Master’s Prepared Nurse Leading Change

The current healthcare facilities are experiencing significant transformations aimed at improving care access, fostering quality of services, improving care outcomes and patients' safety, and cutting down costs to offer affordable care. Quality and costs concern are the main attributes that demand change urgency. Nurses are among the main players who should lead any type of transformative change in the care facility by contributing significantly to the inter-professional teams concerned with implementing the desired modification. This paper shows how master's prepared nurses act as the agent of change in implementing Electronic Healthcare Records (EHR) in a clinical setting. Electronic Medical Records (EMR) is among the current innovative changes being integrated into care facilities to offer quality, affordable, and seamless services to the patient. To be an effective agent of change, a master's prepared nurse should demonstrate an advanced level of attitudes, knowledge, and skills with a transformed focus on care coordination, quality improvement, data coordination, patient-centered care, and care coordination. 

Background on the Healthcare Delivery Situation that Needs Change 

The clinical facility has been using traditional paperwork to handle, track, and store the health records of the patient. Most of this handwritten record are not illegible and cannot be stored or shared electronically. Due to the radical transformation in the current digital technology in the form of web-enabled devices, virtual environments, Smartphones, and Tablets, a clinical facility is required to adopt a more seamless and significant flow of information. Besides, the legal requirements are demanding care centers implement a digital health infrastructure that aims at improving patient safety, participation, outcomes while saving costs and fostering practice efficiencies (Martin, 2014) . In addition, the increased competition from the market creates the urgency to transform the practices in the care setting in order to attain the desired competitive advantage and sustainable growth. The above reasons are the main drivers towards the adoption of a more complete digital architecture (EMR) that offers full information about the patient to enable providers to make quick and well-informed care decisions, lower safety risks, and improve the overall care. 

Essential Elements Needed by Master’s Prepared Nurse Leader to be an Effective Change Agent 

During transformation in the healthcare delivery, nurses need to take purposeful action tograb the resulting opportunities, reshape the challenges accompanying the changes, and stimulate a modification agenda aligned to their unique competencies and roles (Martin, 2014) . Master’s prepared nurse leader should be the main agent of change to ensure that the clinical facility is digitized and computerized to improve quality of care. In order to be effective change agents, they must demonstrate various essential elements. 

First, the nurses should demonstrate the capabilities to embrace this disruptive innovation in the form of EMR. They are required to initiate change by challenging the existing status quo and acting as the advocates. Advocacy is an interpersonal tool which nurses should adopt to enhance a care-giving surrounding. In order to initiate change, the master's nurse should apply a balanced strategy to patient advocacy, professional advocacy, public health, and community advocacy, and issue advocacy (Martin, 2014) . The patient advocacy should emphasize the importance of EMR in enhancing care access and improving both safety and quality of outcomes. As a leader, the nurses should use their issue advocacy to provide available evidence on the importance of the new system of storing patients' data. At a community or health advocacy perspective, it is the leadership role of the nurse to search for new ways of lowering healthcare costs, improving efficiency, and fostering quality of life. Lastly, profession advocacy will require the legitimate placement of other nurses and care providers in the new EMR system based on their training, outcome, experience, and competency and not politics (Martin, 2014) . Observing all these advocacy elements and putting them in practice during change initiation will create an effective agent of transformation. Advocacy on behalf of the patients, the community, and the nursing profession will catalyze both change and innovation in the clinical setting. 

Secondly, they need to create a workplace environment where other care providers feel comfortable to instigate transformation and support the new changes in how patients’ information is recorded, stored, and shared (Martin, 2014) . In this case, they need to develop a robust and achievable change vision by involving all stakeholders. Collaborative participation in creating an EMR implementation roadmap will reduce resistance and facilitate smooth transformation. They need to leverage on the established credibility and respect, engage in thoughtful practices, and act as a role model in transforming the traditional paperwork culture into new electronic information flow and access (Williamsson, Eriksson, & Dellve, 2016) . They need to demonstrate effective formal and informal communication skills to converse the vision to all members of the facility. Such communication should open, horizontal, and two way to incorporate the views, motives, ad understanding of other caregivers and physicians. This will lead to social awareness across the facility based on common sense-making which in turn enhances the adaptability of the EMR and its alignment or orientation to the individual needs and the facility's goals. Thirdly, they need to work as financial stewards by taking an active role in the multidisciplinary team concerned with purchasing of best EHR technologies (Martin, 2014) . This will ensure that the organization procures a highly flexible EHR system that suits the existing expertise and improves innovation adaptability. 

