A change situation refers to the existing barriers and facilitators to change. Examples of the barriers and facilitators to change include the environment, the availability of support service, IT and staff morale. Change is carried out when facilitators’ force exceeds the existing barriers. An effective agent of change mitigates the effect of barriers to alter and enhances the effect of change facilitators. This involves the mobilization of innovators and early adopters to initiate change.
The impact of organizational change is dependent on three factors; the stage of organizational development, the degree of flexibility, and the history of response to change. There are two approaches to change; linear and nonlinear. The linear approach is appropriate for the low-level change in the relatively small nursing organization. It involves identification of the problem (unfreezing), experiencing change followed by acceptance of a new attitude or behavior (refreezing).
The most appropriate theoretical framework for effecting planned change is the Innovation-Decision process developed by Rogers (2003). The nonlinear approach is best suited for complex change. There are two approaches to nonlinear change: the chaos organizational strategy and the learning organization strategy. The roles of change agents in nonlinear change include planning, organizing, implementing, evaluating, and seeking feedback. The main function of the change agent is constantly influencing the group to achieve the predetermined goal.
Teamwork is necessary for the process of delivering quality nursing healthcare. A team is different from a group in that it consists of individuals who are associated with a particular activity. Thus it is important to maintain a good working relationship through effective communication. This enables a clear definition of purpose, promotes commitment, and encourages a high degree of participation by team members to achieve desired outcomes. An effective team leader should have the ability to model action plans, inspire members to share the company’s vision, be innovative, facilitate others to function, and motivate the team members.
Stress within a team is addressed by the identification of communication barriers and avoidance of communication pitfalls. The effective resolution of conflicts in a team is aimed at promoting a willingness to cooperate among members and enhance their commitment to a shared mission. It is important to focus on the strengths of team members and provide an opportunity for using and developing their skills. The acknowledgment of members’ contributions in a specific, personal, sincere, and timely manner as it is critical in building an effective team. The management of emotions is necessary for building trust among team members and reducing conflicts. The team relationship should be built on mutual respect and, most importantly, the members’ adherence to agreements.
Conflict is an important concept in the healthcare environment since it impacts the patient’s safety. It is an important stimulator of change which may be detrimental or positive. Effective resolution of conflict in the workplace deepens on and promotes human relationships. There are three types of conflicts in the healthcare environment. The intrapersonal conflict is basically held within the individual player. Interpersonal conflicts include disagreements between various parties, such as nurses, physicians, and patients. Organizational conflict comprises discord between the organizational policies and strategies with internalized norms among employees and patients.
It is important to understand the four stages of conflict; which are frustration, conceptualization, action, and outcome. This makes it possible to effectively address the problem. There are several strategies that can be employed in resolving conflict, depending on its nature. These include collaboration, competition, compromise, accommodation, and avoidance. Avoidance and accommodation are the most utilized strategies in resolving conflict in the nursing profession. These approaches seek to deter the escalation of conflict. However, they may lead to increased stress among individuals and organizations that gradually constrains the achievement of the desired outcomes.