NURS 6241: Strategic Planning in Health Care Organizations | Week 10

At Jones Memorial, a well-known trauma center in a densely populated urban area, administrators and the rest of the strategic planning team are considering adopting a new health information technology system. They anticipate this will help to monitor health care quality and patient safety, improve communication, and streamline patient flow from intake through discharge and billing.

As the strategic planning team at Jones Memorial prepares for this change, what potential barriers should they anticipate? Whom should they include in the planning process, and how can they use team building to facilitate positive outcomes?

This week, you examine barriers to planned change. You explore how to predict and work with these barriers—from the normal, to-be-expected challenges, such as resistance to change and role adjustments, to those that arise as a result of having an overly complex plan or failure to engage in proper resource management.

Learning Objectives

Students will:

• Analyze strategies for overcoming barriers to change
• Analyze strategies for identifying a team of change champions**This Learning Objective is also assessed in Week 11.

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and application (9th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.

• Chapter 8, “Planned Change”(Note: You may have read this in a previous course.)

Sare, M. V., & Ogilvie, L. (2010). Strategic planning for nurses: Change management in health care. Sudbury, MA: Jones and Bartlett.

• • Review Chapter 7, “The Three Key Elements of the Strategic Planning Process: A Vision That Guides Nursing’s Future Action”
    • “The Architect, Change Agent, and Communicator: Three Crucial Roles in Strategic Planning” section (pp. 135–136)

• • Chapter 9, “Understanding Change Theory: Strategic Planning Change Agents” (pp. 171–194)

• • Chapter 10, “Communicating the Strategic Plan” (pp. 195–212)

• Chapter 11, “Eight Cautionary Tales of Strategic Planning” (pp. 215–226)Chapter 9 examines change theories and how these theories can be applied in strategic planning. Chapter 10 explores the importance of communication throughout the strategic planning process and how strong communication and reduce barriers to change. Chapter 11 provides examples from the field of strategic planning efforts.

Gerrish, K., McDonnell, A., Nolan, M., Guillaume, L., Kirshbaum, M., & Tod, A. (2011). The role of advanced practice nurses in knowledge brokering as a means of promoting evidence-based practice among clinical nurses. Journal of Advanced Nursing, 67(9), 2004–2014.

This article describes some of the barriers to change (in this case, implementing evidence-based practices) that nurses encounter and examines knowledge brokering to facilitate change.

McMurray, A., Chaboyer W., Wallis, M., & Fetherston, C. (2010). Implementing bedside handover: Strategies for change management. Journal of Clinical Nursing, 19(17/18), 2580–2589.

This article examines a change in nursing handover practices to analyze change management with attention to individuals’ attitudes, motivations, and concerns. See Figure 2 for example of unfreezing, moving, and freezing.

Nesse, R. E., Kutcher, G., Wood, D., & Rummans, T. (2010). Framing change for high-value healthcare systems. Journal for Healthcare Quality, 32(1), 23–28.

The authors address factors that impede change and discuss change management principles, including the value of team investment for facilitating change.

Required Media

Laureate Education (Producer). (2013c). Challenges of implementation [Video file]. Retrieved from https://class.waldenu.edu

Note: The approximate length of this media piece is 3 minutes.

Dr. Carol Huston discusses some of the challenges faced when implementing a strategic plan and strategies for addressing those challenges.

Discussion: Team Building and Addressing Barriers to Planned Change

Planning and implementing change can be quite challenging, especially in a complex health care environment. No matter what kind of change is undertaken, there are likely to be some obstacles. Yet, wise leader-managers, and those with whom they work, recognize that change is necessary and revitalizing; they see that planned change can not only contribute to organizational sustainability but also promote high-quality care and positively impact patient outcomes. These leader-managers harness a larger vision and engage in forethought and analysis to minimize and address barriers to planned change.

Based on what you have learned about the change process and strategic planning, what barriers do you think may arise related to the change you are proposing through your Course Project? How would you cultivate stakeholder involvement and promote team building for your planned change?

As you think about these questions, consider the following statement: “The system will evolve based on changes in the behavior of the people in the system” (Nesse, Kutcher, Wood, & Rummans, 2010, p. 27).

Do you agree? Why or why not? How does this relate to the specifics of your strategic plan?

To prepare:

• Review the information presented in the Learning Resources, including Dr. Carol Huston’s comments on addressing barriers to implementing a strategic plan change. Consider insights related to change theory, common barriers to change, and strategies for addressing these barriers that relate to the implementation of your proposed change.
• Identify specific barriers you are likely to encounter with your proposed change, including resistance to change. Evaluate strategies that may be used to minimize or address these barriers.
• Think about the value of stakeholder involvement in planned change, as well as the specifics of stakeholder participation in your strategic plan to champion the change. Who should be involved in strategic planning and at what point? How could they serve as change champions?

