Staffing to Meet the Need

Staffing To Meet the Need Part III

KellyVoelm

Creating Change Within Organizations HCS/587

August 9, 2012

Janet Treadwell

Staffing To Meet the Need Part III

Arnold Bennett says "Any change, even a change for the better, is always accompanied by drawbacks and discomforts." Staffing is one of the most crucial aspects of nursing in healthcare today. The proposed change is to evaluate and incorporate a staggered staffing guideline to minimize overstaffing during slow times and maximize staffing in the busiest times.

We discussed barriers to change, the factors that influence change and the organization's readiness to change. The process – driven change model will use collaboration to introduce and reinforce new behaviors. As this change is monitored we will get a snapshot of how well the change implementation is going.

Staff and patient monitoring will guide additional needs in the change process. We discussed roles and relationships that will affect the success of the change process. Communication must be open, clear and concise to properly evaluate processes and address issues that arise.

As we begin the final part of the change process there are several areas of implementation that must be evaluated. A description of the effectiveness of the organizational change will be determined, an analysis of possible measurement strategies related to organizational change processes, and determining how to measure the quality, cost, and satisfaction outcomes to evaluate the proposed change are some of the areas that must be investigated. "Without a well – defined and implemented process for planning and implementing change, learning throughout the change process, and applying the lessons learned, an organization is likely to encounter difficulties with the change effort and may experience substantial human and financial costs."(Kerman, et all, 2012).

Description of Organizational Change Effectiveness

The effectiveness of change implementation can be enhanced by a common sense of direction and goals, autonomy for employees to respond to a dynamic environment, the ability to achieve required levels of coordination and teamwork, and strategies to advance the purpose and change in response to the dynamic environment.

The common sense of direction and goals allows each employer to be on the same page. The effectiveness of the change implementation could be seriously undermined if there is not this common sense of direction. The upper management and frontline staff have to be clear on what is expected for the organization and each employee regarding the change process. If upper management see the change involving current staff stepping in to alleviate difficult staffing issues and lower frontline staff see upper management hiring additional staff to meet the scheduling needs then the different outlooks will be detrimental to the change process.

There has to be a common direction that allows current staff to pick up the slack prior to additional staff being brought in to cover the issues. The common goal that this change process is geared toward is patient satisfaction and quality of care, as well as, implementing guidelines that integrate staffing and scheduling to eliminate issues with the change process. Organizational learning has to include openness, planning, training, supportive leadership, and managerial strategies that create and clarify shared models of the organization (Kerman, et all, 2012).

Autonomy can be defined as independence of freedom, as of the will or one's actions. Autonomy in nursing allows for independent decisions to be implemented regarding patient care and outcomes. In the change process regarding staggered staffing for Emergency Department scheduling coverage, the nurse's autonomy gives the change process an ownership aspect that bonds the nurse to the organization.

This bond allows the emotional response that not only illustrates increased dedication but more importantly the commitment to go above and beyond to ensure successful change implementation. This emotional response has to have clear, concise, and equitable communication to enhance this bond or the employee will feel disillusioned and will not cooperate with the change process. The autonomy that the nurse has established will strengthen the bond because of the responsibility that has been placed on the employee.

Coordination and teamwork are crucial to the change implementation. The effectiveness of coordination and teamwork will be evident when the organization can see that there are positive changes in the scheduling process and increased, favorable customer satisfaction surveys being received. Effective teamwork will allow for the staggering staffing to distribute the needed coverage without causing extreme overwork of just a minimal amount of the current staff. As the coordination of the staffing process guides the current and new hiring practices it allows for a plethora of additional training to be enlisted for satisfactory customer service.

Analysis of Outcome Measurement Strategies

Analysis of outcome measurement of organizational change is becoming a demand that is evidenced by increased formulation of JCAHO policies, managed care companies, coalitions, and alliances that require a demonstration of the quality of care that the patient receives. The areas of outcome measurement related to our change process will be clinical effectiveness, patient satisfaction, service quality, and efficiency of services delivered.

The clinical effectiveness aspect of outcome measurement analysis will take a look at how the change process has implemented the new scheduling guidelines to reduce over – staffing during low patient times and increase staffing capabilities during high volume times. Adequate staffing, not only reduces staff burnout, ineffective patient care and employee turnover but also increases patient satisfaction which has become one of JCAHO's patient care guidelines

This leads into the patient satisfaction area of outcome measurement analysis. Not only is patient satisfaction one of JCAHO's main patient care guidelines but is also becoming a major aspect of reimbursement for services rendered. Hourly rounding and adequate staffing during high volume patient care times will greatly increase the patient satisfaction part of the change process. Patient satisfaction relies on differing areas of patient care. Pain management, communication, and effective treatments are some patient satisfaction areas that are under the umbrella of the change process.

Service quality is a direct result of the change process. The staffing ratios are a contributing factor that will make or break the service quality aspect of the change process. When staff is hurried, over – worked, under – paid, and spread to thin for patient care then the result will be a decrease in the quality of care that each patient will receive. When staff are afforded adequate patient care time, given incentives for above average care, and have ample resources available for assistance then the patient care will be indicative of this increased quality of service.

The last aspect of outcome management analysis will be the efficiency of services delivered. This area of analysis will be dependent upon patient surveys, management rounding events, and patient call – back visits. Open lines of communication will be imperative to allow for truthful, accurate voicing of concerns and problematic issues that arise.

Measuring Quality, Cost and Satisfaction

Determining how to measure quality, cost and satisfaction is a crucial aspect of a successful change process. To determine the quality of the care that is being given there will need to be a way to evaluate what quality means

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