Change Strategy and Implementation Process Essay

Change Strategy and Implementation Process Essay

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Analyze a professional environment and relevant data, and develop a change strategy (3-5 pages) and discuss how to implement it successfully.
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Introduction
Professional Context Change Strategy and Implementation Process Essay
One area in health care that it is necessary to consider is the environment in which nurses work. It is important that this environment evolves and changes so that all patients are adequately supported. For this assessment, you will develop a change strategy to improve the health care environment. These changes can be rooted in a desire to improve clinical outcomes and data related to assessment accuracy, drug administration, or disease recovery rates. A key skill for master’s-level nurses is to be able to evaluate clinical data and create a change plan to help drive improvements in the data to reach set goals.
Scenario Change Strategy and Implementation Process Essay
Consider a current environment. This could be your current care setting, the care setting presented in the scenario Vila Health: Using Concept Maps for Diagnosis, or a care setting in which you are interested in working. For the setting that you choose you will need to have a data set that depicts sub-optimal outcomes related to a clinical issue. This data could be from existing sources in the course, a relevant data set that already exists (a data set from the case study you used as a basis for your previous Concept Map assessment or from your current place of practice), or an appropriate data set that you have created yourself. (Note: if you choose to create your own data set, check with your instructor first for approval and guidance.)
After you have selected an appropriate data set, use your understanding of the data to create at least one realistic goal (though you may create more) that will be driven by a change strategy appropriate for the environment and goal. Change Strategy and Implementation Process Essay

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Potential topics for this assessment could be:
• Consider ways to help minimize the rate of secondary infections related to the condition, disease, or disorder that you focused on for your previous Concept Map assessment. As a starting point, you could ask yourself, “What could be changed to facilitate safety and minimize risks of infection?”
• Consider how to help a patient experiencing traumatic stress or anxiety over hospitalization. As a starting point, you could ask yourself, “How could the care environment be changed to enhance coping?”
Once you determine the change you would like to make, consider the following:
• What data will you use to justify the change?
• How can the team achieve this change with a reasonable cost?
• What are the effects on the workplace?
• What other implementation considerations do you need to consider to ensure that the change strategy is successful? Change Strategy and Implementation Process Essay
• How does your change strategy address all aspects of the Quadruple Aim, especially the well-being of health care professionals?
• Once the change strategy is implemented, how would you evaluate the efficiency and effectiveness of the care system if the desired outcomes are met?
Instructions
Your assessment submission should include a data table that illustrates the current and desired states of the clinical issue you are attempting to improve through your application of change strategies. Additionally, you will need to explain the rationale for your decisions around your chosen change strategies, as well as how the change strategies will be successfully implemented. The bullet points below correspond to the grading criteria in the scoring guide. Be sure that your change strategy addresses all of them. You may also want to read the Change Strategy and Implementation scoring guide and Guiding Questions: Change Strategy and Implementation [DOCX] Download Guiding Questions: Change Strategy and Implementation [DOCX]to better understand how each grading criterion will be assessed.
• Develop a data table that accurately reflects the current and desired states of one or more clinical outcomes.
• Propose change strategies that will help to achieve the desired state of one or more clinical outcomes. Change Strategy and Implementation Process Essay
• Justify the specific change strategies used to achieve desired outcomes.
• Explain how change strategies will lead to quality improvement with regard to safety and equitable care.
• Explain how change strategies will utilize interprofessional considerations to ensure successful implementation.
• Communicate the change plan in a way that makes the data and rationale easily understood and compelling.
• Integrate relevant sources to support assertions, correctly formatting citations and references using current APA style.
Example assessment: You may use the assessment example, Assessment 2 Example [PDF] Download Assessment 2 Example [PDF], to give you an idea of what a Proficient or higher rating on the scoring guide would look like. Change Strategy and Implementation Process Essay
Submission Requirements
• Length of submission: 3–5 double-spaced, typed pages, not including the title and reference pages. Your plan should be succinct yet substantive.
• Number of references: Cite a minimum of 3–5 sources of scholarly or professional evidence that supports your goal setting, proposed change strategies, quality improvement, and interprofessional considerations. Resources should be no more than five years old.
• APA formatting: The APA Template Tutorial [DOCX] can help you in writing and formatting your analysis. No abstract is required. Change Strategy and Implementation Process Essay

