Change is a vital aspect of nursing practice. However, the complexities of the evolving healthcare system in the delivery of quality patient care present a challenge to nurse leaders’ efforts to lead change. Despite the existing challenges, the speedy pace of change in the healthcare environment creates opportunities that nurse leaders could harness to refine and advance management and leadership skills to adopt and foster change in their organizations. Nurse leaders always initiate, formulate, and implement change initiatives to accomplish institutional objectives and goals. Managing change in the healthcare organizations entails handling the complexity of the change process appropriately. It is about evaluating, planning and implementing tactics, strategies, and operations, and ensuring that the change is relevant and worthwhile. This paper explores various theories that nurse leaders could apply while approaching change in the healthcare environment. Healthcare leaders could harness the components of transformational leadership, process change, and the mission and vision of an organization to effectively adapt to and advance change and growth in their institutions.
Transformational Leadership
Advancing an effective healthcare system that prioritizes patient safety besides high-quality service delivery requires transformational leadership. According to McCaffrey and Reinoso (2017), transformational leadership creates a significant change in the organization's culture and employees. It redesigns values and perceptions and changes the aspirations and expectations of employees. Transformational leaders have the ability, traits, and personalities to set challenging goals, articulate their vision, and lead other staff by example (Krepia et al., 2018). In this case, they enhance the morale and motivation of others while also connecting communities to the collective identity and mission of the organization. As a healthcare leader, the concerned individual visions the desired outcome analyzes the current reality and identifies opportunities to improve healthcare delivery through an organizational cultural change.
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Transformational healthcare leaders act as role models in their enterprises. As noted by Krepia et al. (2018), transformational leaders should demonstrate the change they expect to see. Taking the lead role is imperative in enhancing their effective adaptation and creating followers and motivating others to embrace the change. Transformational leadership allows senior executives to inspire others in the face of challenging goals (McCaffrey & Reinoso, 2017). The desired change may not be palatable or acceptable; however, through transformational leadership, the leaders articulate an appealing and inspiring vision to their followers.
Transformational leaders formulate an interdisciplinary approach to adapt and effect change in their healthcare organizations. Herd et al. (2016) posit that interdisciplinary approach creates opportunities through which healthcare leaders could address health social determinants by acknowledging that other people within the healthcare system have varying perspectives. In other words, adapting to change requires the recognition and respect of other people's opinions. In this context, transformational leaders do not push aside new ideas outside of their normalcy but welcome them as an avenue to strengthen and support their vision and goals towards the organization.
Building bridges and continuous improvement into their organization's fabric is another way healthcare leaders could harness transformational leadership to adapt to change and growth. Herd et al. (2016) say that healthcare leaders should build relationships established on trust. The leaders understand the necessity for consistency in listening to others and understanding their concerns. They demonstrate commitment towards the change to provide others in their organization with a sense of meaning and purpose that synergizes them to accept the change. On a similar note, McCaffrey and Reinoso (2017) state that transformational healthcare leaders should be open to new ideas. As the scholar further expounds, being open and articulating the new ideas creates a culture of consistent improvement with a view of embracing new ways of mitigating challenges in their organizations. Besides, the ensuing open environment allows employees to take the initiative and innovate solution-oriented ideas rather than complain about the present or imminent changes (Herd et al., 2016). Therefore, working together in a way that allows others to participate in creating solutions against organizational problems creates an opportunity for accepting and implementing change in healthcare organizations.
Process Change
Developed by Kurt Lewin, process change theory has been instrumental in promoting adaptation to change in nursing practice. The theory entails a three-stage model, unfreezing-change-refreeze framework that stipulates that individuals have to reject and replace prior learning (DaCosta, 2020). Healthcare leaders could Lewin's process change process could be applied the Lewin's process change theory to advance the adaptation of change and growth. Through the unfreezing aspect, the leaders should find methods that could make it easier to let go of old patterns in their organizations. Herd et al. (2016) state that people resist change more often than not, especially changes that interfere with their comfort zone at the workplace. In this case, the unfreezing phase's importance would be for the healthcare leaders to familiarize themselves and teach the same to others on how the current level of operations or status quo hinders the organization's process.
On the changing composition of Lewin's model, change agents are unfrozen and, therefore, could start embracing the new ways and processes. In the changing step, the healthcare leader should implement the change. However, this phase is marked with anxiety and uncertainty, making it challenging for people to accept change (DaCosta, 2020). As a healthcare leader, it is imperative to initiate education, support, and communication programs to ensure learning the new processes, ways of thinking, and behaviors become easier. Kumar et al. (2015) state that the change process requires careful planning and execution to ensure people remain well aware of the reasons behind the change. Therefore, throughout the change process, healthcare leaders should refer to reasons for change and its benefits to the organization after successful implementation.
The final stage of Lewin's process change model is the refreezing step. In this phase, healthcare leaders should stabilize, solidify, and reinforce the organization's new state of affairs. The new organizational processes, structure, goals, behaviors, and offerings become the new norm (Herd et al., 2016). Hence, the change becomes a reality as the company operations are aligned with the change.
