module seven: learning organizations

Running head: MODULE SEVEN: LEARNING ORGANIZATIONS 1

Module Seven: Learning Organizations

Student’s Name:

Institutional Affiliation:

MODULE SEVEN: LEARNING ORGANIZATIONS 2

Introduction

Nurses and other healthcare providers are expected and required to adhere to certain

standards of behavior while providing care to patients. Nurses and other healthcare professionals

need to be trusted to act ethically at all times. They should focus on the well-being of the

patients, and all decisions made, and the course of action taken should be for the best interests of

the patient. With cases of an ethical dilemma when providing care to patients, an increase in

moral standards and behavior among healthcare professionals becomes essential. The discussion

will focus on inter-professional collaboration as a way of increases hospital morals, the change

process and leaders of change or the agents of change, their roles and the time and resources

needed.

The Change to be initiated

The change to be initiated is inter-professional collaboration as stated in the previous

assignment. High levels of accountability among professionals increase morals among

professionals. Inter-professional collaboration increases the level of accountability hence an

increase in morals among professionals in a hospital. The change initiative is, therefore, to

establish a culture of interprofessional collaboration in the hospital to boost adherence to the set

ethical practice through accountability to others and through experience gained on how to act

under certain circumstances. Inter-professional collaboration refers to joining forces of multiple

healthcare professionals with different professional backgrounds to provide quality care to

patients, their families, and the community as a whole. The collaboration is based on the concept

that better care can be provided when healthcare professionals consider the perspective of each

other (Reeves, Pelone, Harrison, Goldman, & Zwarenstein, 2017).


The Rationale for the Change

The healthcare industry, as a whole, is characterized by increased costs that are linked to

medical errors. Studies indicate that 1 in 7 patients who are beneficiaries of Medicare suffers

harm in their course of care. It has been reported by the U.S Department of Health and Human

Services that 1 in every 20 patients suffers an infection that is related to the hospital care

received (Senders, 2018). Such undesirable outcomes have been linked to a lack of proper

coordination, especially during care transition in various settings hence a lack of protection for

the patients. Healthcare professionals have an ethical obligation to protect patients, protect their

rights and their obligation. To provide safe and quality care, healthcare professionals, must work

together for efficiency and effectiveness. Inter-professional collaboration facilitates the

development of values such as trust, respect, accountability, and integrity as the professionals

strive to achieve excellence and proper work relations. Such values at both individual and

organizational levels boost the morality of individuals and impact their ability to adhere to

ethical standards and their moral obligation to patients and their field of practice.

The need for culturally competent care also requires inter-professional collaboration to

cater for the diverse patient's needs. High moral standards enable professionals to respect the

cultural values and beliefs of the patients despite their difference of opinions. Inter-professional

collaboration enables the individual to gain cultural competence as working with diverse people

enables the development of required skills and experience. Research indicates a link between

inter-professional collaborative practice and cultural competence. Principles that ensure

successful collaborations and which include openness, positive attitudes towards the world view

of others, inclusiveness, mutual respect, and other values form the basis of cultural competence

(Gilliland, Attridge, Attridge, Maize, & McNeill, 2016).


Outcome Desired from the Change

The increased inter-professional collaboration will enable the organization to solve

major problems in the organization, such as medical errors, increased costs, reduced patient

safety and satisfaction, low performance, and others. The existing evidence indicates that inter-

professional collaboration facilitates communication, enhances coordination, and improves the

safety of care offered (Reeves, 2017). The education recommended by the Institute of Medicine

to facilitate inter-professional collaboration focuses on asserting certain values and ethics that

focus on the interests of patients embraces cultural diversity and respects cultural differences,

leveraging the unique roles of other professionals, and improving communication.

The National Center for Interprofessional Practice and Education champions for the use

of high-functioning teams to improve patient experience, outcomes and reduce health costs.

Interprofessional collaboration enhances the quality of care; hence people can live longer and

better (Davis, & Affenito, 2017). In the United States, the annual number of deaths resulting

from medical errors is estimated to be 200,000 and occurs mostly in complex and high-risks

inpatients (Tawfik, Profit, Morgenthaler, Satele, Sinsky, Dyrbye, & Shanafelt, 2018). The results

of a study conducted to evaluate the impact of having a pharmacist in rounds carried out in the

intensive care unit indicated a reduction of two-thirds of cases of adverse drug effects. The study

also indicated a 19% reduction in cases of hospital readmissions and 30% less likelihood of older

patients receiving coordinated care to visit the emergency rooms (Preslaski, Lat, MacLaren, &

Poston, 2013).

Patient satisfaction also increases with interprofessional collaboration. Patients receive

the best care possible as the care plan incorporates various perspectives from different


professionals reducing the chances of errors that may have an adverse impact on the health of the

patient. Coordinated care increases patient's confidence in the care received and improves their

experience. Communication delays are one major cause of patient dissatisfaction and frustration.