Guiding Questions: Change Strategy and Implementation
This document is designed to give you questions to consider and additional guidance to help you successfully complete the Change Strategy and Implementation assessment. You may find it useful to use this document as a pre-writing exercise, as an outlining tool, or as a final check to ensure that you have sufficiently addressed all the grading criteria for this assessment. This document is a resource to help you complete the assessment. Do not turn in this document as your assessment submission.
Develop a data table that accurately reflects the current and desired states of one or more clinical outcomes.
• Does your data table clearly and accurately reflect the current state of one or more clinical outcomes?
o If applicable, have you appropriately citied the source for this data?
o Is your data HIPAA compliant? Change Strategy and Implementation Process Essay
• Does your data table clearly and accurately reflect the desired state of one or more clinical outcomes?
o Have you based your desired state on best practices, guidelines, or regulations?
 Have you cited the relevant sources of evidence that you used to set your desired outcome state?
 Is your data HIPAA compliant?
• Are the data and outcomes in your table relevant to a specific care setting, case study, or other clearly defined condition or issue?
• Are the data and the outcomes relevant and appropriate for the change strategy you will be proposing? Change Strategy and Implementation Process Essay
Propose change strategies that will help to achieve the desired state of one or more clinical outcomes.
• What change strategies do you propose implementing to help achieve your desired outcomes?
• How will you implement the change strategies to help achieve your desired outcomes in the context of the care setting or case study you are using for this assessment?
o What other implementation considerations do you need to take into account to ensure that the change strategy is successful?
o What implementation challenges or hurdles might exist and how might you deal with them?
• How could the efficiency and effectiveness of the care system be evaluated to see if the desired outcomes are met?
Justify the specific change strategies used to achieve desired outcomes.
• Why is each change strategy you have chosen to implement relevant and appropriate for achieving one or more of your desired outcomes? Change Strategy and Implementation Process Essay
o What evidence (literature, best practices, professional guidelines, et cetera) supports your reasoning for implementing a chosen change strategy in the context of the care setting, case study, or desired outcomes you are considering for this assessment?
 How does the evidence support your reasoning and proposed implementation? Be specific.
Explain how change strategies will lead to quality improvement with regard to safety and equitable care.
• Which change strategy (or strategies) will most likely lead to quality improvements in the area of patient safety?
o How will it contribute to quality improvements in this area?
• Which change strategy (or strategies) will most likely lead to quality improvements in the area of equitable care? Change Strategy and Implementation Process Essay
o How will it contribute to quality improvements in this area?
• How might the strategy (or strategies) lead to other improvements related to the Quadruple Aim?
Explain how change strategies will utilize interprofessional considerations to ensure successful implementation.
• Which proposed change strategy (or strategies) will best leverage interprofessional considerations and strategies?
o How will it help ensure successful implementation across interprofessional or multidisciplinary teams? Change Strategy and Implementation Process Essay
o How does your change strategy address the well-being of health care professionals?
Communicate a change plan in a way that makes the data and rationale easily understood and compelling.
• Is your data table clearly presented?
• Are the links between your data table, desired outcomes, and change strategy and implementation clear and justified?
• Is your writing clear and professional?
• Is your writing free from errors?
• Is your submission 3–5 pages (not including the title page and reference list)? Change Strategy and Implementation Process Essay
Integrate relevant sources to support assertions, correctly formatting citations and references using current APA style.
• Did you use 3–5 sources in your assessment?
o Are the sources you used no more than five years old?
• Are your sources cited in APA format throughout the assessment?
• Have you included an attached reference list?
• Did you use the APA Paper Template for the proper formatting and to include a running head and title page? Change Strategy and Implementation Process Essay
o No abstract is needed for this assessment.

