Introduction
Being a part of RWJBarnabas Health in New Jersey, I get a chance to observe how an effective health system should be organized and integrated. This organization has a clear mission and values to reach people and provide them with competent care. In addition to the necessity to advance the overall population health, RWJBarnabas aims at improving the quality of care, collaborating with different physicians, and considering the well-being of all communities (“RWJBarnabas”, 2016).
However, in its intentions to create a perfect image of a strong healthcare organization, RWJBarnabas fails to solve its internal managerial problems, like communication between doctors and nurses. RWJBarnabas managers have to control all activities, hire the best physicians, and use the latest technologies to provide all communities with healthcare services under equal conditions. Still, not much attention is paid to the way of how medical workers communicate with each other. They have to exchange all important facts in time and make sure that neither confusion nor mistakes occur in patient-nurse cooperation.
To avoid misunderstandings between nurses and patients and raise the level of professionalism offered to patients by the RWJBarnabas medical staff, it is recommended to improve the organizational mission and make sure that all medical workers understand the worth of interpersonal communication. The purpose of this paper is twofold: to prove that RWJBarnabas has communication problems in the Medical-Surgical Unit and to identify the recommendations that may be given to improve the work of the chosen healthcare provider.
Problem
Poor and insufficient communication between doctors and nurses may lead to some negative outcomes in hospitals. For example, doctors may not find it necessary to inform nurses about the outcomes of their treatment discussions with patients. As a result, when nurses start talking to patients, they turn out to be unaware of the recent changes in treatment, feel themselves at a loss, and put their professionalism under a serious patient’s question. Such situations may frequently be observed in the Medical-Surgical Unit of RWJBarnabas. Lack of communication is a problem that has to be solved because it has a direct impact on patient-nurse relations, the quality of nursing care, and the general reputation of the healthcare provider.
Realistic Change
To address the problem of poor doctors-nurses communication, one specific change may be offered. It should touch upon the list of values supported by the employees of RWJBarnabas. Regarding the vision of the organization, technology, and information innovations promote fast and high-quality care being offered to patients. These innovations can improve communication in different ways. The growth of digital technologies has already influenced the fields of nursing education and research (Button, Harrington, & Belan, 2014). Now, it is possible to investigate the impact of technologies on communication between doctors and nurses.
The reduction of gaps in health care quality is a part of improvements that may be achieved in a short period (McAlearney et al., 2014). The peculiar feature of the offered change is to make sure that each doctor’s visit to a patient ends up with a brief statement addressed to a nurse. This obligation makes all doctors inform nurses about recent changes in patients’ cases, develops new forms of communication between doctors and nurses, including face-to-face contact or a message, and increases the level of professionalism of the medical staff.
Alignment with the Organization
This section aims at aligning the change with an organization. RWJBarnabas has already established certain missions. At the same time, its employees are ready to undergo some changes with the help of which they can improve the quality of their work and care, employee retention, and customers’ feedbacks. Change can never be easy, and it should result from a properly developed thought and certain deliberate efforts (Marquis & Huston, 2015).
Kurt Lewin is the author of a classic change theory according to which three main steps should be taken: unfreezing, movement, and refreezing (Hayes, 2014). The change in communication between the medical staff of RWJBarnabas requires much time, and this organization has opportunities to develop the change properly. First, it is necessary to prove that the problem exists and needs to be solved. Then, it is expected to explain what kind of work should be done. Finally, new activities and demands have to be implemented. RWJBarnabas should not pay for any new devices and services. Internal organizational changes take place.
Change Model
Lewin’s change model will be used to plan and implement the change. The rationale for this choice is its simplicity and the consideration of the working environment dynamics. Unfreezing is the stage when a problem (the lack of communication between doctors and nurses) is defined and proved, and a solution (to underline and promote the importance of communication) is offered. Movement is the second phase when new attitudes, beliefs, and processes have to be adjusted to shape a new form of behavior. Refreezing is the final step when new behaviors have to be reinforced, and new levels of performance must be maintained.
Steps to Facilitate Change
In addition to the steps defined in the chosen model, there are several suggestions for RWJBarnabas employees to facilitate the change. They include a constant communication of change details and importance so that doctors and nurses understand why they need it, the measurement of change progress, so that all participants know when they have to stop and what lessons they should remember, and the provision of credible examples of how the same changes have been already implemented in other organizations. Some people just need several examples to comprehend what they should do. An understanding of personal doubts and fears is a type of support RWJBarnabas leaders can offer to their employees.
Change Agent
A change agent aims at facilitating change in its organizational and environmental aspects (Scherer, Alban, & Weisbord, 2015). In RWJBarnabas, employees understand the importance of high-quality care and support they should offer to their customers. Patients have their health problems which need to be treated properly. Doctors and nurses are ready to help them. Still, the lack of communication and poor exchange of information may prevent the medical staff from providing appropriate care and support.
It is necessary to hire one manager who can observe the cooperation of doctors and nurses, defined and analyze their mistakes, inform the employees about the necessity to communicate, and make sure that each discussion between a doctor and a patient should end with a discussion between a doctor and a nurse. The change manager should possess such qualities as persistence, confidence, critical thinking, persuasion, and intentions to help, but not only to teach and guide.
Conclusion
In general, the problem of communication that is observed between doctors and nurses of the Medical-Surgical Unit at RWJBarnabas can be solved. It does not require many expenses. One person should be hired as a senior change manager and provided with full powers and access to observe the work of all doctors and nurses of the facility. Employees have to understand that their work is impressive. Still, it can be improved to increase the quality of care, underline the professionalism of the staff, and avoid misunderstandings in communication between doctors, patients, and nurses.
References
Button, D., Harrington, A., & Belan, I. (2014). E-learning & information communication technology (ICT) in nursing education: A review of the literature. Nurse Education Today, 34(10), 1311-1323.
Hayes, J. (2014). The theory and practice of change management (4th ed.). New York, NY: Palgrave Macmillan.
Marquis, B.L., & Huston, C.J. (2015). Leadership roles and management functions in nursing: Theory and application (8th ed). Philadelphia, PA: Lippincott, William & Wilkins.
McAlearney, A., Terris, D., Hardacre, J., Spurgeon, P., Brown, C., Baumgart, A., & Nystrom, M. (2014). Organizational coherence in health care organizations: Conceptual guidance to facilitate quality improvement and organizational change. Quality Management in Health Care, 23(4), 254-267.
RWJBarnabas: Our vision. (2016). Web.
Scherer, J.J., Alban, B., & Weisbord, M. (2015). The origins of organization development. In W.J. Rothwell, J.M. Stavros, & R.L. Sullivan (Eds.), Practicing organization development: Leading transformation and change (4th ed.) (pp. 26-41). Hoboken, NJ: John Willey & Sons.