Part 1: Brief of Strategies
Effective Two-way Communication
Communication is the focal point of all training and change processes. These means that the two critical processes can either succeed or fail purely because of the communication regimen that has been put in place. In the training program, effective communication will be among the focal points. The focus on effective communication will include two-way communication where the focus group will be spoken to and also allowed to speak (Zhu et al., 2016). It is important to note at this point that the focus group selected for training are nursing officers. The criterion for selecting this group shall be addressed in the second part. In the modern hospital, nurses are among the highest trained and most effective professionals on the ground, with some of them having as much as a Ph.D. level education. However, traditionally, nurses had been treated as members of subordinate staff who only need to do what they are told by other professionals such as physicians (Mishra, 2015). The easiest way for a training program for nurses to fail is for them to feel as if they are being treated as support staff and being told what to do then expected to do it by rote. Instead, the training strategy will seek to treat nurses as the most important component of the change process in an attempt to procure their full and unequivocal buy-in (Mackoff, 2014).
Assimilation of Ideas from the Focus Group
In line with the strategy above, the information collected from the nurses themselves will need to be used as an integral part of the change process and proposed policy. As an integral part of effective communication, it is not enough to just listen as it is also essential for the focus group to understand that the information being collected is being put to good use (Mackoff, 2014; Zhu et al., 2016). For example, the study program can begin with only a blueprint of the proposed change policy. The particulars thereof, more so those particulars that relate to practical implementation, can be filled in during the preamble segment of the training section. When the nurses realize that they are not just being told what to do as they are also being asked what needs to be done, buy-in and support will be guaranteed and augmented (Zhu et al., 2016).
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Incorporating Innovation
Another mode of acquiring buy-in and support from the focus group is by incorporating innovation into the change process and the activities that will take place as a result of the proposed policy changes. Doing things by rote may have resulted in industrialization, but it also exponentially limited the quality of work done and the quality of the lives of the workers. The instant change process includes seeking to augment earnings made by treating patients suffering from diabetes-related complications. Managing such patients is hard enough even before the change process and will get harder after the changes are done (Moran, Burson & Conrad, 2016). To incorporate innovation in the change process, the training process will not be about showing the nurses exactly what to do and how to do it. Instead, the training will be about what is expected from the nurses with regard to the change process. The nurses will then be allowed to be innovative about how to go about it. It may even be possible for the nurses, through innovation to develop such effective ways of accomplishing the changes recommended that the blueprints would be amended to include the innovations (Moran, Burson & Conrad, 2016).
Monitoring and Evaluation
The final buy strategy and means of acquiring support from the support group is through monitoring and evaluation. The target group will be more willing to support the change process if they realize that nothing about the change process is cast in stone, hence what does not work will be changed and what works best will be focused on. For decades, nurses have had to contend with doing what they are told, even after they have realized that it is no working as they had been told it would. The change process and its training regimen should not fall on the same trap. Instead, an elaborate and comprehensive monitoring and evaluation process, based, inter alia, on knowledge management technology will be put in place. The nurses will be able to communicate what parts of the change process are not working and cannot work at all, what parts need some adjustments, and what parts are working well. The information will enable the change management team to adjust the change process accordingly.
Part 2: Training Agenda
Institutional Policy to be implemented
The suggested policy change involves raising more money by streamlining the billing process. The said streamlining will mainly involve the accounting department, but there is also a major component thereof that involves nurses. The nurses need to improve the keeping of records on all services rendered to patients and products used on patients more so during emergencies. For example, in most code-blue calls, the patient either cannot breathe or have lost cardiac activity (Iyiola et al., 2016). Most clinicians revert to their instinct to save lives, mostly as all cost and will utilize any resources possible. During such situations, a lot of services are rendered, and products use, but no substantive records are kept regarding the same. Without substantive records, it is not possible to code and bill for such services and products; hence, the hospital loses money. It is this change process that the training regime is predicated upon.
Justification of Importance of Policy Change
The policy change to be implemented is relatively simple but with major implications hence its importance. The said policy is meant to solve a substantive problem in patient management, more so during critical moments. The hospital on focus is a diabetes hospital whose emergency room handles many diabetes-related emergencies. Further, inpatients also commonly suffer from life-threatening events that warrant code-blue calls. Unfortunately, the high number of blue-calls has led to a phenomenon known as code-blue stress (Iyiola et al., 2016). The said stress limits the ability to react effectively to code-blue situation hence increasing the propensity for negative patient outcomes, including death. The solution to the instant problem is the hiring of more nurses and the purchase of more and better equipment, both of which require money.