National healthcare organizations work together to boost the quality of care and patient safety. The “Agency for Healthcare Research and Quality” (AHRQ) formulates evidence-based (EB) guidelines based on clinical research findings to promote quality of care. The AHRQ has set quality indicators (QIs) to assess underperforming clinical outcomes. Moreover, the Joint Commission (JC) promotes quality of care by accrediting medical facilities (Al-Sayedahmed et al., 2021). Thus, hospital settings focus on identifying and improving underperforming clinical outcomes to qualify for accreditation. The desired clinical outcomes are achieved by implementing EB intervention targeting an underperforming patient care area. This paper focuses on implementing a change initiative to reduce the high rates of pressure ulcers caused by Deep Vein Thrombosis (DVT). Change Strategy and Implementation Process Essay

DVT and Pressure Ulcers (PUs)

The treatment for DVT intends to improve the health outcomes of individuals admitted to the inpatient unit. However, the treatment plan does not consider PU risk in this population. Studies show a strong positive relationship between DVT and pressure ulcers. Individual patients diagnosed with DVT are more likely to develop PUs, specifically leg pressure ulcers, during their hospital stay (Howell et al., 2021). Hence, an increase in DVT diagnoses in the medical facility is a significant contributing factor to the increase in PU rates. Therefore, considering PU risk among DVT patients would result in positive health outcomes. Change Strategy and Implementation Process Essay

A Data Table Reflecting the Pressure Ulcers Rates

The clinical outcome of interest is pressure ulcers (PU). In the medical facility, the actual rates of PUs exceeded expectations throughout the four quarters of the 2023-2024 financial year. The table below indicates the actual and target rates of the PUs for the 2023-2024 FY. Change Strategy and Implementation Process Essay

The PU target in the 2^nd quarter of 2023 was 13%, while the actual rate was 16%, exceeding the target score by 3%. Moreover, in the third quarter of 2023, PUs’ actual score exceeded the target limit by 5%. A similar trend was observed in the fourth quarter of 2023 when the actual score exceeded the target by 7%. Lastly, the actual PU rate exceeding the target score by 8% was reported in the first quarter of 2024. The rate of PUs has increased progressively throughout the period, exposing patients with a history of DVT to adverse health outcomes, including prolonged stay and high treatment costs. Change Strategy and Implementation Process Essay

Change Strategies for Achieving the Desired Pressure Ulcers Rates

Change strategies should be implemented in the healthcare organization to lower the current PU score among DVT patients receiving treatment in the inpatient unit. According to Tuzzio et al. (2019), implementing evidence-based (EB) care interventions in hospital settings results in the desired clinical outcomes. The change process focuses on achieving the quantitative outcome measure involving lowering the current PU rates to 10% or below. The proposed change initiative involves educating healthcare providers about the recommended clinical practice guidelines (CPGs) for preventing and treating pressure ulcers in clinical settings. In addition to the education program, the medical facility will adopt reminders and an organizational culture supporting PU prevention and management to boost patient safety. Change Strategy and Implementation Process Essay

Change Strategies Justification

The proposed multi-faceted change initiative combines education programs, clinical reminders, and organizational culture. Pereira et al. (2022) reported the efficacy of combining organizational culture, educational programs, and clinical reminders in enhancing physicians’ adherence to the recommended CPGs. The education program will increase healthcare providers’ knowledge about PU preventive and management practices. Clinical reminders will ensure providers’ adherence to the PU CPGs. Lastly, incorporating the new intervention into the organizational culture will enhance the sustainability of the PUs prevention and treatment practices, resulting in the desired clinical outcomes. Change Strategy and Implementation Process Essay

Change Strategies’ Role in Quality Improvement

            The new change intervention intends to lower the current PU rates in the medical facility through its components. First, the education program will enhance the providers’ understanding of PU prevention and treatment of CPGs. Moreover, clinical alerts will remind healthcare providers about PU prevention and treatment guidelines, enhancing adherence. Lastly, making the PUs’ CPGs part of organizational culture will make the practice guidelines part of the healthcare organization’s clinical operations. Pereira et al. (2022) reported the efficacy of multiple interventions in achieving the desired clinical outcomes in the short and long term. Therefore, adopting the multi-faceted change intervention would enhance the prevention and management of PUs in the healthcare organization. Consequently, the providers’ workload would be reduced significantly, enabling healthcare staff to provide high-quality, timely, effective, and safe care to all individuals seeking medical care services from the medical facility, promoting equitable and safe patient care. Change Strategy and Implementation Process Essay