Inter-professional collaboration bridges the gap between healthcare professionals as they work

together to achieve a common goal, and hence they become more accountable in providing

feedback to other team members. The care provided is, therefore, characterized by consistency,

increasing patient satisfaction.

The Audience to be Convinced

Establishing a culture of interprofessional collaboration requires the involvement and

participation of various stakeholders. There are three major audiences of the change initiative,

and they include the organizational leadership, the healthcare professionals, and the investors.

The three stakeholders determine the success of the proposed change initiative as they provide

resources and the platform for change implementation.

The leaders of the organization are the first audience to convince as they provide

direction to all the involved parties through organizational mission and vision. Leaders shape the

culture of the organization and influence others to follow towards organizational goals. Leaders

play the role of providing motivation and inspiration, building potential teams, and creating a

structure that supports the change. Leaders control all the resources, including financial and

human resources. They make decisions on how to allocate and utilize resources available.

Convincing the leaders of the organization will require valid and viable reasons why the change


is needed and the benefits the change will have on the organization. In return, the leaders are

expected to develop a framework for implementation.

Healthcare professionals are also crucial to the change initiative as they are involved

directly. They are responsible for the day to day activities of achieving the culture of professional

collaboration. They are expected to take an active role in training on how to collaborate and

coordinate care. Their commitment to work as a team determines the outcomes expected. They

have to be convinced of the need for the change, need for training and education on how to work

as a team for effective performance and increased productivity and on how the change initiative

impacts their career and experience.

Investors have to be convinced about how they benefit from investing their resources in

the change initiative. Their contribution has an impact as they avail the resources to facilitate the

change. Inter-professional collaboration requires resources to support certain areas, such as

communication among professionals. Patients will also have to be convinced to participate in

their coordinated care to ensure that they are adequately involved. The families of patients and


the community as a whole are also the audience, and their involvement in the initiative have a

significant impact.

Benefits to the Institution

The main goal of interprofessional collaboration is to provide patient-centered care to

improve patient outcomes. The organization will benefit in various ways. The organization will

experience better performance and increased productivity. A significant amount of research

indicates that collaboration among various disciplines leads to the optimization of patient

outcomes, quality of care offered and the cost incurred (Reeves, et al., 2017). Interprofessional

collaboration empowers the team members as they learn from each other. The collaboration

between the professionals reduces pressure on the individual professionals as they support each

other, knowledge and experiences are shared among the professionals, decisions are made

jointly, and a pool of ideas is created hence better performance and better outcomes. Working as

a team increases the chance for better clinical decisions and plans of care.

The organization will also experience cost reduction due to reduced medical errors,

reduced hospitalization periods, and reduced rate of employee turnover. Interprofessional


collaboration closes communication gaps between the professionals that cause errors and other

inappropriate decisions due to incomplete or incorrect information. Effective communication

promotes informed decision making, hence a better plan of care that is fit for the patient. Such

efforts reduce the length of hospital stays hence reduction on medical costs. Collaboration among

health professionals increases job satisfaction as it reduces cases of burnout, improves work

relations, and individual performance due to increased knowledge and experience (Reeves, et al.,

2017). Proper allocation of duties and responsibilities among the health professionals ensures

manageable workloads through minimization of effort duplication. The organization will not

incur the cost of hiring and training new employees that result from employee resigning and

quitting their jobs.

The organization will also become more competitive as it will be able to offer quality

care to patients. Continuous communication that occurs between patients and the healthcare

professionals increases patient's adherence to their treatment plan; hence better health outcomes

are achieved. Patients will be more satisfied as they will receive patient-centered care where they

are more involved in their care, and the treatment plan is in line with their needs. The


collaboration increases cultural competency among health professionals, and patients receive

health care that is sensitive to their values, beliefs, and practices.

Allocation of Resources and Potential Budget Requirements

A need-based approach will be used to introduce in introducing the culture of

interprofessional collaboration in the organization. The approach is effective as it takes into

account how local health care is delivered to the community members; hence care is organized

towards the identified needs of the target population. The resources required are dependent on

the actions to be taken to facilitate the change initiative. Major requirements to implement the

change include resources facilitating effective communication and information sharing among

the health professionals and the leaders. Meetings will be held to facilitate consultations on how

to support the change initiative through the establishment of policies, values, and other

guidelines that regulate the interaction among the professionals to ensure proper work relations.

Resources to facilitate creating awareness through the provision of education and proper training

on the key competencies required for successful collaboration will also be needed. There is also a


need for talks with the organizational leaders to facilitate the establishment of clear governance

models, operating procedures, and the structured protocols to be followed.

