NUR 590 Do you foresee any issues with the proposed implementation of your project?

I expect certain difficulties in my role as project lead for integrating preparedness tools in our healthcare organization, particularly DOSA and ISR, to improve the delivery of high-quality care services. Staff employees who are used to the current situation may be resistant to trying anything new, such as new technology or methods (Alolabi et al., 2021). To prevent this, prioritizing excellent communication and involvement with all stakeholders is a method to establish and maintain a better degree of preparedness to change inside the business.

It is important to first provide a strong argument for why readiness tools should be used. This may be accomplished through disseminating studies and articles that demonstrate the advantages of evidence-based practice and the use of DOSA and ISR in healthcare settings. We can establish a solid platform for change and instill a sense of urgency among employees by providing evidence of existing efforts to improve patient outcomes, efficiency, and decision-making.

It is crucial to keep up with the most recent research and literature in the fields of healthcare and evidence-based practice to guarantee that the change is founded on the most up-to-date evidence. This may be done through keeping up with relevant academic publications, participating in relevant professional events, and talking to recognized authorities in the subject. By keeping up with the newest research and best practices, we can make educated choices about the deployment of preparedness tools and adjust our approaches appropriately.

Employees and workers are more likely to embrace change and take ownership of the process when they are included in it and asked for their thoughts and comments. They may have their voices heard and have input into the decision-making process through participating in focus groups, questionnaires, and open forums. We can allay employees’ fears, adjust the rollout to meet their requirements, and make the changeover go more smoothly if everyone pitches in.

References

Alolabi, Y. A., Ayupp, K., & Dwaikat, M. A. (2021). Issues and implications of readiness to change. Administrative Sciences, 11(4), 140.

Crawford, C. L., Rondinelli, J., Zuniga, S., Valdez, R. M., Tze‐Polo, L., & Titler, M. G. (2023). Barriers and facilitators influencing EBP readiness: Building organizational and nurse capacity. Worldviews on Evidence‐Based Nursing, 20(1), 27-36.

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Communicating the proposed change message and guaranteeing interest and participation in the change process will let the whole involved team to redirect towards an expected outcome probably patient satisfaction in terms of hygiene and staff’s better health. Some of the tools to ensure the sustenance of the new improvement process are; Process control boards, performance boards, standard work, and improvement huddles, and they are all valuable tools for sustaining improvement. Process control and performance boards communicate improvement outcomes to employees and management.

I do foresee many issues with the implementation of the project. For this project to be brought to fruition, it requires the collaboration of many stakeholders at the earliest stages of the project in the first place. It is a multidisciplinary healthcare team effort where the safety of nurses will be prioritized. Definitely a tremendous effort must be made to teach and guide the participants. Furthermore, the resources needed for the project can be overwhelming for the organization, and this can bring the project to a halt or not even be implemented at all.

One of the strategies to help create or sustain a high level of readiness to change in my organization and to effectively determine if the organization is ready to take on the project would be utilizing two organizational readiness tools. The first would be the Quality Improvement (QI) tool because it requires teamwork. This tool guarantees continuous effort to achieve improvement, efficiency, and effectiveness of the organization’s goal (Kelly, n.d.). the second tool is the Organizational Readiness to Change Assessment (ORCA), which measures the organizational readiness to implement evidence-based practices in clinical settings (Organizational Readiness to Change Assessment (ORCA) Tool | NCCMT, n.d.)

Evidence-based practice is the continuous and judicious use of current best evidence in conjunction with clinical expertise and patient values to guide healthcare decisions. Even more, by ensuring that all stakeholders are fully knowledgeable about the evidence provided by literature, we can minimize biases, skepticism, and unwillingness to participate in the project and encourage them to commit to the organization’s willingness to change fully.

References

Kelly, R. (n.d.). Quality Improvement. Retrieved May 12, 2023, from https://www.hopkinsmedicine.org/nursing/center-nursing-inquiry/nursing-inquiry/quality-improvement.html

Organizational Readiness to Change Assessment (ORCA) tool | NCCMT. (n.d.).

