Essay on Leading Change in Patient Safety Issue

Change is inevitable, and in an organizational setting, change can the difference between success and failure. According to Heckemann et al. (2014), change is an essential aspect of organizational progress, and when stagnation affects progress, change is the only available route that can influence success. In a healthcare setting, implementing change can impact patients’ outcomes in a significant way. More importantly, implementing change to accommodate an electronic medical record system can improve patient experience and hospital communication. This paper is critical as it looks at how a nurse leader would manage change in such a way that nurses fully and flawlessly adapt to a selected electronic medical recording system. The paper uses the Lewin’s change model to outline the essential plans of change, and lastly, it focuses on a leadership style that serves this particular change project.

Electronic Medical Record System

Almost every industry that exists today has some form of technology and computerization. Australians today can purchase airline tickets and check-in online flights, buy online, and most importantly, students can earn online degrees in disciplines like nursing. Yet, despite these advancements, many hospitals still send patients handwritten drug scripts. In like manner, healthcare institutions that lack well-established electronic medical record systems are always in the brink of a major medical error that may damage the hospital’s reputation and, even worse, trigger major medical injury (Heckemann et al., 2014). A well-installed and functioning electronic health record has the potential to transform a healthcare institution from a paper-based institution to an institution that utilizes clinical information to provide a high quality of care to patients.

Over the recent years, researchers have examined the benefits of implementing an electronic medical record system and found that many advantages come with implementing an electronic medical system within a hospital. One benefit includes eliminating poor penmanship, which is common within the healthcare industry, and being able to access computerized records (Xhafa et al., 2014). Electronic medical records also can improve the clinical decision-making process and, more importantly, facilitate the flawless exchange of clinical information. Xhafa et al. (2014) similarly found that electronic health records improve the quality of care and supply medics with customized patient information, including race, medical history, age, and so on. Other studies found that electronic health records improve general organizational outcomes. For instance, a study by Aldosari (2014) found that having a well-defined electronic medical recording systems improves organizational outcomes in areas including finances and operational performance. The study also noted increased morale and satisfaction among patients and nurses who utilize electronic health record systems. Having a well-established electronic health recording system also comes with societal benefits, including being able to conduct research and achieve improved population health.

Kurt Lewin Change Model

Lewin’s change model includes a three-step process (unfreezing, change, and freezing) that offers change agents a high-level approach to organizational improvement (Shirey, 2013). It offers change agents a system to implement change effort, which can be very sensitive in most cases. The three phases in this model help rally people around change and in most cases, a leader may implement unique processes and reassign tasks. But change is only attained if the people are willing to embrace it and help put it into practice. Therefore, Lewin’s change model would perfectly serve this particular change initiative.

The first phase in Lewin’s change model is unfreezing. When developing this model, Kurt Lewin viewed human behaviour as a quasi-stationary equilibrium state (Shirey, 2013). He believed that there are different and equal forces acting towards a behaviour. Therefore, to change that state, Lewin believed that change agents should increase the forces that work for change and decrease those maintaining the current state. In this case, the nurse leader should increase the forces that need the implementation of electronic health records and, more importantly, reduce those that oppose this initiative. In this phase, the change agent must be able to develop a compelling message showing the nurses why the current status quo is not functional (McGarry et al., 2012). The nurse leader use instances including recent medical errors, declined hospital performance, increased patient complaints, and other issues to rally support around the projected change. By pressuring the organization to re-examine its essence, the nurse leader can build a crisis that can trigger a strong motivation, and in many ways, this can help pursue a new balance. Without this, joining in and engaging in the desired transition may be difficult.

After the nurse leader has created a certain level of uncertainty in the unfreeze stage, he can use the change phase to resolve these uncertainties and look for new ways of doing things. Nevertheless, it is important to note that the transition from the unfreeze phase to the change phase may not happen overnight as people may take time to embrace the new direction and take time before participating proactively in the change (McGarry et al., 2012). For the nurses to accept the change and view it as the new norm, they need to understand that it will benefit them directly. The nurse leader also needs to understand that not everyone will align with the change, and more specifically, not every nurse will view the change as beneficial. Some individuals will also be profoundly affected by the change, particularly those who profit heavily from the current system. At the same time, some may take longer to recognize the benefit of the change. The nurse leader needs to foresee and, more importantly, manage these conditions.

Refreezing is the last phase in Lewin’s model of change. According to Harris and Mayo (2018), the refreezing phase comes after the employees have abandoned the status quo and have accepted the change. The nurse leader ought to refreeze when the change is taking shape, and employees embrace the new way of working. Rather than introducing the electronic record system instantly, the leader should gradually introduce it (Stanley, 2017). This would limit confusion, allowing nurses to learn from each other through the course of change. The leader should also watch out, for instance, increased patient outcomes, reduced patient complaints, and improved organizational performance to decide whether it is appropriate to refreeze. The unfreezing, change, and refreezing processes should continue for at least a month. The first two weeks should be used for basic training and introduction to the electronic health system. In the third week, the leader should focus on the electronic system’s adaptability and functionality within the hospital.

