effective communication, along with open communication that involves a discussion about errors as well. Since compared to doctors, nurses interact the most with the patients; leadership is distinct at every level of nursing to create a safer culture with safe practices. Safe health care is vital in the health care industry when it involves patient health safety and outcomes of the rules.
Dealing with resistance to change is very obvious in situations where the nursing staff has to adapt to a different way of working. It is a normal human response that is applicable at all stages of leadership or hierarchy, even in the healthcare industry. The most remarkable way to deal with resistance to change is by accepting that everybody resists changing whether they open express about it or not. A supportive environment should be created by the nurse leader, where every team member represents their resistance and deals with it in an effective manner. ("Leading and managing change: People in focus - Professionals Australia", 2020) While some respond to change understandably by adapting it according to the workplace requirements, some face troubles adjusting. Although with a proper mind-set where they realize a single change can bring out several beneficial outcomes, they find their ways to accept the change.
Throughout this essay, we have tried to focus on change and importance of upgrading as per the needs of the environment surrounding us. Change has always been termed as a vital part of social and human development for survival. The ideal way to manage change is through proper guidance by the leader who knows how to guide his or her team members towards the path of success. First of all, the leaders should themselves understand the change management process thoroughly to execute it further through an appropriate leadership style. Change involves innovation, evolution, development, progress, improvement, and adjustments in a place where it will be applied. The initial process consists in teaching ways to evaluate the change process, followed by improving the method of communication and using necessary actions wherever needed. Handling change brings about the need to have the proper training to overcome the problem that brought about this change. Thus, it can be said that a safe culture is developed and nurtured with the help of effective leadership. (Murray et al., 2017) It is a moral obligation of all healthcare workers, especially the nurses, to provide safety to patient right from the nurse manager or leader to the bedside nurse. Without good team effort and leadership at all levels, it would get difficult for the staff to provide appropriate high-quality care to attain the ideal patient outcomes. Along with that, the nurses should always be committed to the Code of Ethics and the laws that regulate their professional duties.