By Day 3

Post an explanation of strategies you would use to minimize or address barriers, including resistance to change, related to your strategic plan. Explain how you would promote stakeholder involvement for your proposed change, and encourage them to become change champions.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days using one or more of the following approaches:

• Provide feedback on their strategies for addressing barriers to change.
• Suggest additional strategies for addressing barriers or resistance.
• Offer additional insights for identifying appropriate stakeholders.
• Suggest additional stakeholders or change champions to be involved. Team Building and Addressing Barriers to Planned Change Discussion

 

 

ADDITIONAL DETAILS 

Team Building and Addressing Barriers to Planned Change

Introduction

Group change is a challenging task for anyone. The process of convincing a group to do something new can be even more challenging, especially when you’re trying to convince people who are already comfortable with the status quo. To successfully make planned changes in your company or group, you must first convince everyone that there’s an alternative option other than what they currently have going on. After all, if everyone has already decided what they want (or think they need), why would they consider changing anything?

Acquiring and Maintaining the Group

The first step in setting your own goals is to define the problem. What do you want to change? How much time do you need? What are the barriers that are keeping you from achieving those goals?

Once you’ve defined the problem, it’s time to set some concrete numbers. Are there any measurable indicators of success (for example, a new personal record)? If so, how can we use those as benchmarks for our progress over time?

Next up: be ambitious but realistic! Don’t aim for something too lofty—you’ll only be crushed if things don’t go well (and they probably won’t). Instead, focus on what could realistically happen within 3-6 months from now; this way there will still be room for growth and improvement if something goes wrong or takes longer than expected!

The next step is deciding how much effort each member should put into achieving their individual objectives during this period of time: are there set meetings every week where everyone meets up with each other once per month and discusses progress made towards reaching their individual goals? Or maybe just one meeting per quarter which lasts half an hour so everyone has enough time between work hours but doesn’t consume too much energy away from home life either…

Maintaining Productivity and Momentum

Maintaining momentum is important because the more you do something, the more likely it is that your behavior will continue. This can be seen in many different ways—for example, if you are a runner and want to become a marathon runner, then continuing with running every day will help build up your stamina and endurance so that eventually you can run 26 miles! On the other hand, if someone has been running for three months but then stops their training program after two weeks without any new goals or plans in mind, they may find themselves unable to return back into racing shape like what they had hoped previously (and thus never reaching their goal).

There are many ways that maintaining productivity can be achieved:

• Having clear goals helps employees stay focused on their work tasks at hand; this allows them not only focus on completing those tasks but also helps them feel motivated by being able to see where they’ve come from now compared with where they were previously.

• Making sure everyone understands why certain things need done makes sure everyone knows what needs doing before moving onto another project/task

Monitoring Temperatures in the Room

One of the most important things to monitor when you’re addressing any type of barrier is temperature. It’s important to be aware of your own temperature and make sure it’s appropriate for what you’re doing in that moment, whether it’s a team building activity or just getting-to-know-you small talk.

You can use a thermometer (or two) to check the temperature in different parts of your room, but here are some other ways to do so:

• A simple “air conditioner” at one end of your room will help cool down all sides evenly. If there aren’t any windows near this area, place something with an open weave—like muslin—overtop so that air can flow through it easily without being blocked by furniture or other objects. This should also help control how much heat rises into higher areas where people tend not spend much time anyway; otherwise, those spaces may become too warm from all those bodies!

Building Consensus for Planned Change

Consensus building is the process of identifying and addressing concerns. It’s an essential tool for addressing barriers to planned change, as it can be used to build consensus around a plan of action.

Consensus building is not just about accommodating everyone’s opinions; it also requires that you identify which ideas are most important for your group to implement. For example, if you want your team members on board with changing how they use technology in their office space and who decides what changes need to be made, then you’re going to have some tough decisions ahead of you! You’ll want to start by listening carefully and then asking questions such as: ‘What are some things we could do differently?’ or ‘What do we think would work best?’

Communicating and Follow-Up Plans

• Don’t forget to communicate with the group after the meeting. It is important to follow up with the group in the future and make sure they understand what was discussed at that meeting, so it may be helpful for you or a leader or manager to send out an email or text message notifying everyone of where they stand on certain topics.

• Follow up should be done in a timely manner (within 24 hours). If there are any questions about what was said in your meeting, then ask yourself if those answers can wait until next week’s meeting? If not, then make sure that someone else gets these questions answered before sending them back down-line again!

• Follow up should be done by an individual who is familiar with all aspects related to this project/program/etc., rather than just one person who may not have seen everything yet due to schedule conflicts etcetera.”

To convince a group to make a change, you must speak to them directly.

To convince a group to make a change, you must speak to them directly.

• The importance of using a common language: You need to talk about the same thing in as many ways as possible so that everyone understands what you mean. For example, if all members of your group are from different countries and speak different languages, then it’s important that everyone communicates their ideas clearly and consistently. This can be difficult because there may not be an easy way for all parties involved (such as translators) who have different levels of knowledge about certain topics than others do. As such, it’s important not only that everyone understands what they’re saying but also how they say it (ease of expression).

• The need for specificity: When communicating with others through language or body language alone—without using words—you must ensure that these methods match up with those used by others in order for communication between people who don’t share much common ground otherwise happen smoothly enough so as not disrupt other aspects too much before long-term goals could be achieved successfully instead.”

Conclusion

As you can see, there are many ways to address a group’s concerns about change. You don’t have to rely on bullying or manipulation—you just have to call them out on their own behavior. If someone in the group feels uncomfortable with the idea of making a change, then it might be time for that person to step down and let someone else take over.