Leadership Style

There are many leadership styles in today’s organizational settings; however, the most appropriate leadership style to utilize in this case would be the coaching leadership style. The leader who embraces coaching leadership styles seeks to advance employees’ personal and professional growth (Berg & Karlsen, 2016). In most cases, the leader helps build employees’ strengths, recognizes their weaknesses, and builds on their skills more importantly. However, attaining success by employing basic coaching leadership features may prove fatal in the process of change. Hence, for this style to work, the leader has to recognize the two coaching leadership prerequisites. First, the nurses must be willing to embrace the change, and they must be able to work on themselves. Second, the nurse leader must have sufficient knowledge and experience, especially in medicine and management (Berg & Karlsen, 2016). This will ensure that the leader guides the employees. Compared to other leadership styles, including a democratic leadership style, the coaching leadership style would work best to motivate and inspire employees towards change (Wong & M. Giallonardo, 2013). Democratic leaders get the employees to do what they want them to do, but employees often resist and do whatever they see fit. A coaching leader provides direction and offers the employees the ability to attain what is expected from them.

Aspect of Potential Resistance

Employees can resist change, and in most cases, many excuses are given to back up the resistance. Resistance may happen in this case due to surprise and fear of the unknown. Many nurses are accustomed to traditional medical records, and transitioning to electronic health records may be challenging. Organizational politics may also trigger resistance, as some may resist change as a strategy to prove that the decision may be wrong (Stanley, 2017). In like manner, they may resist change to prove that the individual leading the change is not up to the task. To overcome resistance, it is paramount that the leader communicates as early and as often as possible. There should be a constant conversation between the employees and the leader.

Conclusion

Implementing and introducing an electronic medical recording system in a healthcare organization is not an easy task; however, with the right leader, the appropriate leadership model, and an appropriate leadership style, this change can be attained flawlessly. Electronic medical record systems are beneficial for several reasons, including enhanced communication among the medical staff, reduced medical errors, and improved patient outcomes. Lewin’s change model is suitable in this case because it includes three phases, unfreezing, change, and refreezing, which are critical in any given change process. Lewin’s change model would ensure that the nurses abandon convectional health recording systems and fully adapt to the electronic recording system. More importantly, the coaching leadership style would work perfectly in this case. This style would ensure that the nurses are well acquainted with the new recording system. Nevertheless, resistance may occur along the way. To avoid resistance, the leader must communicate every aspect of the change.

References

Aldosari, B. (2014). Rates, levels, and determinants of electronic health record system adoption: A study of hospitals in Riyadh, Saudi Arabia. International Journal of Medical Informatics, 83(5), 330-342. https://doi.org/10.1016/j.ijmedinf.2014.01.006

Berg, M., & Karlsen, J. (2016). A study of coaching leadership style practice in projects. Management Research Review, 39(9), 1122-1142. https://doi.org/10.1108/mrr-07-2015-0157

Harris, J., & Mayo, P. (2018). Taking a case study approach to assessing alternative leadership models in health care. British Journal of Nursing, 27(11), 608-613. https://doi.org/10.12968/bjon.2018.27.11.608

Heckemann, B., Schols, J., & Halfens, R. (2014). A reflective framework to foster emotionally intelligent leadership in nursing. Journal of Nursing Management, 23(6), 744-753. https://doi.org/10.1111/jonm.12204

McGarry, D., Cashin, A., & Fowler, C. (2012). Child and adolescent psychiatric nursing and the ‘plastic man’: Reflections on the implementation of change drawing insights from Lewin’s theory of planned change. Contemporary Nurse, 41(2), 263-270. https://doi.org/10.5172/conu.2012.41.2.263

Shirey, M. (2013). Lewin’s theory of planned change as a strategic resource. JONA: The Journal of Nursing Administration, 43(2), 69-72. https://doi.org/10.1097/nna.0b013e31827f20a9

Stanley, D. (2017). Clinical leadership in nursing and healthcare (2nd ed.). John Wiley & Sons, Ltd.

Wong, C., & M. Giallonardo, L. (2013). Authentic leadership and nurse-assessed adverse patient outcomes. Journal of Nursing Management, 21(5), 740-752. https://doi.org/10.1111/jonm.12075

Xhafa, F., Li, J., Zhao, G., Li, J., Chen, X., & Wong, D. (2014). Designing cloud-based electronic health record system with attribute-based encryption. Multimedia Tools and Applications, 74(10), 3441-3458. https://doi.org/10.1007/s11042-013-1829-6