In any complex system, there is a high probability of change due to some factors like upgrades or technological advancements. At SMV, which is a skilled nursing health facility, the healthcare system need to be advanced to integrate resident’s code status information. In the current system, this slot is lacking; as a result, there is less information accessible during the emergency moments. The change of the system will improve healthcare programs that would enhance effective care for the resident during emergency. The new change will be evaluated by analysing the SMV’s available system equilibrium. In the rational for change, the theory of change proposed by Lewin involving three states; unfreezing, change, and unfreezing will be applied.
It is important to address the driving forces that enhance and restrain the new concept of change at SMV. The plan for change and the examination of the change is significant. In the plan for change, concepts of values, attitudes and role relationships from the supporters proves to be vital. Ultimately, behavioural and objectives and strategies for the proposed change will be discussed. Conclusive, the measures to evaluate the new change is significant. Having the resident’s code status readily available will affect the facility and their residents in a positive way by providing care more efficiently and quickly in a medical emergency.
Systems refer to the set of elements that collaboratively accomplish a given task or goal (Gillies, 1982). The system has some interconnected components that operate together allowing the overall program to serve as one whole complex. For instance, SMV is a skilled nursing system/facility which is located at CA. the goal of SMV is to integrate healthcare providers’ working as a team in offering healthcare services. SMV proves to be a sophisticated system containing several subsystems for the facility to function effectively and entirely. Examples of these subsystems include the board of directors, office administrators and managers, social services, activities coordinator and facility kitchen. In such complex facilities like the SMV, evaluation for change is a mandatory exercise that ensures that effective approaches are employed. For change to take place is such a sophisticated facility, the analysis of the change is conducted, prepare and plan for change and evaluate the essence for change.
Analysing the System for Change
Equilibrium is the current condition that is being interrupted and stimulated by modifications between the driving as well as the restraining factors. After the driving forces and the restraining forces are equivalent, the equilibrium can be attained again (Nordby, 2015). In the current SMV facility, the state of balance is detected. The stability at the SMV facility is regarded by the availability of the of the resident’s code status information. However, since possessing such knowledge to the resident’s medical records is the preservation of the status quo; therefore, the facility needs to disrupt and enhance change.
To develop and enhance change, the application of Lewin’s Change Theory is paramount. Lewin’s Change Theory is structured into three crucial stages: unfreezing, change and freezing. The unfreezing stage is the first level, and it incorporated the discovery process for the system’s termination of a counterproductive behaviour and motivated to look for a new productive behaviour (Kaminski, 2011). Change is the second stage of the Lewin’s change theory. This stage can also be referred to as “process of change.” This stage involves the brainstorming concepts within the system to achieve anticipated enhancement. At this stage, views and actions are considered to spearhead the change needed. The refreezing stage is the third and final stage in theory. This stage entails the establishment of the change as the new standard practice (Kaminski, 2011). At the present state, SMV is at the frozen stage with the concept of having the resident’s code status information accessible in the resident’s medical chart. In several occasions, a cardiac arrest has taken place, and the nurses had first to get back to the resident’s medical chart to consider their code status before executing any life-saving measure.
The approach of unfreezing the SMV’s change starts with the implementation of the driving as well as restraining forces of the facility. Driving forces are the factors that inspire the idea and the steps taken to attain the new concept. Therefore, the critical or the fundamental driving factor at SMV that demands the change is understanding the relevance of the resident’s code status data that is readily accessible in times of crisis. As a result, to enhance proper record keeping, electronic medical charting system is needed at the facility. Resultantly, in the facility today, with a click of a button on click care software, one can see the resident’s allergies, primary colour, and diet. Regardless of this, there is no slot for the resident’s code status information. An additional idea to act as a driving force includes merely putting a sign at the resident’s door or by their bed stating their code status information (Kaminski, 2011). Currently, at every entry you have the resident’s name with a photo of the resident; there is plenty of space available to add this information. Strengthening these forces can be done by explaining to staff, director of nursing, and facility administrators how crucial it is to have this vital piece of information readily available.