Mission and Vision of an Organization
The mission and vision of an organization set the pace for organizational goals and objectives. Healthcare organizations envision providing high-quality healthcare services while at the same time, creating a motivated staff (Herd et al., 2016). Healthcare leaders should operate within the confines of an organization's mission and vision. In this case, they will be able to adapt to change and growth and inspire other employees to accept and implement the new ways or goals embodied in the desired change. Kumar et al. (2015) present that healthcare leaders should look beyond the walls of their organizations to broaden their objectives and goals in the hospitals. While looking beyond the hospital's walls, the healthcare leaders should operate and inspire others to work within the organization's scope as tabulated in its mission and vision.
Healthcare leaders should push their institutions to take responsibility for the health of the larger community, but not just their immediate patients. However, according to Kumar et al. (2015), communication is key to effecting change aligned with the broader mission and vision of a healthcare organization. Appropriate and effective communication skills support the mission and vision-grounded leadership aspects. Herd et al. (2016) opine that proper communication in the hospital settings makes the organization's mission and vision precise, engaging, compelling, and understandable, thereby making it easier to adapt to change. Therefore, healthcare leaders focused on embracing change, and inculcating the same to others should be committed to the institution's mission and vision to create willing supporters ready to invest more efforts in the new ways of accomplishing their tasks.
Healthcare leaders could also harness the mission and vision of their organization to adapt to change and growth by supporting accountability in the institutions. According to Kumar et al. (2015), change and growth come with new ways to interfere with the considered normalcy in organizations. Likewise, Herd et al. (2016) argue that change and growth disrupt the comfort zone of various employees leading to resistance to the change. However, healthcare leaders could hold their peers and staff accountable, particularly those undermining the organization's mission and vision (Kumar et al., 2015). The leaders set change or growth-aligned goals and measure their progress against the organization's mission and vision. Thus, while setting an example in adhering to the new norms and organizational goals, the leaders communicate optimism about the goals, provide meaning for new tasks, and challenge them with high standards.
Change-Driven Improvement in Healthcare Practice
Proper record keeping in health institutions is crucial in promoting the seamless implementation of hospital programs and service delivery to the patients. It is a communication instrument that fosters coordination of medical services, evaluation of the efficacy and quality of care, education, legal protection, regulatory services, accreditation, research, and clinical decision-making (Cantor & Thorpe, 2018). Initially, record keeping involved tedious and complex paperwork characterized by some challenges, including loss of data, outdated information, and processing delays. The introduction of electronic health register (EHR) revolutionized the healthcare sector. Although the introduction of EHR was subject to resistance in many hospitals, it is beneficial because it provides up-to-date, complete, and accurate information about patients at every point of care (Cantor & Thorpe, 2018). Besides, it enhances coordination and provision of efficient care by promoting quick access to patient's medical records while at the same time promoting secure sharing of information with other clinicians as well as the patient.
Measuring Future Success in Change
Effective and high-quality health service delivery demonstrates a precise implementation of better organizational programs, accurate and reliable processes, and proper communication at all service delivery levels. Hospitals and the medical staff should focus on implementing new ways that change the status quo and improve the quality of products and services offered in the healthcare institutions. Quantifying key healthcare parameters is essential in measuring the effectiveness of change. The success in any change could be measured by quantifying the number of patients served; the average time spent addressing the patient's problems, and the cost of healthcare delivery. Other essential factors that should be considered in measuring the future success of a change include staff performance and patient complaints.
Conclusion
In the U.S and globally, there is a notable wave of change in nursing profession and practice. In most instances, change nurse leaders’ roles in initiating, formulating, and implementing change is fundamental. Although it is sometimes challenging, it is imperative to develop strategic approaches to enhance the acceptance, implementation, and success of the change. The complexity of some changes put healthcare leaders in a precarious position. The leaders have to create a balance between the medical staff's expectations and the needs of the patients being handled at specific healthcare institutions. To strike this balance, healthcare leaders could harness the transformational leadership, process change, and the mission and vision of an organization to effectively adapt to and advance change and growth in their institutions.
References
Cantor, M. N., & Thorpe, L. (2018). Integrating data on social determinants of health into electronic health records. Health Affairs , 37 (4), 585-590.
DaCosta, J. (2020). Insights for implementing change in healthcare. British Journal of Healthcare Management , 26 (1), 20-26.
Herd, A. M., Adams-Pope, B. L., Bowers, A., & Sims, B. (2016). Finding what works: Leadership competencies for the changing healthcare environment. Journal of Leadership Education , 15 (4), 217-233.
Krepia, V., Katsaragakis, S., Kaitelidou, D., & Prezerakos, P. (2018). Transformational leadership and its evolution in nursing. Progress in Health Sciences , 8 (1), 189-194.
Kumar, S., Kumar, N., Deshmukh, V., & Adhish, V. S. (2015). Change management skills. Indian journal of community medicine: official publication of Indian Association of Preventive & Social Medicine , 40 (2), 85.
McCaffrey, R., & Reinoso, H. (2017). Transformational leadership: A model for advanced practice holistic nurses. Journal of Holistic Nursing , 35 (4), 397-404.
