Case Study: Force Field Analysis and Strategies for Change In this case study you are a charge nurse on a medical/surgical unit that just implemented a barcode medication administration system (BCMA) that the hospital spent millions of dollars to implement. You have noticed some staff resistance to this change and some nurses overriding the safety features of the system. Proper orientation and training has been provided, yet you have noticed that staff have developed “workarounds” to the system. Some reasons suggested for not following proper procedure include the system delaying medication administration to their patients due to it taking more time to use, not wanting to wake their patients, and the equipment not always working. You need to identify driving and restraining forces impacting the refreezing of the BCMA system and develop strategies …show more content…
There are two opposing forces, the driving forces or those seeking to promote change and restraining forces or those attempting to maintain the status quo. For any change to occur, the driving forces must exceed the restraining forces (DePaul University/SNL Online, 2010). In the case study above, some driving forces of implementing the BCMA system include: (1) improved patient safety, (2) reduced medication administration errors, and (3) overall cost of the system. Restraining forces include: (1) workarounds of the system, (2) conformity to norms, and (3) delay in medication administration. The driving forces of improved patient safety, reduced medication errors, and cost the hospital paid for the system all facilitate change. On the other hand, the restraining forces of workarounds, conformity, and delayed medication administration impede change. Ways to reduce the intensity of the restraining forces should be looked at to push the system towards
Connecting and teaming up with other community interested parties allows the organization to support the financial and quality goals, and coordinate care across the board giving more efficient and quality care (McKesson, 2018). This could help bring occupancy and admission levels up along with maximizing technology’s value by connecting the dots to help reduce complexities and cost. As regulatory, financial, clinical and consumer pressures influence healthcare organizations to produce and provide more effective and efficient care, healthcare technology becomes even more
The world of healthcare changes every day. Technology, as we know it evolves and changes the actual care that patients receive and even post care as well. It has been determined that most faults are caused by system failures. When a break in the system has occurred it must then be decided where the,” inefficiencies, ineffective care and preventable errors” to then influence changes within the broken system (Hughes, 2008). Improvements sometimes can begin with measurements and benchmarks which in turn will allow organizations to assess the trouble spots and broken areas within the system. Many times those broken areas within the system will be owned by the humans who operate within these systems. According to the Institute of Medicine (IOM)
Kimmel, K. C., & Sensmeier, J. (2002). A Technological Approach to Enhancing Patient Safety. Retrieved from https://blackboard.ohio.edu/bbcswebdav/pid-3906938-dt-content-rid-20290664_1/courses/NRSE_4510_1021_SEM_SPRG_2013-14/EHR_1%281%29.pdf
When assessing where the industry will go over the next ten years, there is one area that stands out. Government involvement in healthcare has become a major player in how this industry is changing. New regulations are being introduced at a rapid rate and have pushed hospitals into constant change management (Arab Kash, Spaulding, Johnson, & Gamm, 2014).
The purpose of this paper is to distinguish, outline, and evaluate the affects that workarounds have on patient safety and quality. According to Alexander, Frith, and Hoy (2015), a workaround is defined as when a problems arise within the workflow and a worker uses an unauthorized way around the health information technology system. This being said, workarounds are present in the hustle and bustle of the stressful hospital workflow, and in return can potentially lead to negative consequences. Therefore, it is essential for health care professionals to recognize the workaround, analyze their workflow, and then develop possible solutions.
Martin, L., Williams, S., Haskard, K., & DiMatteo, R. (2005). Therapeutics and Clinical Risk Management. The Challenge of Patient Adherence, 189-199. Retrieved November 12, 2014, from http://www.dovepress.com/getfile.php?fileID=384
“The police are the public and the public are the police; the police being only members of the public who are paid to give full time attention to duties which are incumbent on every citizen in the interests of community welfare and existence,” Robert Peel. The use of force for police officers is something I find to be justified and right, because it can possible help save the officers life and any witnesses lives.
