Lewin's Change Theory Applied to Nursing

Introduction

In today’s technologically advanced world change in the healthcare system is inevitable. The healthcare system has to equally adjust to meet the current world needs. This change will automatically require health experts such as nurses to equally adapt to the new trends which may lead to anxiety or fear of failure in the nurses leading to resistance in some cases.

This paper focuses on highlighting the required changes in the medical scene and how nurses should be trained to adapt to them. The Lewin’s change management theory will be the main area of focus as it will be used to skillfully plan for how these anticipated changes will be implemented in the nursing workforce.

Safety in the medical scene is a major concern in any country in the world and such errors could have dire consequences to both the patient and health practitioner. Furthermore the care offered to a patient is vital for their overall improvement in their health as they stay in the hospital and eventually get discharged. For this paper I will focus on ways the patient discharge system in most hospitals has been handicapped for a long time and ways of improving this service for the benefit of the patient.

The current increase in financial pressure in most medical institutions has resulted into the formation and creation of policies that would limit the duration a patient may spend in hospital. This has not only been beneficial to patients as the financial weight of paying hospital bills has lessened but also improved most hospitals service delivery. Several procedures and processes have to be followed before a patient is fully discharged from hospital such as clearing from the wards, confirming all prescriptions and compiling of the final patients’ bill. A proper discharge system will not only lessen the financial burden to a hospital but also avail resources such as bed space for other patients that may be admitted. This will also ease the traffic flow and support patient flow throughout the hospital. Concerns about quality and safety, particularly of emergency department patients impacted by lack of access to inpatient beds, have led Joint Commission to implement leadership standards that hospitals should “manage the flow of patients throughoutthe hospital”(El-Eid, Kaddoum, Tamim, & Hitti, 2015). Admission of inpatients in the emergency department has remained to a global menace that has resulted into overcrowding as a result of deleterious patient care outcomes along with adversely impacted emergency departments efficiency metrics. Several factors influence a patient’s length of stay in any hospital. These include the efficiency of the discharge system as well as the timing of the patients’ discharge.

Lewin’s Change Management

In today’s world nurses are expected to keep up with the changing technology in the healthcare environment. The systems implemented in all of these scenarios are made of modern integrated technology that comes with little guidelines on how they could be swiftly absorbed into the current healthcare needs. The Lewin’s change management theory is a theory that has been used by most healthcare facilities to understand human behavior as a result of change from the norm. This is because the theory relates to the changes in patterns in human behavior such as resistance that could be anticipated (Bozak, 2003).

This theory is normally implemented in 3 different stages. The first stage is known as the unfreezing stage that involves identifying the difficulties related to the identified problem and strategies to solving these problems are sought. Unfreezing also requires identifying the problem to be solved and communicating with the relevant stakeholders to find solutions for these problems. The second stage is the moving stage which is simply the stage at which actual change is observed including the planning and implementation stages of the project. The final stage is the refreezing stage that “the process of freezing or refreezing the changed practice occurs and leads to a time of stability and evaluation.”(El-Eid, Kaddoum, Tamim, & Hitti, 2015)

Delays in the discharge systems are not uncommon however with the right adjustments to the existing systems in place, this might just improve. One of the areas to improve has to be the coordination between the multiple groups involved in discharging patients. Proper coordination between physicians, nurses, ancillary service staff, patients and their families and the financial departments has to be availed in order to have a smooth discharging procedure for all patients. Various modern integrated technology could be introduced in order to ease the burden of having to wait in long queues waiting for prescriptions and bills to be availed before discharge. Considering how much time is usually wasted as patients wait in long queues waiting for their medical bills to be compiled or even have their prescription written up and sent to the pharmacy for drug collection, this is the best option. A structured, coordinated and systematic system of hospital discharge system is required in order to facilitate the discharge system that would ensure an easy transition of the patient from the hospital to the community and eventually improve the patient health outcome in both the clinical and social aspect(El-Eid, Kaddoum, Tamim, & Hitti, 2015). A patient’s wellbeing is overly determined by their transition from hospital to home care and the care they receive afterwards. This can only be achieved through a timely discharge that would give a patient an easier time to heal and recuperate at the comfort of their homes.

In addition to the formulation of a proper discharge system for the patients, adequate measures have to be put in place to maintain the system such as re-staffing, educating the nurses and other service providers on how to coordinate with the program and training of all medical service providers on the relevance of the new system in improving the services offered. This is the third and final stage of the Lewin’s change management theory that would ensure all the framework put in place have been properly applied.

Conclusion

The Lewin change Management theory is not new in the medical scene where it has been used in many occasions in planning of different management strategies. The theory tries to assess and address human behavior as a result of change and in this case the behavior to look out of for in this case is resistance by the medical staff. Resistance to change especially as a result of introduction of integrated technology meant to find solutions to problems within the medical scene is also common. In this case solutions to delays in patient discharge have to be found in order to ease congestion in most hospitals. Proper planning using the Lewin’s change management theory has to be done that would ensure these new systems will stay in place long enough and stay efficient. The unfreezing stage is essential for the identification of the problem to be solved which in this case is the delay in discharge processes, the moving stage is essentially the stage at which these solutions are to be implemented and applied while the final stage is the stage at which strategies meant to ensure these solutions are maintained are put in place. Based on the simplicity of this planning theory, the Lewin Change Management theory is the best choice for the implementation of the required changes in the discharge process of patients.