Assignment: Evolving Health Care

Assignment: Evolving Health Care

Assignment: Evolving Health Care

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Change is inevitable, if not always welcome. Organizational change is essential for adaptation; creative change is mandatory for growth (Heath & Heath, 2010). Change, though, is a continu- ally unfolding process rather than an either/or event. The process begins with the present state, is disrupted, moves through a transition period, and ultimately comes to a desired state. Once the desired state has been reached, however, the process begins again.

Leading change is never needed more in today’s rapidly evolving system of health care. Those who initiate and manage change often encounter resistance. Even when planned, it can be threatening and a source of conflict because change is the process of making something different from what it was. There is a sense of loss of the familiar, the status quo. This is particu- larly true when change is unplanned or beyond human control. Even when change is expected and valued, a grief reaction still may occur.

Although nurses should understand and anticipate these reactions to change, they need to develop and exude a different approach. They can view change as a challenge and encourage their colleagues to participate. They can become uncomfortable with the status quo and be willing to take risks.

This is a particular fortuitous time for the nursing profession (Nickitas, 2010). The Institute of Medicine’s report on the future of nursing proposes radical change for the profession (IOM, 2010). Specifically, they propose:

● Nurses should practice to the full extent of their education and training. ● Nurses should achieve higher levels of education and training through an improved

education system that promotes seamless academic progression. ● Nurses should be full partners with physicians and other health care professionals in

redesigning health care in the United States. ● Effective workforce planning and policymaking require better data collection and an

improved information infrastructure.

Furthermore, the IOM makes eight recommendations:

● Remove scope-of-practice barriers. ● Expand opportunities for nurses to lead and diffuse collaborative improvement efforts. ● Implement nurse residency programs. ● Increase the proportion of nurses with baccalaureate degrees to 80 percent by 2020. ● Ensure nurses engage in lifelong learning. ● Prepare and enable nurses to lead change to advance health. ● Build an infrastructure for the collection and analysis of interprofessional health care

workforce data (IOM, 2010).

The Nurse as Change Agent A change agent is one who works to bring about a change. Being a change agent, however, is not easy. Although the end result of change may benefit nurses and patients alike, initially it requires time, effort, and energy, all in short supply in the high-stress environment of health care.

Several recent reports document nurses’ roles in facilitating change. Holtrop et al. (2008) found that nurse consultants improved healthy behaviors in patients served by 10 primary care practices in two health care systems. Also, MacDavitt, Cieplincki, and Walker (2011) report that small changes in communication resulted in improved patient satisfaction on a pediatric inpatient unit. Finally, McMurray et al. (2010) found that nurse managers played a key role in implementing successful change in bedside handover in two hospitals.

Changes will continue at a rapid pace with or without nursing’s expert guidance. Nurses, like organizations, cannot afford merely to survive changes. If they are to exist as a distinct pro- fession that has expertise in helping individuals respond to actual or potential health problems,

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