Human factors are derived from construction and adapted to a system of development in health care by carefully examining the relationship between people, environment, and technology. The consideration of human factors acknowledges the capability or inability to perform a precise task while executing multiple functions at once. Human factors provide an organized method to prevent errors and create exceptional efficiency. Careful attention must be exercised in all levels of care such as the physical, social, and external environment. It is also vital to carefully consider the type of work completed and the quality of performance. Applying human factors to the structure of healthcare can help reduce risks and improve outcomes for patients. This includes physical, behavioral, and cognitive performance which is important to a successful health care system that can prevent errors. A well-designed health care system can anticipate errors before they occur and not after the mistake has been committed. A culture of safety in nursing demands strong leadership that pays attention to variations in workloads, preventing interruptions at work, promotes communication and courtesy for everyone involved. Implementing a structure of human factors will guide research and provide a better understanding of a nurse’s complicated work environment. Nurses today are face challenges that affect patient safety such as heavy workloads, distractions, multiple tasks, and inadequate staffing. Poor communication and failure to comply with proper protocols can also adversely affect patient safety. Understanding human factors can help nurses prevent errors and improve quality of care. In order to standardize care the crew resource management program was
Also, these studies question those who are effected; in this case, those who are most effected, is everyone. Doctors and nurses spend the most time working within these systems, but the information that is put into these systems effects every individual in America, because it is their information. Because nurses are often considered “both coordinators and providers of patient care” and they “attend to the whole patient,” their opinion is highly regarded (Otieno, Toyama, Asonuma, Kanai-Pak, & Naitoh, 2007, p. 210). It is clear that the use of these new systems is much debated, and many people have their own, individualized opinion. This information suggests that when there is a problem in the medical field, those who address it attempt to gather opinions from everyone who is involved before proceeding. It has been proven by multiple studies that this system of record keeping does in fact have potential to significantly improve patient health through efficiency, and it is because of this that the majority of hospitals have already completed, or begun the transfer from paperless to electronic (Otieno, Toyama, Asonuma, Kanai-Pak, & Naitoh,
Managing Change: Who Moved my Cheese? Darrin Ruble National University Managing Change: Who Moved my Cheese? Rashid-Al-Abri (2007) claims that change in the healthcare industry has been a dramatic phenomenon that requires the personnel to accept changes or they will be surpassed by them. Therefore, there is the need to follow the steps of change: evaluation, planning, implementation, and management. The characters are different, but the individual control that these characters display plays a fundamental role in the acceptance and the administration of change.
...mplications that allow for opportunities of change. One of the presumptions is for training and staffing (Shi & Singh, 2012). With the utilization of health care improvements, the staff will need additional instructions on the performance of equipment and how to efficiently achieve the desired results. Managers or supervisors recognize the need for supplemental staffing and training to optimize patient satisfaction and quality of care. The health care administrator must also focus on changes in insurance policies and rules governing the provision of medical assistance (Shi & Singh, 2012).
Technology is stated as the scientific method and material used to achieve a commercial or industrial objective. To go one step further, nursing technology is using a tool to advance nursing practice. “The Institute of medicine identified that technology as a viable method of enhancing patient care delivery and improving staff productivity” Sensmeier, Horowitz (2003 page). Because inadequate nursing staff causes shortcuts to be taken, there are mistakes made that could have possibly been prevented. Errors by nursing staff were variously reported as being responsible for between 44,000 and 98,000 hospital deaths per year. Sensmeier, Horowitz (2003). Technology can have a large impact on nursing. In the past 5 to 10 years, computerized patient records have increased less than 10%. This number shows us that we are still not embracing technology to its full potential. Today in most hospital systems computerized electronic charting is being used. Many hospitals have many different systems for...
...d procedures are now being monitored to improve clinical processes. Ensuring that these processes are implemented in a timely, effective manner can also improve the quality of care given to patients. Management of the processes ensures accountability of the effectiveness of care, which, as mentioned earlier, improves outcomes. Lastly, providing reimbursements based on the quality of care and not the quantity also decreases the “wasting” and overuse of supplies. Providers previously felt the need to do more than necessary to meet a certain quota based on a quantity of supplies or other interventions used. Changing this goal can significantly decrease the cost of care due to using on the supplies necessary to provide effective, high-quality care. I look forward to this implementation of change and hope to see others encouraging an increase in high-quality healthcare.
The force field analysis model is a general purpose technique model that was originally developed by Kurt Lewin. The force field analysis model views organizational behavior as a dynamic balance of forces working in opposite directions. These dynamic forces are seen as driving forces and restraining forces. The driving forces are the forces that support and invoke change within the organizations. The restraining forces are the forces that go against the change or hinder the ability of the organization to successfully implement change. A focre field analysis of Starbucks using one organizational change initiative that the organization is attempting to put into place will be reviewed.
...ntinually evolve, a certain degree of freedom must be felt by its members, bureaucracy represents and organization from which chaos has completely been eliminated. Nurse Executives, therefore, will need to encourage staff to challenge existing practice. Given the current environment, creative conflict will need to be supported in order for our continued growth.” (McGuire, 1999, p. 9) I believe that Capital Health is on a path for success. They have modernized there organization chart causing a more decentralized environment. This new atmosphere fosters empowerment of its nursing staff. This sense of ownership over their practice provides growth not only for individual nurse, but the entire profession. This positive proactive change of the organizational structure will allow the hospital to experience continued growth and development that is propelled from within.