Introduction
BayCare is a not-for-profit healthcare system that provides services to individuals residing in Central Florida. Services cover inpatient and outpatient interventions with core areas of medicine, including behavioral health. BayCare encompasses 15 hospitals with the common goal of providing high-quality care based on empathy and compassion (Evolution change management, 2017). BayCare follows the need to integrate change into nursing practice, which is why it recently introduced hourly rounds as a preventive intervention to reduce patient falls.
Implementing Change
BayCare decided to introduce changes related to the nursing organization to improve the quality of care provided and to create preventive measures against complications. Among the measures introduced were hourly nursing rounds aimed at assessing patients and checking their condition, reducing the frequency of falls among patients with significant disabilities or general health problems. This measure combines several essential criteria for change: it is rational and evidence-based (Meade et al., 2006), encouraged by the organization itself, and tied to specific BayCare values. The change introduced has positively impacted the patient comfort situation in hospitals.
This intervention was planned to improve overall patient safety in BayCare-owned hospitals. It included preparing nurses for the change, as this is the only way to achieve an understanding among staff of why interventions are essential. In addition, the nurses received a lot of background information about the change being introduced, its practical side, and the associated opportunities. Finally, they shared their perceptions of the change and discussed its perspectives.
This tight and confident plan to prepare for the integration of the change allowed BayCare to make significant gains in the impact of the intervention. The number of falls among patients decreased significantly, and the nurses took a leadership role in making their rounds. Having a leader who managed the other nurses made it possible to reach a mutual understanding of what order should be established during rounds. Truong et al. (2021) indicated that such organization and autonomy promoted a standard policy and evaluation of the effectiveness of the changes being introduced. Consequently, having a leadership position and a source of organization for introducing hourly rounds allowed for positive results.
BayCare’s behavior can be assessed as positive and consistent with organizational values and principles. The organization took a long time to think about the intervention and put much effort into its implementation. Nevertheless, it must be recognized that BayCare encountered typical problems, expressed in a lack of total acceptance of the practices being introduced and a lack of understanding of the need for change. Mistakes in the first stages of introducing the change can be attributed to the fact that the encouragement of the change was initially ad hoc and was not extended universally to participants. BayCare learned its lesson from this: added information resources to training, prepared equipment for nurses, and regulated human resources processes.
Change Action Plan
For BayCare, the most promising plan for change that will significantly improve current outcomes and reduce unnecessary risk may be a plan with about five steps. At the first stage, BayCare should worry about who, in addition to direct leadership, would be willing to participate in implementing change (Sumanasiri, 2020). Although they brought in a nurse leader, this was not enough to be fully organized. This is why BayCare must establish a task force of individuals who can position staff and manage change integration. This change team will identify a fundamental problem – injuries among patients in hospitals from falls (Di Massimo et al., 2022). The problem is valid, and the change team must make a case for why they should be in charge of the current policy.
Secondly, BayCare must establish the quantitative and qualitative indicators the change will target. This step allows us to determine exactly who and why the target audience for the changes are – individuals at risk of injury from falls, and who will prevent them – nurses. This step should also establish a goal: to reduce falls and injuries from falls. BayCare’s third phase will establish that introducing hourly rounds is an evidence-based practice to improve patient safety. This phase consists of collecting data on ways to overcome the problem, the effectiveness of those ways, and directly developing an individualized solution pathway (Rousseau & Have, 2022). These two phases define the relationship between theoretical assumptions and explicit practical evidence from potential interventions that can be implemented in the current setting.
In the fourth step, the organization’s main task is to develop a plan for continuous improvement that can be integrated into the change process. For BayCare, it consists, in particular, of equipping the nurses on rounds with the necessary equipment, changing the team of supervising nurses and changing how they communicate with each other. This step improves accountability for actions taken and feedback, which allows for the evaluation of integrated changes (Errida & Lotfi, 2021). Without change tracking, the likelihood of successfully implementing change will gradually diminish.
