Patient and medication safety have been the top priorities among healthcare organizations since errors in medication threatens patient’s safety. Various technologies have been adopted to reduce and possibly eliminate error during medication administration. The strategies include electronic medical records, patient identity cards, among others (Batras, Duff & Smith, 2016). Despite the introduction of these technologies in the health care system, medication errors have not been completely eradicated; thus, the need to introduce bar code medicine administration technology to curb problematic medical errors.
Several healthcare facilities have applied the Kurt Lewin model in introducing new healthcare technologies. The theory gives insights into how human behaviour changes concerning change as well as patterns of resisting change. The theory comprises of three precise phases, namely; change unfreezing, changing and refreezing. The model objectively identifies a particular change, forces that can obstruct the change from being realized, forces that conflict with the change and factors that can promote and drive the change (Cummings, Bridgman & Brown, 2016) . The intended change can only occur when the subject healthcare facility fully comprehends the behaviours that oppose or support implementation of the new project and strive to reinforce the driving factors.
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The unfreezing phase in Lewin's model entails finding solutions to difficulties related to implementing the change. The implementing team builds on the supporting factors while the conflicting factors get restrained. In this stage, key stakeholders likely to be affected by the new project are identified and gathers together to air their views and list the forces that are likely to affect the implementation of the project. The moving or changing phase is a stage where the actual change is implemented owing to suppression of opposing factors, thus giving way for supporting forces to drive the change positively. The implemented project then yields the desired change. The refreezing phase is where stability and sustainability assessments are conducted, and the general effectiveness of the newly implemented project determined ( Udod & Wagner, 2018). Here indicators of desirable change are used to evaluate if the objectives have been achieved, whether there were any detrimental outcomes and how to go about undesired consequences.
I would apply the Lewin's model to develop an implementation plan for the introduction of bar code system of medication. The technique used in the system incorporates electronic medical record-keeping and electronic practitioner order entry into exercise, thus reducing the likelihood of medication error. The system also reduces paperwork and consequently eliminating cases of ineligible documents, missed signatures and misplaced prescriptions. Bar code medication system comprises of a barcoded pack of medication, patient bands with bar codes and an electric scanner usually connected to medicine cart. The health care giver scans both the band on the patient and the suppository pack (Batras, Duff & Smith, 2016). Concurrently, the cart links to the patient’s medical records electronically to verify that the particular patient is the right one for the medication.
The unfreezing stage, in this case, will involve identification of the change focus precisely introducing bar code system of medicine administration at a big healthcare facility. The key activities in this step will be engaging all players who will be affected by the bar code scanning method of medicine delivery, including nurses, administration officers, doctors front line officers and even the patients. The process should be straightforward and open to establish a sense of trust in all the stakeholders consulted. Taking views, and ideas from the very least officers in this stages creates a touch of authorization, thus reducing project resistance as everybody understands that the new project is for the good of all.
Round table discussions may be essential to identify the opposing and driving forces. In this facility, the driving forces may include management support, ease of use of the system, adequate resource investment and better time and human resource management. The restricting factors might be resistance to use the new system, computer illiteracy and organizational distrust. Of great importance in this phase is to engage all key players and mobilize stakeholder to work on diminishing opposing forces and building on driving forces that will ensure successful adoption of the new system of delivering medicine to patients.
The changing phase will comprise the implementation of the bar code system across the organization with the help of all relevant teams. Due to the magnitude of the new technology, it is imperative to ensure inclusivity to ensure an effective rollout. The final phase of refreezing entails assessing the stability and sustainability of the bar code system. Again, the process requires the active participation of stakeholders until completion of the project and ascertaining that users are comfortable using it ( Udod & Wagner, 2018) . Once the bar code is fully operational, a report detailing the challenges faced, how they overcame, and the successes achieved is prepared for reference in future .
Implementation of any healthcare plan of this magnitude requires careful selection of change management plan and establishment of a complete plan for eventual success. Applying Lewin's change management model to plan actualization of projects such as bar code scanning in a health facility can be useful in promoting acceptance. The theory involves all players, including front line officers; in planning, implementation and evaluation stages. This "buy-in" creates a sense of project ownership and eventually, its success.
Holding round table discussions to brainstorm and identify the opposing and driving forces is an important process in Lewin's theory. The process creates trust and promotes project support by the stakeholder as they consider it as their own project. Habitually, nurses and junior staff like the front-line officers are involuntarily coerced to adopt change having been deprived the chance to contribute to it. This often erodes staff trust in the facility, and the tendency to resist any attempt to change the status quo. By applying Lewin's model, project resistance and mistrust within the facility are reduced through encouraging stakeholders' active participation throughout the entire process of change.
References
Batras, D., Duff, C., & Smith, B. J. (2016). Organizational change theory: implications for health promotion practice. Health promotion international , 31 (1), 231-241.
Cummings, S., Bridgman, T., & Brown, K. G. (2016). Unfreezing change as three steps: Rethinking Kurt Lewin’s legacy for change management. Human Relations , 69 (1), 33-60.
Udod, S., & Wagner, J. (2018). Common Change Theories and Application to Different Nursing Situations. Leadership and Influencing Change in Nursing .
