401213 : Clinical Leadership and Professional Relationships : Implemen
Scenario
A recent state-wide quality improvement project has shown that a fully electronic medication system improves the safety of medication administration. In order to share this knowledge, the state organisation has shared the results on a quality improvement website. The two hundred bed hospital where you work has recently had some medication critical incidents. These critical incidents occur in the context of a general increase of minor medication errors over the last three years. The hospital’s most senior Nurse/ Midwifery Leader has reviewed the information on the state’s quality improvement website. The Nurse/ Midwifery Leader calls the Nurse/ Midwifery Unit Managers for a meeting and advises of the general increase in medication errors and that there is an expectation that all wards will have adopted the fully electronic medication system within six months. The electronic medication system is freely available from the government and can be installed directly onto the ward computers.
Discuss how an effective Nurse/ Midwifery Unit Manager would lead this change to address this patient safety issue.
provide reasons to adopt the fully electronic medication system use Lewin’s model to outline a plan of change that includes milestones and timeframes choose and apply a leadership style to the plan of change. Critically evaluate the choice and compare with at least one other leadership style describe two aspects of potential resistance and discuss how the resistance might be addressed.
Answer:
LEADERSHIP
INTRODUCTION
There has been a recent proposal by the state to implement the electronic medication system after showing that it improves on the safety of medication administration. The state has shared the results on the websites (Volpi & Giannelli, 2015). This comes as a coincidence since there have been several errors at the 200 bed hospital where I work. The nurse leader has just called a meeting to provide information on how the project should be implemented within six months. The medication system is freely available on the website and can be installed freely in all the computers at the wards.
Effective leadership is a mandatory requirement or skill in all healthcare environments. Organizational change is also paramount in the healthcare organizations since most of this changes take place to the benefit of the patients, the healthcare workers and the organization at large (SAA, 2016) .In this assignment, there will be an illustration of how the 200 bed hospital will change from the manual medication system to the electronic medication system.
DISCUSSION
BENEFITS OF THE ELECTRONIC MEDICATION SYSTEM
The solution in medication error lies in the use of an electronic medication system. This is a digital program that can be applied in different cases. The electronic medication system has the ability to prescribe drugs (Dalal, Barto, & Smith, 2015). This can be done by the use of desktops. The EM can also be used in the decision support systems especially where there is evidence based order sets, allergy checking and also drug interactions. The system can also be used to order and supply different solutions like the electronic transfer of prescriptions as well as the inventory solutions .Finally, the system can also be utilized in the electronic medical records. This system is associated with different advantages.
The electronic medication system if implemented at our hospital would benefit both the nurses or the midwives, the patients and the hospital in general. This is because there would be less paperwork and less time will be spent on a patient (Sethuraman, Kannikeswaran, Murray, Zidan, & Chamberlain, 2015). This therefore increases efficiency and the number of patients served and this therefor increases the income of the hospital. There will be less administration errors since the changes will be noted instantly. This acts in the benefits of the patient as they would recover on time. The system is also more accurate and since they have reminders, the patient would never miss on medications. There would also be easier reporting to the supervisors for quick decision making. The Ems would generally improve the output and input of the organizations and we are therefore supposed to embrace it quickly.
PLAN OF CHANGE USING THE LEWINS THREE STEP MODEL
The Lewins model has three steps and they include and it is a very important tool which can be used to implement a plan of change. The initial step is the unfreezing stage. This involves setting the basis for change and bring out a positive perspective regarding the Electronic Medication System (Bakari, Hunjra, & Niazi, 2017). This would be achieved by picking out the different heads of departments then they would be trained and educated on the benefits of the electronic medication system. The training and meetings should be only for one month .The meetings and the training ought to be very simple and enjoyable so that the participants can enjoy and feel how simple it is. The training should also be quick to identify the advantages of the electronic medication system (Cummings, Bridgman, & Brown, 2015).In this 200 bed hospital for example, the head of departments should be educated on how the system can administer medicines within a very short time and how safe it is.
Changing is the second step in Lewins model. In this stage, all the nurses should now be told of disadvantages of the manual medication system and why there is need for change. They should be told of how to get rid of the paper works. Paper works are very risky as they can be burnt or stolen. This are now what should be changed. This stage can last for only two weeks. Refreezing is now the final step and this involves making the changes permanent. This is the stage where the desktops and the laptops are finally installed in all the wards and there is no space for the old paperwork or manual prescription of the drugs. This stage can take around eight weeks.
LEADERSHIP STYLE TO BE USED
To implement the plan, I would utilize the transformational leadership style. This is because this is the most preferred leadership style among employees. This style involves bringing about change through motivation and effective communication (Zampieron, Spanio, Bernardi, Milan, & Buja, 2012) .In this scenario, I would motivate all the healthcare providers on the importance of the change from paperwork or manual medication system to the electronic medication system .I would allow the other employees to also air their views and then get the way forward on how the change would be accomplished (Anderson & Sun, 2015). This style has been successfully used on many instances and that’s why I would also stick to it.
