IHP 600 Module 7 Change Management Paper Example

From Announcement to Habit: Leading the Staffing Change at Summit Valley Medical Center

[Student Name]

Southern New Hampshire University

IHP 600: Social and Organizational Issues in Healthcare

Module Seven Paper

[Instructor Name]

[Date]

The organization, setting and figures below are a composite written as a model document. No real employer, client, colleague or patient is described.

From Announcement to Habit: Leading the Staffing Change at Summit Valley Medical Center

Summit Valley Medical Center has a history of announcing initiatives that disappear within a year. Nurses remember a hourly rounding program, a new scheduling system and a recognition campaign that each launched with enthusiasm and faded. The staffing changes now proposed, assignment caps on medical-surgical units, dedicated break relief and a twelve-month residency, are more expensive and more visible than any of those. This paper assesses readiness for the change and applies a staged model to lead it.

Readiness as a Shared State

Weiner (2009) proposed that organizational readiness for change has two parts: change commitment, which is how firmly members as a group intend to carry a change out, and change efficacy, which is how capable they jointly feel of pulling it off. He argued that readiness is highest when people value the change and judge that the tasks, resources and situational factors make success possible, and that high readiness leads to greater effort and persistence during implementation. Because readiness is shared, it has to be assessed across groups rather than inferred from a few enthusiastic leaders.

Assessing Readiness at Summit Valley

Readiness was assessed through a short survey of 214 nurses and interviews with managers and executives. Commitment is high among bedside nurses: 84% agreed the changes are needed. Efficacy is lower: only 36% believed leaders would sustain the changes beyond a year, and managers doubted they would receive authority to use the new resources. Among executives, commitment varied, with the chief financial officer supporting a phased trial but not a hospital-wide launch.

Table 1. Readiness Indicators by Group

Note. Composite results from a nurse survey and leader interviews.

What the Readiness Profile Means

The profile shows that the task is not to persuade nurses the change is needed but to convince them it will happen and last. That shifts the plan's emphasis from communication about why toward visible early action, resourced managers and public tracking of results. Executive commitment must be secured before launch so that frontline efficacy is not undermined by mixed messages.

A Staged Model for Change

Appelbaum et al. (2012) reviewed the evidence for Kotter's eight-stage model: establishing urgency, forming a guiding coalition, creating a vision, communicating it, empowering action, securing early wins, building on those gains and then embedding the change in culture. They found the model widely used and consistent with much of the research, though few studies tested it as a whole, and they noted that organizations sometimes need to work on several stages at once rather than strictly in order. The model is used here as a checklist for sequencing rather than a rigid recipe.

Urgency and Coalition

Urgency already exists among nurses, so the first task is to build it among executives and the board, using the $9.7 million annual turnover cost, the link between staffing and patient safety and the union petition now circulating. The guiding coalition will include the chief nursing officer as sponsor, the chief financial officer, two medical-surgical managers, three staff nurses chosen by the shared governance council, a hospitalist and a human resources partner. Including finance from the start addresses the executive commitment gap.

Vision and Communication

The vision is short: safe assignments, real breaks and support for every new nurse, so that nurses choose to stay. Communication will rely on unit huddles led by coalition members, not only email from executives, and every message will include a date and a named owner. Because nurses doubt follow-through, the coalition will publish a monthly one-page report on staffing, breaks taken and turnover by unit.

Empowering Action

Managers will receive authority to approve break relief and one additional nurse on high-acuity shifts without executive sign-off, within a set monthly budget. Charge nurses will be trained to assign by acuity. Policies requiring mandatory overtime will be revised so that it becomes a last resort with a monthly cap per nurse.

Short-Term Wins

The change will begin on the three highest-turnover medical-surgical units for six months. Early targets are visible within weeks: breaks taken on at least 80% of shifts, mandatory overtime cut by half and the first residency cohort of twelve new graduates started with protected education time. Meeting these targets publicly, and celebrating the staff who made them happen, will build the efficacy the readiness assessment found lacking.

Leadership Behaviors That Sustain Change

Shanafelt and Noseworthy (2017) described organizational strategies that leaders can use to reduce burnout, among them measuring burnout openly, training and assessing leaders, building community among colleagues and giving staff more flexibility over when and how they work. Two apply directly here. First, unit leaders will be assessed partly on staff survey results, which signals that well-being is part of their job. Second, flexible scheduling pilots will be offered on the first three units to address the instability nurses described.

Anticipating Resistance

Pushback should be expected from three groups. Some executives may press to end the trial early if savings lag. Hospitalists may object if capped assignments slow admissions. Experienced nurses on other units may resent that the first units receive resources first. Each will be addressed: a savings dashboard reviewed monthly with finance, a bed-flow protocol developed with hospitalists and a published schedule for extending the change to all units.

Consolidating and Anchoring

If six-month targets are met, the change will extend to the remaining medical-surgical units, then to the emergency department. Anchoring means writing the assignment standards and break relief into policy and the annual budget, including readiness questions in the yearly staff survey and telling the story of the change in orientation so new staff learn it as how Summit Valley works.

Conclusion

Summit Valley's nurses already want the change; what they doubt is that leaders will carry it through. By securing executive commitment, empowering managers, starting small with visible wins and anchoring the change in policy and budget, the hospital can turn a proposal into lasting practice.

References

Appelbaum, S. H., Habashy, S., Malo, J.-L., & Shafiq, H. (2012). Back to the future: Revisiting Kotter's 1996 change model. Journal of Management Development, 31(8), 764-782. https://doi.org/10.1108/02621711211253231

Shanafelt, T. D., & Noseworthy, J. H. (2017). Executive leadership and physician well-being: Nine organizational strategies to promote engagement and reduce burnout. Mayo Clinic Proceedings, 92(1), 129-146. https://doi.org/10.1016/j.mayocp.2016.10.004

Weiner, B. J. (2009). A theory of organizational readiness for change. Implementation Science, 4, Article 67. https://doi.org/10.1186/1748-5908-4-67