Change paper in nursing based on Lewins theory
A hospital has initiated a program which utilizes computer system called Meditec in replace of the traditional paper charting. The ER department of the said hospital has started using the program and has been successful with its implementation. However, a certain department at the 4th floor of the hospital receives resistance to the system from some staffs especially the older nurses who are afraid to use the computer. The focus of the paper is the steps and strategies that the hospital management need to undertake to be able for all the employees of the hospital accept the changes brought about by the new system and for the system to be utilized affectively.
The use of the computer system in a hospital is a strategy not only implemented by hospitals but by almost all business firms and institutions and has brought a lot of changes as well as advantages. The use of technology such as the computer and the internet makes the process in an organization, may it be paper works or production process, easier, more accurate and more reliable than the traditional way of doing things.
In a hospital, creating a change involves many stakeholders including the patients who receive the services provided by the hospital. Once the computer system is implemented there will be improved and enhanced services that are definitely advantageous in the part of the patients. Another stakeholder who will benefit from the Meditec is the nurses. The nurses are the one who have direct access to the computer system. The nurses’ task which is to provide health care involves the sorting of patients’ records, laboratory and pathology test results and integrating these record to other departments that are involved in decision making.
The system is basically a network of computers within the hospitals interconnected with each other to be able to implement sharing of information across departments. The information shared in the network has to be patient records and some confidential records have to be accessed by authorized persons only with the use of password. This centralized and distributed databases and linkages between computer systems significantly enhance access to patient information, saving time and resources.
Though investing in the development and installation of computer systems costs a substantial amount and resources, many medical institutions still invest into it due to its many benefits it can provide including the storage of medical records and electronic links among departments and sophisticated support in the form of diagnostic tools, error detection, and automated reminders (1987; 1993). The implementation of Meditec needs resources not only the physical equipment as well as the human resource and skills necessary to run such system.
In implementing computer-based system, the hospital will need technical support, from the installation to its maintenance. Also, a hospital is an institution where not all employees are adept with the use of computers. Most hospitals have older nurses and staffs that are afraid to use computer because of lack of knowledge in computer. This results to resistance and objection of some employees with the system. Some who resist the system may insist that the hospital need not waste money because the hospital can run in a traditional way while some employees, although they support the computer-based system can not admit that they do not know how to use the system.
The goal of the system is to make the work of nurses less time consuming, less paper works, more accurate shared data and easy to access information system within the hospital so that the nurses can focus on the core of their job which is providing health care services and not managing of the paper works in the hospital.
A strategy or change according to (1947 , 2006), a social psychologist has three phases: unfreezing or getting the need to change to be accepted; moving or putting the changes into effect; and refreezing or consolidating the changes so that there is no reversion.
Unfreezing or preparing is the initiation of change and involves preparation for what is to happen (2006). The implementation of computer-based information system in the hospital is actually a change program. According to the force field analysis, a management technique developed by 2006), there are two variables involved in planning and preparing a change program: the driving forces that seek to promote change and the restraining forces that attempt to maintain status quo or to resist change ( 2006). It is important that the plan is informed and shared with the employees because they are the one who will be using and implementing the system.
In the hospital, the driving force is the technology. The management saw the advantages and benefits that this kind of technology can give the hospitals such as information available more quickly; accuracy and consistency of information; and free up people’s time to do other tasks. Also, pressure from the management to implement the system is another driving force. Competition from other hospitals can also be considered as a driving force to this situation.
The restraining forces in this situation are the fear of the use of computer and lack of technological knowledge about the computer. Concerns about competence, personal uncertainty and preference for the way things are done now are just some of the reasons why people resist change according to ( 2006). The cost of the technology used can also be considered restraining force but in this situation, the hospital seems to be willing to invest in such system. When the driving force is just as strong as the restraining force, then no change will happen which only mean that the implementation of the system is not successful thus, it is important to overcome resistance.
Moving, the 2nd phase of change as noted above is putting changes into effect. This is now the phase where the restraining forces will be overcome. Basically, there are five possible approaches or strategies to overcome resistance (1973 , 2006). These are the directive strategies; expert strategies; negotiating strategies; educative strategies; and participative strategies.
Looking at the restraining forces, the better approach could be the educative strategies. The system is not new to the hospital since it has been implemented in the ER so educating the nurses and other employees involved in the change will not be that difficult in the part of the management. The system is expected to be functional and operating in three months time. As long as there are available resources and equipments, installation and testing will not take long. By the time the network has been installed, the training of nurses and staff can be started. Training schedules should not be conflict with work schedules so the staffs and nurses at the 4th floor should be divided into groups. One group can attend the training in the morning and the other group in the afternoon training session. Moreover, younger nurses and employees usually have the knowledge in computers and are not easy to educate whatever system the hospital is using.
Educative strategies should involved orientation, lectures on basic knowledge and operation of computer, knowledge on how to access confidential data for authorized employees only, and educating them on how to maximize the usefulness of having a system such as Meditec. A two-months training is enough to train and educate employees of the basics of computers. The trainers should not only have the technical knowledge but also have the ability to convince all employees that the system is not only advantage on the part of the hospital but more importantly on the part of them, the employees, making their works easier and less-time consuming. Management may opt to hire trainers and educators outside the hospital and one staff of ER may demonstrate the use of the system. Consequently, the hospital should organize a technical department that will be responsible for the maintenance and technical aspects of the system. This department should also be responsible in educating and promoting technological developments that will help enhance services provided by the hospital.
During the training, it should also be emphasized that the world is driven by technologies and every organization including hospitals are adapting to the changes brought about by technologies. The hospital should take advantage of the benefits technology brings especially when it is related to customer service and quality health care. Proper motivations are needed to embed the new system within the culture of the hospital.
The change strategy will be constrained with the time available. With the hospital’s case, the basic knowledge is only what the employees needed and as the system is implemented, employees will get used to it especially when the employees are starting to get the benefits brought about by the system. At this stage, refreezing phase is now taking place.
After the seminar/training, it is expected that all employees will now embrace the new system and will be happier with their work. The system may be modified as new technology emerge and as the requirement of the hospital arise. However, the hospital should be aware that a system may experience lockdown due to external uncontrollable factors. In case like this, there should be back up file so that the hospital operation can still continue.
It can be concluded that changes in work situation is not easy to implement because there are always those who are against or what are called restraining forces. However, these forces can be approached using different strategies. The strategy used above is educative. It is an effective strategy because it gives the employees better understanding of the change, making them adapt to the change less resistive. The study has provided important knowledge on how to implement changes especially in today’s technology driven world and when people always seek on ways on how to improve ones life.
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