The scenario of the Agency for Healthcare Research and Quality (n.d.) illustrates a situation of coordination issues at a workplace: a 60-year-old female patient who is believed to have a diverticular perforation is transported to OR, but the patient’s nurse is not informed about it, and no pre-operational protocols are provided. To deal with the core problem, and not its symptom, the following change plan is suggested and backed up by theoretical research.
A larger number of meetings is suggested to improve the relationships and communication between the employees. In order to increase the understanding of the employees’ responsibilities and relationships with their colleagues, these meetings will be upgraded to action research (AR). AR is a framework that links research and practice in a common effort of organizational improvement (Munten, van den Bogaard, Cox, Garretsen, & Bongers, 2010). AR will increase the understanding of the current citation and may provide insider solutions that are most suitable for this organization. AR involves employees in the processes of research and action, which correlates with the modern trends in nursing leadership. The form of AR is also a momentum-gaining strategy, as it turns the process of research and change into a constant, self-sustainable mechanism.
The second and the third changes will be carried out to ensure that the meetings fulfill their purpose. To ensure that the new educational environment is being promoted, training on the leadership and followership and AR will be provided. A body (committee or council) will be established to oversee the meetings and keep track of the suggested ideas. An internet forum for the facilitation of the mentioned processes will be created to ensure the momentum for these changes. Being transferred to the Internet, the processes of AR and knowledge sharing will become simpler, more accessible and attractive.
In other words, the change will be aimed at the improvement of employees’ relationships and collaboration, their professional development, and the creation of an educational environment, all of which is vital to the successful operation of a healthcare organization (Messmer & Turkel, 2010, p. 237). The improvements in the organizational culture can resolve the problem, the symptom of which has been noted, improve the employees’ relationships and job satisfaction (Springer, Clark, Strohfus, & Belcheir, 2011). The actual change includes the creation of the council, the increased number of meetings, and training while the momentum is gained through AR and process modernization, but all these elements constitute a consistent system that is described below in the three steps of Lewin’s theory as presented in the article by Shirey (2013).
The first stage of Lewin’s change theory presupposes “unfreezing” the current situation, and in this plan, it means creating the committee and launching the AR to define the problem, spread the awareness of it, and find the proper solution as a part of the first stage of change. The object of this AR is the leadership and followership within the organization. Nowadays it is recognized that transformational empowering leadership tends to improve the performance of medical units in numerous aspects, including improved knowledge, experience, and information flow and application (Johansson, Fogelberg-Dahm, & Wadensten, 2010; Curtis, de Vries, & Sheerin, 2011). The current situation should be examined and compared to the modern trends to ensure the change. The revision of the situation is the second stage (transition stage in the terms of Lewin). It involves the creation of a detailed plan of action and related activities that would ensure its smooth implementation. In order to provide the employees with a ground for comparison, the training is going to be introduced during this stage; it will also ensure that the employees understand the change and are ready to embrace it. The final, refreezing stage stabilizes the change it by embedding it into policies, practices, and the culture of the organization itself. It includes both the achievements in the field of corporate culture and those of AR. The specifics of AR ensure wide involvement of employees, which should facilitate the transition to the refreezing stage.
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