LDR 615 Benchmark-Change Initiative: Develop a Change Model Assignment

LDR 615 Benchmark-Change Initiative: Develop a Change Model Assignment

LDR 615 Benchmark-Change Initiative: Develop a Change Model Assignment

Change Initiative Paper         

            The dynamism of the healthcare industry and the complexity of the same makes it inevitable for change to occur in healthcare settings. In order to effect change, healthcare organizations will adopt the usage of varied healthcare models as standalones or in combination. Mahmood (2018) observes that whereas numerous models of change exist, the healthcare field has only applied four of them namely Kotter’s Model, Lewin’s Model, Balanced Scorecard, and Gannt Charts. These change models play an effective role in reducing the rate of nurse turnovers such as the one witnessed at the University of Texas Medical Branch Medical-Surgical floor. The adoption of leadership strategies such as effective staffing ratios and enhanced interpersonal relationship based on the Lewin’s Model of Change at the University of Texas Medical Branch’s floor nursing will be foundational to the present paper. The Lewin’s Change Model entails the usage of freezing, change and unfreezing that will inform the current project. 

Culture and Behavior at The University of Texas Medical Branch

            The UTMB facility predominantly has a change management culture within its operations. The phenomenon has ensured that the facility constantly renews its capabilities, direction and structure so as to serve the dynamic needs of the internal and external driving forces that influence organizational success (Hussein et al., 2018). Moreover, the facility always favors the adoption of evidence-based practice to address some of the challenges facing healthcare including leadership issues such as the retention of nurses.

            The UTMB facility also does not give priority to the status quo of the facility. Hussein et al. (2018) assert that the presence of status quo preference forms a bottleneck to the initiation and eventual implementation of change initiatives. Therefore, the presence of a contrary behavior at the UTMB facility makes it amenable to any change initiative regarding any issue that may be affecting the facility such as the high rate of nurse turnover at its floor area.


Methods to Evaluate the Need for Change

            The need for change as regards nurse retention and the leadership role at the UTMB will depend on a host of parameters. Both internal and external factors will play a crucial role in demonstrating that the leadership need to address the high rate of floor nursing staff turnover. Internal factors such as nurse burnout, failing quality indicators, increased patient readmission rates, and higher patient mortality indicate the impact of nurse turnover on the quality of services offered by the hospital. According to Halter et al. (2017), the presence of such internal factors play fundamental roles in determining the need for change. As a consequence, a need exists to address the issue of nurse turnover at the UTMB to ensure that the quality indicators as discussed above remain high.

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            External factors also reveal important information concerning the need for change in a healthcare facility. The UTMB hospital has registered failing patronage over the last couple of years due to the reduced internal quality factors discussed above. Further, statistics reveal that the rate of patient satisfaction has failed at the facility, which indicates the need to address the causative factors. Most importantly, the generation of revenue at the hospital has reduced by a fifth. Hughes (2017) argues that failing profits at a healthcare facility forms one of the most important indicators concerning the need for change. Thus, the fact that it coincides with the issue of increased nurse turnover implies that it has a direct impact on the same.

LDR 615 Benchmark-Change Initiative Develope a Change Model Assignment
LDR 615 Benchmark-Change Initiative Develope a Change Model Assignment

Choosing Individuals/Teams Necessary for Change

            The evaluation of the need for change has revealed that the UTMB needs to formulate a team to oversee the change regarding the issue of nurse turnovers. To this, end making a choice concerning change agents becomes an important facet of the change process. The individual that will oversee the change process will need to have certain aspects. Indeed, the success of any change process heavily depends on the workability and quality of the change agent and influential decision makers within a facility (Zbieg, Batorski, & Żak, 2016). As such, the change agents for the nurse turnover reduction initiative at the UTMB facility will need to have qualities that facilitate the above.

            The nurse managers will play the frontline role in ensuring the implementation of the enhanced interpersonal relationship and reduced nurse-to-patient ratios. To achieve this objective, the managers will have to possess micro and macro-perspectives.  Moreover, they should have the ability to respect eternal standards and own beliefs. The change agents will need proactivity to effectively induce the change.  The change agents for the project will also need to have empathy for the floor nurses to implement the required measures appropriately (Kodama & Fukahori, 2017). A confluence of the characteristics necessary for the change agents or teams will ensure that interpersonal relationships and reduction of staff-to-nurse ratio interventions become effectively implemented at the UTMB. 


Communication Strategies

            The effectiveness of a change initiative will depend on the type of communication adopted by an organization. Given that the objective entails creating an interpersonal relationship between the leaders and the nurses, UTMB will adopt an informal communication strategy. The usage of this strategy occurs so as to leverage on the informal social paths, connection, and dependencies to enhance interprofessional associations between nurses and the leadership of UMBT (Zbieg, Batorski, & Żak, 2016). Further, the decision to choose the informal communication receives inspiration from the fact that it acts as a reliable proxy for the roles that employees plan in a company.

            Moreover, the UTMB will also adopt the formal communication strategies including to pass certain messages. The diffusion of the information to the entire company will occur based on cascade communication. The organization already prepared itself for widespread change concerning retention of floor nurses. As such, a group of managers will train a lower and larger cadre of employees, who in turn pass the information to their colleagues. Zbieg, Batorski, and Żak (2016) posit that the training on the organizational vision and value of the company and the important role that floor nurses play will make them feel valued and want to remain with UTMB.