The final step would be to evaluate the final plan and begin implementing it. BayCare should provide all of its goals, objectives, and potential solutions in a list or flowchart that will serve as a practical guide to change. Leaders and leadership who have proposed to launch the change process should take responsibility for keeping the communication pathways straight because it will allow them to manage competently (Sumanasiri, 2020). During the final evaluation phase, the change team must weigh in on the introduced changes and disseminate them to the individuals who will implement them – leaders and nurses. BayCare will be better able to prepare for all the potential outcomes of the change, which are more likely to be positive (Rousseau & Have, 2022). The organization must begin implementing the changes and monitor their implementation carefully to avoid increasing the risks of failure or making mistakes. The steps described will accomplish this if BayCare ensures sufficient communication (Errida & Lotfi, 2021) and assesses exactly how employees may respond to change (Higgins & Bourne, 2018). Taken together, these steps will achieve the most favorable outcome possible.
Ways to Leverage Insights from Employees
Personnel is the main driving force behind the organization that allows any change to occur. In essence, the staff is the individuals who do the fieldwork, and any company needs to maintain its involvement in change processes to achieve positive results (Albrecht et al., 2022). Involvement can consist of direct staff involvement in decision-making for BayCare, and it is the feedback from the nurses who start making the rounds. This information goes to management, and management accepts and analyzes it, decides to add resources to the nurses, and brings the information down again (Albrecht et al., 2022). This communication allows the company’s values to be maintained at all stages of change management. Higgins and Bourne (2018) suggest that to successfully implement change, potential behavioral patterns among staff must be assessed, e.g., rejection or active participation. Since nurses are the first to respond to a new work policy, their opinions are the primary source of information about the effectiveness of changes in the implementation and improvement phases.
The competitive ability of any organization is made up of whether its activities are in the community’s best interest and the staff of that organization. The employees act as the key to creating a dynamic, evolving environment in which change flows easily (Ghar & Masood, 2022). BayCare can use its relationships with staff to co-design changes that benefit all stakeholders. If management is willing to consult with their current change agents in the early stages, the success of such a change will be much higher. During their preparation phase, it is essential to reach out directly to the nurses to understand the change (Errida & Lotfi, 2021). Simply guiding will not be enough; it is important to hear what the staff who are the fastest to experience the effects of change are saying.
Alignment with Organization Goals
BayCare, like any other healthcare organization, is committed to delivering the highest level of care. Their goal is to achieve positive outcomes in patient care and population survival. According to BayCare’s official statement, their values are trust, respect, and dignity (Our mission and values, n.d.). As part of the change process, it is reflected in the stages of establishing the underlying problem and how it is addressed (Evolution change management, 2017). As BayCare strives to provide highly skilled care, this cannot be achieved without a positive trend in hospital surveillance. Integrating changes to continually improve patient monitoring and the organization of their safe and comfortable hospital stays is critical.
The values of trust and respect are best seen in stages three and four of the change process. The organization accepts the responsibility to respect the current evidence of evidence-based practices that can enable progress in solving the problem. In addition, it also considers the views of the nurses who will integrate these practices into the work. A trusting relationship is created between management and patients through the caring work of the nurses, in which health care directs all efforts to help patients (Our mission and Values, n.d.). BayCare, through this process of change, provides its patients with the support, resources, and equipment that will best achieve the primary goal of recovery.
Conclusion
Thus, any change process that integrates into an organization must go through specific steps to achieve the best results. Concerning BayCare’s change practices, significant progress has been made in reducing the incidence of falls among patients within the hospital. This has been achieved through the introduction of hourly patient rounds, which have allowed falls to be identified and prevented. For this change, it is recommended that the change process be based on a five-step model that seeks to clearly define who is making the change, how, why, and for whom, and what goals it is trying to achieve. This aligns with BayCare’s values of striving to provide patients with a comfortable and safe hospital stay despite their health challenges. BayCare should focus on direct interaction with staff and learning their behavioral strategies, establishing communication and feedback systems, and preparing the ground for change in a timely and appropriate manner. This will allow the organization to achieve results with maximum efficiency and minimize costs.
References
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