Scenario: you have a patient that has a diverticular perforation and acute abdomen. At this point, her physician decides to send her to the OR. The unit clerk is aware of the plan, but the patient's nurse is not. The patient is transported to the OR. Moments later, the OR calls to report that the patient has no permits signed, nor have any other pre-op protocols been completed. Using Lewin's change model to explain the process of preparing the organization for changes, 2 changes required for improvement with rationales and describe 2 courses of action used to develop momentum for changes and how the organization will reinforce the changes
Lewin's Change Model provides a framework to explain the process of preparing an organization for changes. It consists of three stages: unfreezing, changing, and refreezing. Let's apply this model to the scenario you provided.
Unfreezing stage:
1. Change 1: Improve communication and coordination between the physician, unit clerk, and nurse.
Rationale: The lack of awareness among the patient's nurse about the decision to send the patient to the OR highlights a breakdown in communication within the organization. By improving communication, this issue can be resolved.
2. Change 2: Implement a standardized process for obtaining permits and completing pre-op protocols.
Rationale: The absence of signed permits and incomplete pre-op protocols is a significant procedural issue that requires a standardized approach to prevent such incidents in the future.
Changing stage:
To develop momentum for changes, the organization can consider the following courses of action:
1. Course of Action 1: Provide training and education to staff members on communication protocols and pre-op procedures.
Explanation: By ensuring that all staff members receive proper training and education, they will have a better understanding of their roles and responsibilities, resulting in improved communication and adherence to pre-op protocols.
2. Course of Action 2: Implement a centralized electronic system for managing permits and pre-op protocols.
Explanation: By introducing an electronic system, such as an electronic medical record (EMR) system, the organization can streamline the process of obtaining permits and completing pre-op protocols. This would enable efficient tracking and reduce the chances of missing or incomplete documentation.
Refreezing stage:
To reinforce the changes made, the organization can consider the following strategies:
1. Strategy 1: Conduct regular audits and evaluations of communication processes and adherence to pre-op protocols.
Explanation: Regular audits would identify any gaps or issues in communication and the completion of pre-op protocols. By addressing these findings promptly, the organization can reinforce the importance of following the new processes.
2. Strategy 2: Provide positive reinforcement and recognition for staff members who demonstrate effective communication and adherence to pre-op protocols.
Explanation: Recognizing and rewarding staff members who consistently comply with the new procedures would motivate others to adhere to the changes. This positive reinforcement helps solidify the new practices within the organization.
By implementing these changes, developing momentum, and reinforcing the new processes, the organization can improve communication, ensure proper permits are signed, and complete pre-op protocols in a timely and efficient manner, ultimately enhancing patient care and safety.
Lewin's Change Model, often referred to as the unfreeze-change-refreeze model, provides a framework for understanding and implementing organizational changes. In this scenario, we can utilize this model to identify necessary improvements and the actions needed to develop momentum and reinforce changes.
1. Two changes required for improvement with rationales:
a. Improve communication and information flow: It is crucial to establish a clear and effective communication system within the organization. In this case, the nurse was not informed of the plan to send the patient to the OR, leading to a breakdown in information flow. By improving communication channels, such incidents can be prevented, ensuring that essential information reaches the relevant stakeholders in a timely manner.
b. Implement standardized protocols and procedures: The absence of signed permits and incomplete pre-op protocols indicates a lack of adherence to standardized procedures. Introducing and enforcing standardized protocols can help streamline processes and ensure that all necessary steps are followed before patients are taken to the OR. This will enhance patient safety and minimize errors.
2. Two courses of action used to develop momentum for changes and reinforce the changes:
a. Training and education: Organize training sessions for the unit clerk, nurse, and other relevant staff members to educate them on the importance of proper documentation, pre-op protocols, and effective communication. By providing knowledge and skills, employees will be better equipped to adapt to the changes and understand their significance in improving patient care.
b. Continuous monitoring and feedback: Implement a system of continuous monitoring and feedback to assess the effectiveness of the changes and identify any gaps or areas that require improvement. This can involve regular audits, performance evaluations, and feedback sessions with staff members. Positive reinforcement, constructive feedback, and recognition of achievements will help reinforce the importance of following protocols and ensure sustained change.
By following these two courses of action, the organization can develop momentum for change and reinforce the changes over time. Continuous monitoring and feedback mechanisms ensure that the changes are embedded into the organization's culture and are consistently practiced. Training and education sessions help in building the necessary knowledge and skills to support the changes effectively. Ultimately, these actions will help the organization improve its processes, enhance patient safety, and provide better overall care.