NURS FPX 6212 Assessment 4 Planning for Change: A Leaders Vision

Planning for Change: A Leader’s Vision

Overview of the Goals

Santa Clary Valley Medical Center (SCVMC) is facing an issue related to medication errors, especially in the medication administration process. These errors put patient safety and the quality of healthcare services at stake. That is why addressing the issue is crucial for the development of patient care. The major factors behind the problem are the lack of the use of an Electronic Health Record (EHR) system, missing counter-checking of prescriptions, and lack of nursing staff which increases their workload and causes errors in medication administration. So, an initiative is needed with the goal of reducing these errors by implementing effective and evidence-based strategies and organizational change processes.

Key Elements of the Change Plan

The key elements of the plan include goal setting, outcome estimation, finding evidence-based and cost-effective measures to achieve the goals, analysis of their potential effects on health outcomes and organizational performance, plan execution, stakeholder involvement, and finally, implementation of the initiative.

NURS FPX 6212 Assessment 4 Planning for Change: A Leaders Vision

Scope of Plan

The change plan is based on evidence-based strategies and a change model (Lewin’s model), which makes the plan beneficial to the health organization. For example, the strategies proposed in the plan are an increase in nurse staffing, double-checking of prescriptions with the inclusion of pharmacists, interprofessional collaboration, and implementation of the Electronic Health Record (EHR) system. All of these strategies are proven useful in reducing medication errors. Along with the reduction in errors, they will also improve the overall quality of healthcare services by reducing error-related readmissions and costs (Härkänen et al., 2019; Holmgren et al., 2019; Tariq & Scherbak, 2022). Lewin’s Change model helps an organization identify, plan, and implement that plan. It allows the organization to plan an initiative through a proper process (Hussain et al., 2018).

Existing Organizational Functions

Comparison of the qualities in SCVMC with those of high-performance health organizations underlines some areas in the existing organizational functions and processes that are affecting quality and safety. The hospital lacks nurse staffing which causes an increase in the workload, reduces focus, and thus causes medication errors (Härkänen et al., 2019). Additionally, the setting’s management has not implemented any effective strategy, like the implementation of new technology for a reduction in medication errors. The organization does not have an Electronic Health Record (EHR) system for counter-checking prescriptions. Lack of double-checking medication errors affects safety and quality as these errors increase the chances of morbidities, mortalities, and readmissions (Soon et al., 2020). They also lack safety and risk management as they have not addressed the issue of wrong medication administration. 

Areas of Uncertainty

The professional knowledge of new and advanced technology among health providers to reduce medication errors is an area of uncertainty. Management can further assess the uncertainty to find a useful solution.

Current Outcome Measures

The current outcome measures to curb the issue of medication administration errors are listed below:

• Increase in nursing staff
• Inclusion of pharmacists in double-checking prescriptions
• Increase in the use of electronic health systems

Improvement in Outcomes, Quality, and Safety

An increase in nursing staff will divide the workload among all nurses in a way that nurses will be able to perform their tasks, especially those related to medication with focus (Banda et al., 2022). Lesser chances of medication errors increase patient safety and satisfaction. The satisfaction level of patients interprets the quality of services in a health organization. Collaboration among different professionals and nurses about medication and prescriptions will enhance interprofessional communication.

NURS FPX 6212 Assessment 4 Planning for Change: A Leaders Vision

It will avoid any misunderstanding related to drug orders, names, or doses which will enhance patient safety and service quality (Ilardo & Speciale, 2020). The inclusion of pharmacists for double-checking prescriptions will also reduce the errors as they are more familiar with the right drug dose and combination of different drugs (Tariq & Scherbak, 2022). Finally, using EHR for electronic prescribing and recording medication data will enhance patient safety by minimizing related errors in the medication process (Assiri, 2022). All of these measures improve health outcomes, such as an increase in patient safety, an increase in patient satisfaction, and a reduction in readmissions and related costs. Better health outcomes bring about an environment of quality and safety in a health organization.

Strengths and Weaknesses of Outcome Measures

The strength of the outcome measures is their proven potential to reduce medication errors, improve patient safety, and enhance care quality. The weakness is associated with the implementation of EHR and its use. Lack of proper knowledge and training about EHR can affect nurse work routine and delay the medication process as they will have to spend extra time on the system. It can also increase the chances of burnout among them (Riaz et al., 2022).