The Plan to Change
To ensure that the change becomes actualized in the SMV facility, the ide should be directed to the Director of Nursing and the facility administrators. Then the idea is presented to the supporters to ensure that they have the concrete view of what is expected from the project. Finally, the Director of Nursing and the Facility Administrators will be left with the role of adopting the initiative as a first step of approving the change (Watson, 1969). The change will significantly allow values, attitudes and role relationship operate coherently with the healthcare professional team at the SMV facility. This approach shows that the healthcare professionals are concerned about the resident’s life and the care provided therein. With the resident’s code information status easily and readily available during an emergency, the condition is essential in promoting improved care services in the life-saving measures in an immediate effect.
With the change, the attitude of the healthcare professional team would be improved and impart more confidence when providing care. This is because they will be providing care with the profound knowledge of the resident’s code status. As a result, the change will significantly facilitate various role relationships within the facility positively knowing that life-saving measure has been conducted in a precisely under the influence of the code status. The most beneficiaries of the change are healthcare team including the registered nurses, licensed vocational nurses, as well as the certified nursing assistants (Watson, 1969). On top of the healthcare’s privilege of treating using a resident’s status information code, the change will encourage less anxiety during life-saving services in medical emergencies. However, the most important supporters of the initiative would be the residents and their families. This is because everybody could be happy and appreciate the action to hasten the emergency treatment.
A behavioural objective would be the healthcare team as well as facility administrators to analyse how the current status quo is affecting medical emergencies; the outcome includes realizing the time that is taken away from the resident to provide life-saving measures. Another goal or aim is to merely the availability and the accessibility to the resident’s code status since the information will be readily available. The ultimate result for this is allowing the healthcare providers to have the resident’s code status a few steps away rather than running the nurse’s station as they look for the information (Watson, 1969). The change initiative objectively aims at evaluating how the change is likely to influence the care provided to the resident during the medical emergencies. The healthcare team and the facility would incorporate the residents and their families in the care service.
The key strategy for change involves persuasion (Watson, 1969). The healthcare team, nurses and the certified nursing assistants are supposed to pull their efforts together in support for the change and explain the rationality for change to the Director of Nursing. The explanation on how the change initiative would positively impact the implementation during the care provision process and same time crisis would essentially be influential. Once the Director of Nursing supports the idea and is on board, the purpose of this change could be further moved up to the facility administrators (Watson, 1969). In partnership with the Director of Nursing, the healthcare professionals would persuade the facility administrators on the importance of the change initiative proposed in the emergency department.
Evaluation is critical to identify the positivity and the negativity of the change initiative. To assess this change, it is essential for the healthcare professional to address and explain how the change would affect them during the medical emergency. A short survey can be implemented after each medical emergency that the healthcare provider(s) who cared for the resident during the medical emergency would need to fill out (Kaminski, 2011). The evaluation of the impact of the change will incorporate three fundamental questions: (1) where did the medical emergency occur, (2) where was the resident’s code status retrieved (electronic health record from computer on nurse’s cart, sign near resident’s door, or resident’s paper medical record at nurse’s station), and (3) how retrieving resident’s code status affected their implementation in providing life saving measures to the resident.
The third question is essential and crucial since it gives healthcare professionals an opportunity to provide feedback for the new change. The survey would be evaluated monthly to determine if the change initiative was effective in saving the lives or not. Ultimately, after a year, the stakeholders; director of nursing, the healthcare professionals and the facility administrators will come together to determine how the change initiative would improve the timely manner in providing care to the resident within a medical emergency.
Conclusively, Lewin’s concept of freezing includes the establishment of the new change initiative as the status quo (Kaminski, 2011). The change would not have any problem when it is implemented since it would benefit everybody in the facility. As a healthcare operator, it is essential that the professional team provide efficiently and quality care to the resident and the clients, especially during medical emergencies. The implementation of the change could enhance this. The resident’s code status within reach will allow the healthcare team to offer effective and quality cares more quickly during the emergency condition.