Running Head: SEMINAR 2 DISCUSSION QUESTION 1

Seminar 2 Discussion Question

Raymonta Green

Kennesaw State University

WellStar School of Nursing

NURS 7873 – Nurse Educator Practicum 1

Dr. Anne White

February 10, 2023

Change is inevitable and to grow and adapt to the advancement of a given field, change

must be assessed, performed, and evaluated. Krakow (2021) listed the best organizational change

management strategies as planning, transparency, truthfulness, communication, planning,

providing training, monitoring, and strong leadership capabilities. In the assigned case study, one

area of improvement that the interdisciplinary healthcare improvement project panel decided to

focus on for change was reducing the number of falls in the patients. Some of the strategies that I

noticed used in the case study for change were planning, transparency, truthfulness,

communication, training, and monitoring. Planning was implemented in the case study through

the form of the committee recognizing the clinical guideline published by the U.S. Agency for

Health Care Research and Quality (AHRQ) and seeking references from the research.

Transparency and truthfulness were illustrated in the case study in the form of the committee

realizing that the AHRQ research guidelines were far too in-depth, complex, and time-

consuming to obtain that desired successful outcome, and instead chose to go with two strong

innovations that would have the greatest effect. Communication was demonstrated in the form of

the committee choosing one designated nurse from each unit and was charged with the

responsibility of being the leader for change, under the direction and direct communication of the

committee, to implement the two chosen innovations from the AHRQ. The training was

implemented in the form of an informational campaign design and in-services being conducted

on each unit, while monitoring was the desired outcome of a reduction of the rate of falls in

patients by 75%.

Per the literature, Roger’s Theory of Diffusion is defined as “the process by which new

ideas are disseminated and integrated through a kind of change by which alteration occurs in the

structure and function of a social system, where new ideas are invented, diffused, and adopted or
SEMINAR 2 DISCUSSION QUESTION 3

rejected, leading to certain consequences, social change occurs” (Wittmann, et al., 2022). Roger's

Theory of Diffusion includes five key components which are knowledge, persuasion, decision,

implementation, and confirmation. Evidence of this theory's application is apparent within the

assigned case study. Knowledge was illustrated by the committee assessing the problem of

increased fall rates and understanding the complications that it has on the hospital system and

patients' outcome of care and referencing the AHRQ for guidance on how to combat the

problem. Persuasion was evident in the form of the interdisciplinary healthcare team's decision

and understanding that the increased fall risk was of the highest safety and should be focused on

for improvement. A decision was demonstrated in the form of the committee deciding to take

just two innovations for implementation for the AHRG guideline that would give the highest

effect of a positive outcome for the problem. Implementation was shown when unit leaders were

decided and campaigns and in-services were designed to be given across the staffing of the

hospital system. Lastly, confirmation was identified when the chosen innovations resulted in a

75% rate reduction in falls in the hospital system.

The ANA, American Nurses Association, has several competencies that are essential to

leadership, and Wittmann, et., al (2022) identify them as collaboration, communication,

education, environmental health, ethics, evidence-based practice, leadership, professional

practice evaluation, quality of practice, and resources utilization. These competencies of a leader

support the process of Roger's Theory of Diffusion by taking the steps from the theory and

incorporating them with the competencies of an effective leader. In a nursing journal on the

importance of leadership styles towards the quality of care measurements in healthcare settings,

it was concluded that “Effective leadership of healthcare professionals is critical for

strengthening quality and integration of care. Healthcare organizations need to ensure technical
SEMINAR 2 DISCUSSION QUESTION 4

and professional expertise, build capacity, and organizational culture, and balance leadership

priorities and existing skills to improve quality indicators in health care and move a step

forward” (Sfantou, 2017). The step of knowledge can be incorporated with the competency of

education by educating on the problem of focus at hand and the competency of quality of

practice by identifying the standard at which a hospital organization should operate with the

identified focus. The step of persuasion can be incorporated with the competency of ethics by

ensuring that the patient's safety of health is prioritized and the competency of leadership by

being able to rally and motivate the team or committee to come together and agree on the most

impactful problem against the hospital and the patient. The step of a decision can be incorporated

with the competency of evidence-based practice to ensure that the implementation that is chosen

is the most current in research and has been applied to a practical situation that has delivered a

desirable outcome. The step of implementation can be incorporated with communication and

collaboration across the team and hospital to ensure that the training is equal and effectively

provided across all entities of the hospital, alongside the competency of resource utilization by

ensuring that the knowledge, experiences, and materials are being fully used to ensure that

training is the most impactful to the staff. Lastly, the step of monitoring can be incorporated with

the competency of professional practice evaluation to evaluate and see what went wrong, what

went right, what changes needed to be implemented, what changes should sustain, was the goal

reached, or was the target missed.