Change Model to be Applied 

Kotter’s Eight Steps Model is the best to be applied by the master’s prepared nurse to implement the EMR system. The first step entails creating the urgency of adopting the EHR system by showing staffs on the number of errors of traditional paperwork as well as explaining the efficiency to be offered by the new system. In the second step, the master's nurse needs to establish a guiding team compromising of champions of change (Campbell, 2008) . This includes selecting workers with relevant skills in EHR and desire to reduce costs, medical errors, and improve quality of care. The team members should bring the credibility required to establish trust, create passion, and motivate other members. The third entails creating the change vision through involving the guiding team and other stakeholders. In this case, the master’s nurse should create a concise and clear statement focusing on lowering transcription errors, improving the safety of the patient, instituting quality control strategies, and redesigning the flow of patients’ information in the clinical setting (Campbell, 2008) . The master’s nurse should develop a vision that captures the future of the care center. 

The fourth step includes communication of the vision to facilitate engagement of the whole facility (Auguste, 2013) . Therefore, master's nurses should demonstrate effective communication skills and approaches to eliminate panic, anger, fear, and anxiety across health professionals and caregivers. Communication, in this case, should focus on promoting the vision, identifying and overcoming resistance, and building commitment. In the fifth step, the master's nurses should be bold enough to remove obstacles that may hinder the adoption of EMR. The sixth step entails creating and celebrating short-term wins through empowering and motivating those that have successfully completed their tasks. The seventh step entails maintaining the momentum through sustaining and creating more change (Campbell, 2008) . This requires the master’s nurses to be more innovative in re-energizing the team members to identify solutions related to future problems of installing EMR. In the last phase, the master’s nurses should make the change stick by creating an innovative culture and allocating top positions of EHR systems to the champions of change. 

Proposed Plan 

The plan will consider three main phases of adopting the EHR as shown below: 

Strategies to Initiate Change and Improve Outcomes 

The first strategy is to understand workers emotions such as anger, exhaustion, panic, anxiety, false pride, cynicism, and pessimism that may undermine the adoption of EHR systems. As a leader, a master’s nurse should change these negative emotions into positive ones such as enthusiasm, excitement, trust, and passion. Secondly, the master's nurse leader should focus on creating a change mindset among workers by providing them with substantial information on EHR adoption in the form of eye-catching, compelling, and emotion-triggering presentation. The aim is to create a "see-feel-change" scenario that transforms their thinking and behavior (Campbell, 2008) . 

Conclusion 

As agents of change, master’s nurses should adopt Kotter’s Eight Model to facilitate successful transformation. The models offer the leadership skills which are required to initiate change, engage the car facility, and sustain transformation. Adoption of EMR will require substantial engagement between the master's nurse leaders and other stakeholders to improve the quality of care, patients' safety, and offer affordable care. 

References 

Auguste, J. (2013). Applying Kotter’s 8-Step Process for Leading Change to the Digital Transformation of an Orthopedic Surgical Practice Group in Toronto, Canada. Health & Medical Informatics, 4 (3), 1-4. 

Campbell, R. J. (2008). Change Management in Health Care. The Health Care Manager, 27 (1), 23-39. 

Martin, M. (2014). Nursing during an era of change: A challenge and Opportunity. Journal of Nursing Education and Practice, 4 (1), 189-200. 

Williamsson, A., Eriksson, A., & Dellve, L. (2016). Organization of change agents during care process redesign in Swedish health care. Journal of Hospital Administration, 5 (3), 20-33.