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Nursing Change initiative paper - Essay Example

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In the Kotter world of change their is the theory that change has both emotional and situational components. Kotter uses an 8 step model that manages both at several points in the model. The theory consists of developing urgency, building a guiding team, creating a vision, communicating for buy in, enabling action, creating short term wins, don't let up and making it stick…
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Download file to see previous pages This paper will discuss the change effort to be made in one institution, Comanche Regional Hospital.
Most people that have a change issue in their company are aware that a change needs to happen. They begin to get complaints or sales fall off. In the case of Comanche Regional Hospital the bottom line is running in the red and the turnover rate of new motivated managers is very high because of the age and beliefs of the older senior team running the facility. Even when there is a need for change as great as this one, however, complacency is most often the problem (Kotter, 1996). Urgency, at this stage must be created. In this case, there is a huge barrier and that is the mature management team that has been there for some time and talks a lot about change but never sees it happen. The next step in this case is the board. Creating a sense of urgency demands risky action. Going to a board meeting with a group of recent department directors who turned over quickly and customers that have in the past used the hospital is the move in this case that will create urgency the fastest. At the same time take a well created report to a management meeting showing how the bottom line is dropping off, how many jobs will be lost in what departments (it is much more urgent for a department director who must go to his staff and tell them they are laid off) and show over the last two years the number of department directors that have been hired and who have left the organization. Relate that to the cost of recruiting, hiring, and orienting this group. Continue by showing where the hospital could be as far as raises and incentives and management bonus if the bottom line is improved and that money is not spent recruiting the same positions all the time. Most recently there has been a very poor JCAHO review which came close to causing a closure of the facility. This has created a sense of urgency in itself and because of that and that we will create it is time to strike.
Create a Coalition
In every organization there are formal and informal leaders. Those people must be identified at this time as they will need to be on the guiding coalition. There are two champions that have influence and could be chosen at this time. One is Dr. Ben who has general influence in the hospital as well as in the community. He is well liked and retired from practice but working closely with other physicians. The other is Dr. Dale who is the head of the hospitalist program and this year will be Chief of Staff. Nurse D will be added to the list as she is a manager of the medical departments and has a good ability to work well with management as well as the nurses and staff. She is highly respected. Nurse A is the department director for the critical care units and due to the fact that she is fairly new to the hospital and has led successful change in her past, she is a great addition to this coalition. JP is a board member who has good communication skills among all of the different factions and has respect on both side of the boundaries. He will provide the coalition with more power and be able to carry what is needed back to the board. Each of the other seats will be filled by staff people who have been progressive in stepping out of the box to improve things in their ...Download file to see next pagesRead More
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