External and Internal Forces of Change


It is necessary to note that the process of the implementation of changes can be complicated by numerous internal and external forces that may be hard to handle in some situations. Numerous books and peer-reviewed articles on this subject matter are available, and some of the techniques suggested are quite comprehensive. It would be beneficial to review the experience of one of the organizations to understand the approaches that were utilized, and how the most significant problems were resolved.

Driving and Resisting Forces

Chreim, Williams, and Coller (2012) explore the process of change, and one of the health care facilities had to deal with challenges that are quite similar. One of the vital forces that facilitate organizational change is new techniques. Health care institutions are aware that they should be implemented because they are cost-effective and help to increase the number of positive outcomes. However, the issue is that it can be complicated because of the lack of education and experience. A lot of resources should be utilized on pieces of training, but many organizations have to deal with shortages (Westerlund, Garvare, Höög, & Nyström, 2015). Another significant force of change is the influence of health care professionals, and it is possible to take advantage of this fact during the process of implementation (Chreim et al., 2012). Moreover, nurses are respected at Kendall Regional Medical Center, and they would support the introduction of such procedures. One of the issues that may occur is that they already have a set of tasks, and the need to perform conscious sedation may be met with disapproval. Also, they may think that it is the responsibility of anesthesiologists. However, they should be provided with all the necessary information to ensure that they recognize that such skills are highly valued and would not resist the changes.

Internal and External Challenges

It would be useful to focus on learning in case the current educational level is not appropriate (Takian, Sheikh, & Barber, 2014). Moreover, employees have more time to get used to such changes if the implementation is relatively slow. Another factor that should not be disregarded is regulation by the government, and it may complicate the situation because it has been trying to ensure that only the most efficient approaches are used, and the ones that are not as useful are replaced (Grebner & Mattingly, 2016). Moreover, a management team has studied current developments. The organization was pressured to enhance the quality of procedures because the demands of patients are always increasing, and it can also be regarded as a significant challenge. Furthermore, it has focused on the needs of stakeholders. Another problem that should be considered is that it is entirely possible that a new technology or technique will be introduced. The organization keeps track of the latest trends in the industry to be aware of current developments, and it helps to address this challenge. Another internal complication that is quite common is that some of the definitions used during the process of implementation are rather broad, and plans are not detailed. Also, the organization that is studied has overestimated the experience of employees in this area (Chreim et al., 2012). Therefore, it had to modify the approach because it could be seen that consequences would be severe if the problem is not addressed.


Another significant aspect that should not be overlooked is that it may not be an easy task to maintain such changes most of the time. It is suggested that it would be beneficial to develop the strategy based on the vision. This response to the challenge is appropriate when it comes to conscious sedation, and the organization should ensure that the amounts of resources devoted to this project are reasonable. The number of patients that would require such interventions is relatively small, but professionals that would be capable of performing such procedures should always be available. Another response that needs to be highlighted is that the organization has tried to ensure that the outcomes are clear. This approach is reasonable because employees are ready to accept changes when they are aware of what is expected (Borkowski, 2015). The importance of communication patterns also should not be overlooked, and the level of interactions between practitioners in the organization used to be limited. However, discussions of problems and techniques have been quite helpful. This approach also should not be overlooked, and it would be reasonable to ensure that nurses and anesthesiologists communicate with each other, and it would help to make the process much easier.


In conclusion, it is possible to state that several challenges that could complicate the process are currently present. The way the institution tried to address such issues is fascinating and should be considered. However, the problem is that it is not an easy task to find the information regarding the implementation of similar approaches. However, available suggestions are quite sufficient, and it is not likely that the complications will occur if all the factors are taken into account.


Borkowski, N. (2015). Organizational behavior theory and design in health care (2nd ed.). Burlington, MA: Jones & Bartlett Publishers.

Chreim, S., Williams, B. E., & Coller, K. E. (2012). A radical change in a healthcare organization: Mapping transition between templates, enabling factors, and implementation processes. Journal of Health Organization and Management, 26(2), 215-236. Web.

Grebner, L., & Mattingly, R. (2016). Management of health information: Functions & applications (2nd ed.). Boston, MA: Cengage Learning.

Takian, A., Sheikh, A., & Barber, N. (2014). Organizational learning in the implementation and adoption of national electronic health records: Case studies of two hospitals participating in the National Programme for Information Technology in England. Health Informatics Journal, 20(3), 199-212. Web.

Westerlund, A., Garvare, R., Höög, E., & Nyström, M. E. (2015). Facilitating system-wide organizational change in health care. International Journal of Quality and Service Sciences, 7(1), 72-89.

Video Voice-over

Cite this paper

Select style


NursingBird. (2023, September 16). External and Internal Forces of Change. Retrieved from https://nursingbird.com/external-and-internal-forces-of-change/


NursingBird. (2023, September 16). External and Internal Forces of Change. https://nursingbird.com/external-and-internal-forces-of-change/

Work Cited

"External and Internal Forces of Change." NursingBird, 16 Sept. 2023, nursingbird.com/external-and-internal-forces-of-change/.


NursingBird. (2023) 'External and Internal Forces of Change'. 16 September.


NursingBird. 2023. "External and Internal Forces of Change." September 16, 2023. https://nursingbird.com/external-and-internal-forces-of-change/.

1. NursingBird. "External and Internal Forces of Change." September 16, 2023. https://nursingbird.com/external-and-internal-forces-of-change/.


NursingBird. "External and Internal Forces of Change." September 16, 2023. https://nursingbird.com/external-and-internal-forces-of-change/.