Strategies to Gather Stakeholder Support and Overcome Resistance

            The process of change occurs based on the support received from stakeholders. However, the complexities of certain change lead to the existence of stakeholder intransigence. The inclusion of stakeholders in change initiatives has numerous values such as feelings of common value, satisfaction, trust, and commitment (Pandi-Perumal et al., 2015). Making the floor nurses and their managers to feel needed forms one of the most important strategies that will make them support the project. Secondly, it becomes important to define the vision processes of the change that would see nurse the hospital leadership improve their interpersonal processes with the floor nurses. The explanations offered concerning the visions of the hospital and how the nurses influence that will make them feel valued hence offer support to the project.

            The process of overcoming stakeholder resistance will also depend on explanations offered concerning the benefits of the process. The UTMB leadership will have to maintain a positive association with stakeholders and communicate with them throughout the entirety of the project (Pandi-Perumal et al., 2015). Further, undertaking continuous interactions with the stakeholders and answering their reservations will play a fundamental role.  


Implementation Strategies

            The implementation of the proper interpersonal relationships will play an important role in ensuring that nurses become satisfied with their environment. The issue of nurse turnover rate occurs at the start of the nursing career when the leadership does not explain to nurses their roles and their impact on the quality of services. Thus, in order to improve the retention of nurses, the leadership of the floor nurses will conduct job—interviews with the nurses so as to create a positive impression (Lapeña-Moñux, Cibanal-Juan, Pedraz-Marcos, & Macía-Soler, 2014). Moreover, the nurse leaderships should create proper and effective interpersonal relationships with the floor nurses. Such an approach will allow the floor nurses at the UTMB to express their problems to the management and offer solutions as to how the leadership can address them. Therefore, the strategies lead to the existence of positive relational skills and attitudes, which lead to improved job satisfaction and reduced occupational stress.

Sustainability Strategies

            The sustainability of a change initiative becomes important in the change initiative in healthcare. The very first step in the process entails the identification of the threats to a project at its start and when ready for execution. The UTMB will achieve above via the usage of The National Health Service Sustainability Model, which identifies the long-term excellence of the project (Silver et al., 2016). The identification will follow be followed by the adoption of tools such as process control boards, improvement hurdles, performance board and standard work. The UMBT will use the above tools to ensure the sustainability of the project.

            The performance boards and process control form methodologies used to communicate the improvement outcomes to the leadership and staff. The standard work forms a visual or written outline of the contemporary best practices for the nurses’ floor roles and offers a framework to ensure that they follow positive practices in a consistent manner (Silver et al., 2016). The improvement hurdles on the other hand entails short, regular meetings between the staff and the leadership at UTMB that will anticipate issues, assess performance and then support an improvement culture of the existing relationships between them.

The Kurt Lewin’s Change Model Concept Map


Mahmood, T. (2018). What models of change can be used to implement change in postgraduate medical education?. Advances in medical education and practice, 9, 175. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5865584/

Hussain, S. T., Lei, S., Akram, T., Haider, M. J., Hussain, S. H., & Ali, M. (2018). Kurt Lewin’s change model: A critical review of the role of leadership and employee involvement in organizational change. Journal of Innovation & Knowledge, 3(3), 123-127. Retrieved from https://scholar.google.com/scholar?hl=en&as_sdt=0%2C5&q=Kurt+Lewin%27s+change+model%3A+A+critical+review+of+the+role+of+leadership+and+employee+involvement+in+organizational+change&btnG=#d=gs_cit&u=%2Fscholar%3Fq%3Dinfo%3AegojmIvISB0J%3Ascholar.google.com%2F%26output%3Dcite%26scirp%3D0%26hl%3Den

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Hughes, V. (2017). Leadership strategies to promote nurse retention. Sci J Nurs Pract, 1(1), 1-5.

Zbieg, A., Batorski, D., & Żak, B. (2016). How to Select Change Agents in Organizations? A Comparison of the Classical and Network Approaches. Problemy Zarządzania, (4/2016 (64), t. 2), 120-143.

Kodama, Y., & Fukahori, H. (2017). Nurse managers’ attributes to promote change in their wards: a qualitative study. Nursing open, 4(4), 209–217. https://doi.org/10.1002/nop2.87

Pandi-Perumal, S. R., Akhter, S., Zizi, F., Jean-Louis, G., Ramasubramanian, C., Edward Freeman, R., & Narasimhan, M. (2015). Project stakeholder management in the clinical research environment: How to do it right. Frontiers in psychiatry, 6, 71.

Lapeña-Moñux, Y. R., Cibanal-Juan, L., Pedraz-Marcos, A., & Macía-Soler, M. (2014). Interpersonal relationships among hospital nurses and the use of communication skills. Texto & Contexto-Enfermagem, 23(3), 555-562.

Silver, S. A., McQuillan, R., Harel, Z., Weizman, A. V., Thomas, A., Nesrallah, G., … & Chertow, G. M. (2016). How to sustain change and support continuous quality improvement. Clinical Journal of the American Society of Nephrology, 11(5), 916-924.