Steps to Achieve Outcomes

The following steps are required to achieve improved outcomes:

• Adoption of an evidence-based change model for better implementation of the interventions
• Short staff huddles and meetings for effective collaboration and communication among professionals 
• Collaborative patient rounds to avoid medication administration errors related to prescription misunderstanding
• Training of health providers for better use of EHR system for expected outcome achievement
• Devising rules and responsibilities for staff members through hospital policy and guidelines
• Frequent evaluation of the proposed change plan to identify loopholes and address them for better results

Underlying Assumptions

The steps are determined based on assumptions about the effectiveness of the sources and techniques used in them. For example, EHR is assumed to improve the quality of healthcare services in today’s era of technology (Upadhyay & Hu, 2022). Similarly, short staff huddles, meetings, training, and other techniques are significant in bringing change in any health organization (Wahl et al., 2022).

Future Vision of Organizational Potential

The organization can develop a quality and safety culture through the evaluation of the proposed interventions. Thus, the management will know the system’s shortcomings and improve them by making the required changes. For example, long-term use of EHR will need frequent maintenance of its software and equipment. Moreover, the achievement of expected health outcomes from the changes will also improve service quality, cost burden, and the reputation of the hospital. It will motivate management to sustain the culture of quality and safety. The benefits of the proposed changes will also garner the support of stakeholders.

Role of Nurse Leaders and Opportunities for Collaboration

Nurse leaders can play their role in managing and training nursing staff. For example, they can conduct short staff huddles and meetings for task allocation and other briefings related to new initiatives. Moreover, they can monitor their performance and compliance with the provided guidelines. Nurse leaders can adopt transformational leadership strategies for this purpose because a transformational leader has the potential to integrate subordinates and work under a shared vision (Asif et al., 2019).

NURS FPX 6212 Assessment 4 Planning for Change: A Leaders Vision

There exist opportunities for interprofessional collaboration in the role of nurse leaders. For training staff about technology, they can collaborate with the members of information technology (IT). Furthermore, they can also collaborate with pharmacists in educating nurses about safe medication administration, dose quantity, and drug combination.

Conclusion

The key elements of the plan implementation include goal devising, planning, implementation, and evaluation of the plan. The existing functions at SCVMC lack several qualities that high-performance organizations contain and cause medication errors. The estimation of outcomes and measures to achieve those goals is imperative for healthcare development. Specific evidence-based measures will reduce medication errors and related events in the setting. Plan evaluation and achievement of expected outcomes will help the organization develop and sustain the change in the future.

References

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Assiri, G. (2022). The impact of patient access to their electronic health record on medication management safety: A narrative review. Saudi Pharmaceutical Journal, 30(3). https://doi.org/10.1016/j.jsps.2022.01.001

Banda, Z., Simbota, M., & Mula, C. (2022). Nurses’ perceptions on the effects of high nursing workload on patient care in an intensive care unit of a referral hospital in Malawi: A qualitative study. BMC Nursing, 21(1). https://doi.org/10.1186/s12912-022-00918-x

Härkänen, M., Vehviläinen‐Julkunen, K., Murrells, T., Paananen, J., Franklin, B. D., & Rafferty, A. M. (2019). The contribution of staffing to medication administration errors: A text mining analysis of incident report data. Journal of Nursing Scholarship, 52(1), 113–123. https://doi.org/10.1111/jnu.12531

Holmgren, A. J., Co, Z., Newmark, L., Danforth, M., Classen, D., & Bates, D. (2019). Assessing the safety of electronic health records: A national longitudinal study of medication-related decision support. BMJ Quality & Safety, 29(1), 52–59. https://doi.org/10.1136/bmjqs-2019-009609

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. Science Direct. https://doi.org/10.1016/j.jik.2016.07.002

Ilardo, M. L., & Speciale, A. (2020). The community pharmacist: perceived barriers and patient-centered care communication. International Journal of Environmental Research and Public Health, 17(2). https://doi.org/10.3390/ijerph17020536

Riaz, S., Nazir, S., Zia, T., Yasmeen, T., Shoukat, S., & Latif, W. (2022). Knowledge and perception of electronic health records among nurses. Pakistan Journal of Medical and Health Sciences, 16(7), 82–84. https://doi.org/10.53350/pjmhs2216782

Soon, H. C., Geppetti, P., Lupi, C., & Kho, B. P. (2020). Medication safety. Textbook of Patient Safety and Clinical Risk Management, 435–453. https://doi.org/10.1007/978-3-030-59403-9_31

Tariq, R. A., & Scherbak, Y. (2022, July 3). Medication dispensing errors and prevention. National Library of Medicine; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK519065/

Upadhyay, S., & Hu, H. (2022). A qualitative analysis of the impact of Electronic Health Records (EHR) on healthcare quality and safety: Clinicians’ lived experiences. Health Services Insights, 15(11786329211070722), 117863292110707. https://doi.org/10.1177/11786329211070722

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