Wittman, et., al (2022) identify a six steps checklist for assessing an organization's

effectiveness which includes, “establishing boundaries of an evaluation, conducting a

performance needs assessment, defining the criteria or merit, planning and implementation of the

evaluation, synthesizing performance data with values, and communicating and reporting
SEMINAR 2 DISCUSSION QUESTION 5

evaluation findings”. For this assigned case study, the checklist can be applied by first

establishing the boundaries of the evaluation. In a review article on the importance of leadership

and organizational performance system reviews, it was concluded that “positive relationships

have been noticed between performance management systems, clinical performance, and clinical

outcome. The performance of healthcare systems and organizations is positively consistent with

leadership, management practices, manager characteristics, and cultural features that are related

to values and administrative approaches” (Al-Habib, 2020). The interdisciplinary healthcare

team was identified as the primary liaisons and power brokers for the project. The evaluation was

requested due to the increased rate of falls within the hospital setting. The primary beneficiaries

of the evaluation would be the patients' and the organizational participants are the nursing and

ancillary staff charged with improving the fall rates. Next, the conduction of performance needs

assessment was completed. The purpose of the committee was established to initiate hospital-

wide clinical improvement initiatives. The performance levels needed for the committee were

deemed necessary for a multidisciplinary approach from different healthcare professions. A

SWOT analysis was completed after realizing the AHRQ guidelines were beneficial but can be

overwhelming to staff and instead the strengths of it were chosen to be implemented instead.

Next, the definition of the criteria to be used for evaluation was completed. The performance

standards for the problem were identified through the AHRQ guidelines that were assessed and

evaluated by the committee. Next is the planning for the implementation of the evaluation.

Within the assigned case study, there was no information applied on how data was collected or

analyzed. Within this step, there would need to be the identification of data sources, collection

methods, and methods to analyze data. The next step is to synthesize performance data with

values. This was another section where information was not provided on how in the case study.
SEMINAR 2 DISCUSSION QUESTION 6

In this step, a profile would need to be created on the effectiveness, strengths, and weaknesses.

Lastly, is the communication and report evaluation of activities. This was another section where

information was not provided. In this step communication of the project, and progress need to be

delivered, as statements of clarification and reactions, and follow-up support. Relevant criteria

would be the communication of goals, the resources that are needed for the implementation of

change, the climate and culture of the staff involved in the implementations, success or failure of

the implementations, education on the strengths and weakness of the implementations, and plans

to change or maintain the implementations so that the problem may not arise again.
SEMINAR 2 DISCUSSION QUESTION 7

References:

Al-Habib N. M. I. (2020). Leadership and organizational performance: Is it essential in

healthcare systems improvement? A review of the literature. Saudi journal of anesthesia, 14(1),

69–76. https://doi.org/10.4103/sja.SJA_288_19

Krakow, S. (2021, September). The 10 best organizational change management strategies.

The Best Organizational Change Management Strategies | Champlain College Online. Retrieved

February 10, 2023, from https://online.champlain.edu/blog/best-organizational-change-

management-strategies

Sfantou, D. F., Laliotis, A., Patelarou, A. E., Sifaki-Pistolla, D., Matalliotakis, M., &

Patelarou, E. (2017). Importance of Leadership Style towards Quality of Care Measures in

Healthcare Settings: A Systematic Review. Healthcare (Basel, Switzerland), 5(4), 73.

https://doi.org/10.3390/healthcare5040073

Wittmann-Price, R. A., Godshall, M., Wilson, L., Billings, D. M. G., Cornelius, F. H.,

Fennessey, A., George, T. P., Gittings, K. K., Smith, G. M. E., Kelly, S. H., Kiefer, R. A.,

McHugh, M. K., Okupniak, C., Shaffer, K. M., Weaver, D., & Zukowsky, K. (2022). Certified

nurse educator (Cne) and certified nurse educator novice (Cnen) review. Springer Publishing

Company.