Autocrat leadership style involves a leader having total power over other workers. The leader in this case has total control and would not consider the suggestions from other workers (Yahaya & Ebrahim, 2016). As compared to the transformational leadership, this type would not allow the transition to the new electronic medication system (Saleem, 2015). This is because it is very difficult to achieve change where there is no communication.
POTENTIAL ASPECTS OF RESISTANCE AND HOW THEY CAN BE HANDLED.
The potential aspects of resistance in this plan would arise from the increased costs of operation. This would mean the hospital would incur extra expenses to acquire the soft wares and hardware that would be used to change the order of operations. The patients would be required to pay more for the services and this is where the resistance might arise from. To address this resistance, the hospital will be restricted from charging higher fees for the services rather than carry out an internal audit.
The plan might also experience resistance from other staffs due to addiction. Studies have found out that healthcare workers tend to be addicted to computers especially those installed with music or videos and internet. Most of them waste much time on such useless things rather than doing their intended functions and lead to more errors .To address this resistance, the workers should be told of potential penalties to anyone found using the desktops for functions rather than those they are intended for.
CONCLUSION:
Medication errors has been a common occurrences in healthcare organizations. Those people affected are the children especially those below the age of 12 years and adults who are above 60 years. The 200 bed hospital in which I work in is not an exception. There is therefore the need to come up with a long lasting solution to errors in medication. The solution is the electronic medication system which uses different hardware and soft wares. To implement the change, there is the Lewin Three step model to be used. It has three steps, unfreezing, changing and freezing. This steps have specific timeframes or milestones in which they are to be achieved. Transformational leadership is the best style to use when there is need for change. It motivates employees as opposed to the autocratic style. There are chances of resistance in implementing the plan and therefore needs strategies to address the resistance. Change is envitable and all healthcare workers ought to take it positively.
References:
Anderson, M. H., & Sun, P. Y. (2015). Reviewing Leadership Styles: Overlaps and the Need for a New ‘Full-Range’ Theory. International Journal of Management Reviews, 19(1), 76-96. doi:10.1111/ijmr.12082
Bakari, H., Hunjra, A. I., & Niazi, G. S. (2017). How Does Authentic Leadership Influence Planned Organizational Change? The Role of Employees’ Perceptions: Integration of Theory of Planned Behavior and Lewin's Three Step Model. Journal of Change Management, 17(2), 155-187. doi:10.1080/14697017.2017.1299370
Cummings, S., Bridgman, T., & Brown, K. G. (2015). Unfreezing change as three steps: Rethinking Kurt Lewin’s legacy for change management. Human Relations, 69(1), 33-60. doi:10.1177/0018726715577707
Dalal, K. S., Barto, D., & Smith, T. R. (2015). Preventing medication errors in critical care. Nursing Critical Care, 10(5), 27-32. doi:10.1097/01.ccn.0000471002.71461.8d
SAA, H. (2016). Medication Errors by Novice Nurses in a Pediatric and Neonatal Care Setting of Pakistan: Analysis of Problems and Proposed Solutions. Pediatrics and Neonatal Nursing: Open Access ( ISSN 2470-0983 ), 2(1). doi:10.16966/2470-0983.110
Saleem, H. (2015). The Impact of Leadership Styles on Job Satisfaction and Mediating Role of Perceived Organizational Politics. Procedia - Social and Behavioral Sciences, 172, 563-569. doi:10.1016/j.sbspro.2015.01.403
Sethuraman, U., Kannikeswaran, N., Murray, K. P., Zidan, M. A., & Chamberlain, J. M. (2015). Prescription Errors Before and After Introduction of Electronic Medication Alert System in a Pediatric Emergency Department. Academic Emergency Medicine, 22(6), 714-719. doi:10.1111/acem.12678
Volpi, E., & Giannelli, A. (2015). Human Factors Approach in the Design of an Electronic Medication Management System for Preventing Inpatient Medication Errors. Journal of Pharmacovigilance, s2. doi:10.4172/2329-6887.s2-006
Yahaya, R., & Ebrahim, F. (2016). Leadership styles and organizational commitment: literature review. Journal of Management Development, 35(2), 190-216. doi:10.1108/jmd-01-2015-0004
Zampieron, A., Spanio, D., Bernardi, P., Milan, R., & Buja, A. (2012). Nurse managers’ preferred and perceived leadership styles: a study at an Italian hospital. Journal of Nursing Management, 21(3), 521-528. doi:10.1111/j.1365-2834.2012.01358.x
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