Role of Focus Group in the Policy Change
As indicated in the section above, the focus group for the policy change training program is the nurses. One may wonder why nurses are the primary focus, yet the issue of finances is mainly an administrative one. The simple answer is without the input of nurses, administration in general, and specifically, the accounting department cannot be able to raise money effectively. Patients are charged through the process of coding and billing for services. For the process to begin, the services rendered must be recorded first. Normally, it is the nurse who is closest to the patient and thus able to keep a record regarding all the services that a patient has received (Everhart et al., 2013). Based on such records, accountants are able to bill clients. The issue of loss of funds through poor billing can thus best be canvassed at the nursing level. It is based on this that nurses are the focus group for the training program.
Learning and Skill Development Materials
It is important to note that the training program herein is not about educating nurses on the activities involved in the change process but rather enabling them to adjust to it. The nurses are well educated and competent in caring for patients, including code-blue patients. Similarly, the nurses are also adept recording activities for the purposes of billing. However, the nurses need to be able to retain meticulous and comprehensive records in the middle of a life-threatening crisis hence the need for the training program herein. Among the concepts that can assist nurses in attaining the above is lean thinking. The concept of lean thinking as applied to the process herein revolves around eliminating wastage of time during the process of taking care of patients, to create ample time to keep records, even in the middle of a crisis (Dannapfel, Poksinska & Thomas, 2014). There is no blueprint for lean thinking in this situation as every situation has its own ‘time wasters’ so does every nurse. The general idea is to evaluate every process, find out what the time wasters are, then seek to eliminate them.
The second important approach is Kaizen, which refers to the innovative process of improvement (Gershengorn, Kocher & Factor, 2014). Under this concept, the nurses need to learn that just because something has always been done in a certain way does not mean that that is the most effective and efficient way of doing it. Every process can be bettered or made more effective. Increasing the quality of something will reduce the need to redo it or do it again sooner. Further, increasing efficiency increases the extra time (Gershengorn, Kocher & Factor, 2014). Kaizen will, therefore, place more free time in the hands of the nurses. The extra time can then be used to make better records about the services rendered to patients hence enabling the change process canvassed herein. Both lean thinking and kaizen do not involve telling nurses what to do, but rather setting their innovative minds free so that they can play a substantive role in the change process (Moran, Burson & Conrad, 2016).
References
Dannapfel, P., Poksinska, B., & Thomas, K. (2014). Dissemination strategy for Lean thinking in health care. International Journal of Health Care Quality Assurance , 27(5), 391–404
Everhart, D., Neff, D., Al-Amin, M., Nogle, J., & Weech-Maldonado, R. (2013). The effects of nurse staffing on hospital financial performance. Health Care Management Review , 38(2), 146-155. doi:10.1097/hmr.0b013e318257292b
Gershengorn, H. B., Kocher, R., & Factor, P. (2014). Management strategies to effect change in intensive care units: Lessons from the world of business: Part II. Quality-improvement strategies. Annals of the American Thoracic Society , 11(3), 444–453.
Iyiola, O. O., Osibanjo, A. O., Oyewunmi, A. E., Kehinde, O. J., & Igbinoba, A. O. (2016). Code blue-stress among nurses in a teaching hospital and its effects on healthcare delivery. The Social Sciences, 11(7), 1312-1317. ISSN 1818-5800
Mackoff, B. L. (2014). AONE Leadership Laboratory Insights: The Practice of Change Leadership. Nurse Leader,12(6), 23-26. doi:10.1016/j.mnl.2014.10.004
Mishra, S. (2015). Respect for nursing professional: Silence must be heard. Indian Heart Journal,67 (5), 413-415. doi:10.1016/j.ihj.2015.07.003
Moran, K. J., Burson, R., & Conrad, D. (2016). The doctor of nursing practice scholarly project . Burlington, Massachusetts: Jones & Bartlett Publishers.
Zhu, X., Baloh, J., Ward, M. M., & Stewart, G. L. (2016). Deliberation makes a difference: preparation strategies for teamstepps implementation in small and rural hospitals. Medical Care Research and Review , 73 (3), 283-307. doi: 10.1177/1077558715607349