Applying Interprofessional Considerations to the Change Strategies

Incorporating interprofessional team members into an EBP care intervention ensures the successful implementation of the change plan. In clinical settings, multidisciplinary team members provide essential information during the implementation of a change project (Jørgensen et al., 2020). Interprofessional team members to be involved in implementing the proposed change initiative include representatives of physicians, nurse leaders, advanced nurse practitioners, registered nurses, and nurse assistants. These healthcare professionals are preferred since they are involved in the prevention and treatment of PUs among DVT patients. Hence, these healthcare staff would provide the change team with essential information regarding PUs, resulting in implementing the most effective change strategies. Additionally, these interprofessional members would incorporate the new EB care intervention into their clinical practice, reducing the rate of PUs in the medical facility through effective prevention and management of PUs. Change Strategy and Implementation Process Essay

Conclusion

Pressure ulcers (PU) have increased significantly among DVT patients in the medical facility. The actual rates of PUs increased progressively throughout the 2023-2024 financial year, exceeding the set target. The high rate of PUs exposes DVT patients to adverse health outcomes, such as increased average hospital stay period and increased treatment costs. A multi-faceted change intervention has been proposed to lower the rate of PUs in the healthcare organization to 10% or less. These outcomes will be achieved by implementing three components of the change intervention, including an education program focusing on PUs’ CPGs, clinical alarms, and organizational culture. Interprofessional team members, including physicians and nurses, would be involved in implementing the multi-faceted change intervention. These healthcare professionals will incorporate the recommended PU prevention and management guidelines into their clinical practices, reducing PU rates of PUs and related adverse health outcomes. Change Strategy and Implementation Process Essay

References

Al-Sayedahmed, H., Al-Tawfiq, J., Al-Dossary, B., & Al-Yami, S. (2021). Impact of accreditation certification on improving healthcare quality and patient safety at Johns Hopkins Aramco Healthcare. Global Journal on Quality and Safety in Healthcare, 4(3), 117-122. https://meridian.allenpress.com/innovationsjournals-JQSH/article/4/3/117/469060/Impact-of-Accreditation-Certification-on-Improving

Howell, M., Loera, S., Tickner, A., Maydick-Youngberg, D., Faust, E., Martin, S., … & Kirkland-Kyhn, H. (2021). Practice dilemmas: conditions that mimic pressure Ulcers/Injuries-to be or not to be? Wound Management & Prevention, 67(2), 12-38. https://doi.org/10.25270/wmp.2021.2.1238

Jørgensen, M. J., Pedersen, C. G., Martin, H. M., & Lomborg, K. (2020). Implementation of patient involvement methods in the clinical setting: a qualitative study exploring the health professional perspective. Journal of Evaluation in Clinical Practice, 26(3), 765-776. https://doi.org/10.1111/jep.13217

Pereira, V. C., Silva, S. N., Carvalho, V. K., Zanghelini, F., & Barreto, J. O. (2022). Strategies for the implementation of clinical practice guidelines in public health: an overview of systematic reviews. Health Research Policy and Systems, 20(1), 13. https://health-policy-systems.biomedcentral.com/articles/10.1186/s12961-022-00815-4

Tuzzio, L., Larson, E. B., Chambers, D. A., Coronado, G. D., Curtis, L. H., Weber, W. J., … & Meyers, C. M. (2019, March). Pragmatic clinical trials offer unique opportunities for disseminating, implementing, and sustaining evidence-based practices into clinical care: Proceedings of a workshop. In Healthcare (Vol. 7, No. 1, pp. 51-57). Elsevier. https://doi.org/10.1016/j.hjdsi.2018.12.003 Change Strategy and Implementation Process Essay