As you mentioned it can be difficult to get a project started if the resources aren’t available or if it will put a strain on the available resources. Another good tool to use to evaluate readiness for change is the ADKAR model. “The ADKAR Model of Change Management is an outcome-oriented change management method that aims to limit resistance to organizational change” (Kaminski, 2022).

Kaminski, J. (2022). Theory applied to informatics – The Prosci ADKAR Model. Canadian

Journal of Nursing Informatics, 17(2), 1–7. https://eds-s-ebscohost-com.lopes.idm.oclc.org/eds/pdfviewer/pdfviewer?vid=1&sid=99656c54-1c85-471c-a7e3-bfcf5d1e2c1e%40redis

The ORCA Tool is a validated survey instrument designed to assess an organization’s readiness for change in healthcare settings. It measures several key domains, including leadership engagement, available resources, organizational climate, and staff attributes. The tool helps identify strengths and areas for organizational improvement to implement and sustain quality improvement initiatives effectively.

Crittendon et al. (2020) wrote an article about organizational readiness to change in the context of quality improvement in family medicine residency programs. The authors reviewed the application and findings of the Organizational Readiness to Change Assessment (ORCA) Tool. They distributed the ORCA Tool to residents, faculty, and staff. The results showed that the program was moderately ready for change in most domains. Using the ORCA tools will help you achieve your goal of assessing your organization’s readiness to change.

Crittendon, D. R., Cunningham, A., Payton, C., Mills, G., Kelly, S. P., LaNoue, M., & Arenson, C. (2020). Organizational readiness to change: Quality improvement in family medicine residency. PRiMER: Peer-review Reports in Medical Education Research. https://doi.org/10.22454/primer.2020.441200

Resistance to change is truly a big hurdle for any innovation. I think it takes a lot of education backed up with evidence to get through skepticism and unwillingness to participate. If the stakeholders see the benefits that they will reap in the end, we can get more to participate in our EBP and ultimately create a successful positive change in our organizations. As we know, change is not easy, but as advanced practice nurses and leaders in our field, we are empowered with knowledge, skills, and tools to effect EBP changes in our organizations.

DeNisco, S. M. (2021). Advanced practice nursing: Essential knowledge for the profession (4th ed.). Jones & Bartlett Learning.

Implementing the evidence-based practice of early ambulation in post-surgical patients can be associated with several challenges. Implementing the evidence-based practice of early ambulation in post-surgical patients requires addressing issues such as resistance to change, resource allocation, staff training, and workflow modifications. These issues need to be anticipated and managed to ensure successful implementation. Healthcare organizations often need more support from healthcare providers, who may be comfortable with traditional practices or skeptical about the benefits of early ambulation. Ensuring that staff members receive appropriate education and training is essential to facilitate the practice change.

Employing change management principles is vital to create and sustain readiness for change. Communicate the benefits of early ambulation to all stakeholders, emphasizing patient outcomes, reduced complications, and improved recovery times. Leadership support and involvement are crucial in providing necessary resources and fostering a culture of change. A multidisciplinary team comprising representatives from different departments involved in post-surgical care(Lavin & Ida,2022). This team can collaborate to develop protocols, guidelines, and training programs for early ambulation.

Reviewing recent research studies, systematic reviews, and clinical practice guidelines to gather evidence supporting the benefits of early ambulation in post-surgical patients to ensure that the change is based on current evidence (Bramer,2018). This will provide a foundation for the implementation plan.

Bramer, W. M., de Jonge, G. B., Rethlefsen, M. L., Mast, F., & Kleijnen, J. (2018). A systematic approach to searching: an efficient and complete method to develop literature searches. Journal of the Medical Library Association : JMLA, 106(4), 531–541. https://doi.org/10.5195/jmla.2018.283

Lavin, J. M., & Ida, J. B. (2022). Quality Improvement Methodology. Otolaryngologic clinics of North America, 55(6), 1301–1310. https://doi.org/10.1016/j.otc.2022.07.008

NUR 590 Do you foresee any issues with the proposed implementation of your project?