Workplace Reengineering, Reorganization, and Redesign From Nursing Management: Principles and Practice

Patricia Stanfill Edens, RN, MS, MBA, FACHE

September 13, 2005

In This Article

Leading Change

Leading change is the ability to motivate others to achieve a set of goals and objectives. In a progressive organization, senior leadership may request a contingency plan for continuing inpatient declines or staffing vacancies. The manager may be asked to define a plan that incorporates the mission and vision of the organization while addressing the need to cut costs or deal with impending staff shortages. Change leadership requires creative thinking, the ability to appropriately influence others, an ability to see beyond the job description, and a flexible attitude. It also requires an ability to see the global picture for the industry and the facility so that a fair allocation of human, financial, and clinical capital occurs. It is crucial to involve the staff in decision making after first explaining the purpose of the planning exercise. If the manager does not have the trust of the employees, this will be the most difficult step in the change process, as the employees will perceive change as negative and threatening rather than as a way to enhance the performance of the facility. The goal for the manager is to be able to effect change without a loss of employee trust. If change is not managed well, employee resistance will lead to failure of the effort, turnover of staff, negative impact on the quality of patient care, and decline in productivity.

Change management requires an agent to manage the process. If senior management demands a change in patient satisfaction scores, and the employees do not understand what they can do to accomplish this task, it is the responsibility of the manager to become the change agent to reconcile the request of senior management with actions that the employee can understand. For employees, these actions might include introducing themselves upon entering the room, explaining their role, and always asking if there is anything else the patient needs before departing. In a more global sense, finances -- savings or increases in revenue, personal or professional needs, patient's needs, or organizational needs dictate change priorities.