The resources required include more space in the facility to enable effective

communication. The facility may be required to redesign the facility to eliminate barriers to

effective communication. The course of action required is the provision of open space to be

shared by the professionals. The health professionals will require training on how to work as a

team by understanding the roles of the other professionals, the established protocols, policies,

and other operating guidelines. Changes in the communication systems will be required to

facilitate effective communication among the team members. The organization will also be

required to hire new human resources to ensure balance in the teams to be formed. All the

courses of actions to be taken for the implementation of the change initiative will require

finances to cater for the cost of meetings health and any materials required for training and for

making adjustments on the physical environment. The table below is the potential budget for the

establishment of the change initiative:

Expenses Estimated Costs ($)


Training tools and technology 4,500

Training content 3,600

Redesigning the facility 20,000

Adjusting the Communication systems 8,000

The hiring of new employees 26,000

Patient and community education 5,000

The Group to Lead the Initiative and why they were Chosen

The leaders of the organization will lead to the change initiative. The leading group or the

change agents will include leaders at all levels, including the heads of departments, the managing

team, nurse leaders and all those who are in leadership positions. A committee composed of the

leaders will be formed to oversee the change initiative. The committee will play various roles in

ensuring that the change is successively implemented. The committee members will act as

advocates and will champion a change in behavior, values, performance, and outcomes. They


will act as role models by demonstrating the attitude and the behavior expects from the rest of

the staff. This can be evident in their interaction with the rest of the staff in areas such as

decision making on issues affecting the staff members and through communication.

The leaders were chosen because they are in a better position to create the necessary

influence for the successful implementation of the change. The leaders are responsible for

decision making, and implementing the change will involve making the decision on various

issues such as the necessary policies to be put in place. They are in control of resources,

including financial resources, human resources, and equipment. They approve the organization's

budget to facilitate operations. They have the mandate to hold other people accountable for their

actions. The rate of major change initiatives being successful is estimated to be 30% (Quast, &

Kuhn, 2019). Such data necessitate the need for a proper sense of direction to ensure that the

change initiative is carried out successfully. The leaders are responsible for providing the vision,

mission, relevant information and goals, which guides the efforts of the staff. The culture of

interprofessional collaboration can, therefore, be championed by leaders by motivating the rest of

the professionals to work towards the achievement of the set goals.


The Proposed Timeline

The five-step stages of change model (SCM) will be used to implement the change. The

model consist of five stages that include pre-contemplating, contemplating, planning, action and

maintenance stage (Mitchell, 2013). The hospital is currently in pre-contemplating stage as they

are not aware of the change needed. The second stage is contemplating stage and will involve

convincing the audience discussed above by presenting the reasons for and benefits of the change

initiative. A lot of learning and training will be required to facilitate interprofessional

collaboration. Studies indicate that the majority of professionals tend to ignore other

professionals due to a lack of collaboration during their professional education. The

professionals develop negative biases and perceptions towards the roles of other professionals

(Davis & Affenito, 2017).

The major step will be educating the professionals on the need to understand and respect

the roles of other professionals. The preparation and the action stage will include policy making,

redesigning of the facility, communication systems and technologies. The major activities to be

undertaken to facilitate the implementation of the change will require longer periods to be


implemented. A significant number of activities will only be implemented one at the time, as

they can only be carried out in a particular order. The last change, which is maintenance will

involve formation of interprofessional teams and guidelines on how to relate with other

professionals. The change is expected to take place in a minimum period of 12 months to ensure

all the necessary plans are put in place. The table below shows an estimated period for each

activity:

Activity Timeframe

Creating awareness of the need for

Interprofessional Collaboration

1st -2nd month

Policymaking

Budgeting

2nd -5th month

Adjustment on the communication system

and redesigning the physical facility

6th -9th month


Providing the necessary training and

education

8th- 9th month

Formation of the collaboration teams 10th -11th

Measures of Success

There is a worldwide growing understanding of the need for interprofessional

collaboration to provide well-functioning health care. Evidence indicates that the majority of

health care facilities are only able to achieve moderate teamwork and collaboration, while the

experience and the perception differ among professionals (Morley &Cashell, 2017). The success

of interprofessional collaboration will be measured from various perspectives, including the

patient, the health professionals, and the management team. It will be based on both health

outcomes, a change in behavior, and experience. The measure of behavior will be from the

perspective of health professionals. It will measure a change in attitude and perception towards

the role of other professionals and their experience in team care. It is predicted that a successful


team will have members with trust in one another, accountable, and interdependent. The team

members feel safe to act in openness and with transparency despite the differences.

The experience of patients will also be used as a success measure since the change

initiative is need-based, and the success is determined by the ability to meet the needs of the

patients. The ratings provided by the patients will reflect their experience based on their

satisfaction with the care given. Health outcomes such as medical errors, hospital readmissions,

and cases of hospital-acquired infection will also be used as measures to determine the success of

the collaboration. Such cases are expected to reduce or cease with interprofessional

collaboration. Costs incurred will be a measure to be used by the management to determine the

effectiveness of the collaboration. The results will be compared with previous performance to

determine whether the change initiative is successful.

The change initiative will have a great impact on various established frameworks in the

organization and it will require a significant amount of time to make the necessary adjustments.

The change is expected to be part of the organizational culture in the long-run to impact the


moral obligation of the health care professionals by promoting accountability of the professionals

to each other and to the organization as a whole.


References

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