Change Management Proposal For Parkway Nursing Care Management Essay

Park way nursing is also a business and, like every other business, it needs good management to keep it running smoothly. .The occupation, medical and health services manager encompasses all individuals who plan, direct, coordinate, and supervise the delivery of healthcare. Medical and health services managers include specialists and generalists. Specialists are in charge of specific clinical departments or services, while generalists manage or help to manage an entire facility or system. The structure and financing of healthcare is changing rapidly. Future medical and health services managers must be prepared to deal with evolving integrated healthcare delivery systems, technological innovations, an increasingly complex regulatory environment, restructuring of work, and an increased focus on preventive care. They will be called upon to improve efficiency in healthcare facilities and the quality of the healthcare provided. Increasingly, medical and health services managers will work in organizations in which they must optimize efficiency of a variety of interrelated services.

The healthcare professions all involve life and death situations. In these situations, quality is crucial and quantity is irrelevant, Health care is continually changing in the way health care professionals like individual practitioners and clinical managers organize and deliver care to the patients. For this reason, health care knowledge must continuously grow and expand to keep health care approaches relevant, current and appropriate. Without new knowledge, health care professionals cannot improve techniques for therapies and even management.

2 Survey Results:

Survey results suggesting that No of patients going up but the staff member’s quantity are still the same. The staff member having plenty of problems like injuries, incidents, absences. Lots of this problem indicates that AI is not good for the company. Hospital nurse staffing is a matter of major concern because of the effects it can have on patient safety and quality of care, members are worried because management only focuses on expand the business, but they couldn’t able to balance the ratio between staff member and patients. If the management doesn’t able to manage staff properly then the problem comes. The concern is certain things can’t calculate like caring of the patients, feelings, help, and relationship etc. The management should be develops service unit goals; identifies, plans, and coordinates new programs; reviews policy and procedure manuals to assure that they are current; provides expert nursing consultation to staff, patients and public; monitors and evaluates patient care for ethical, legal, and safe conduct; ensures proper and safe functioning of unit equipment and promotes individual and environmental safety; resolves patient care problems and provides direct patient care. The Nurse Manager makes final decisions regarding operations of work unit and defers to an administrative superior regarding policy decisions with broad impact or agency-wide scope.

Problems Identification:

Parkway having sufficient problem with staffing injuries, patient’s satisfaction, communication, absences, incidents with patients, many staff are dissatisfied with their jobs, shifting problem, stress…etc the most common problem are follows…


Parkway focuses on filling the beds.

Quality and service drop

Staff and patients injuries


No of patients are increases but no extra staff.

No Increment no bonus.

Physical Demand

Need to recruit strong new staff who can lift the patients easily

Female nurses troubling to lift male patients

Able to push the Beds, gurneys, and wheelchairs

Communicate face to face with individuals

Read, write, speak and understand the English language

Documentation: (Electronic)

Government requirement

Staff has to learn new things

A medical record should accurately reflect

Electronic health records systems can also provide additional functionality, such as interactive alerts to clinicians, interactive flow sheets, and tailored order sets, all of which can’t be done be done with paper-based systems.


Focus on filling beds:

Shortages of staff but no of patients increase

Management always need big business

Not enough motivation

Not enough staff

Change Management Strategy:

Any nature of business employees is a most important assets; this is why they created the Human Resource department. Its purpose is to manage, train and look after the workers of the business. It is also their responsibility to implement health and safety legislation at work and look after the employees. There are many roles that this department manages; these ultimately help the business to achieve its objectives. These include: Manpower planning. Recruitment and selection. Induction and training. Promotion and transfers Appraisal and termination of employment Rewards and conditions of employment. Working conditions. Career development and welfare. Wage bargaining and disputes. An effective and efficient business manages their employees or human resources well. The better this is done, the more the workers will be happier, better motivated, more productive and more responsive.

Forms of resistance

Leadership must come from the top level.

Not enough staff against increase patient staff has to work long hours.

Focus in the profit never increase staff position can worse.

Documentation (Electronic) old staff using manual, if you go for new electronic system the old staff do not want to use new system.

Patient staff injuries



Resistance in Parkway

People feel unsecure with their job.

People not willing to take on additional responsibilities

Lack of communication with management.

Nurses not willing to let go of the bond that they have developed with the patients.

Overcoming the resistances

Improve the working environment.

Train new people (if recruit new staff) and current staff too.

Implement documentation (electronic)

Communicate with the current employee that’s if they start new training is good for them once they know job is safe for them resistance ratio will come down.

Try to reduce injury to patients as well as staff.


Implementation :

Our methods use several basic principles. You are always the leader – we only facilitate. When facilitating, demonstrating and teaching we use examples from our personal experience. If an exercise or workshop is needed you do not perform theoretical exercises. You will use actual live situations in your own organization.

Here are some of the exercises that can be used in Leadership Implementation:

Survey: You identify the areas which will get affected by change in the implementation in the first step. We conduct a survey that will reveal to you the size of challenge you face in implementation. It includes essential information for successful implementation: identification of positive/negative attitudes that will help or hinder critical tasks to make it happen, milestones that must be met and much other data for a successful plan.

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Breakthrough: This exercise focuses you on the one or two key elements that block the implementation. Once identified, we help you break through the blocks so that the implementation proceeds smoothly and quickly

Start Event: This facilitated event is designed to communicate your message and the essential steps for a successful implementation. The audience is all the people that will implement or be affected by the process. The feeling of commitment out of this event is profound and without parallel in conventional training.

Strategy Event: Strategy for implementation is required at many different levels. There is the overall master strategy. There are also mini-strategies within it. The most important are the many mini-strategies that departments, work-groups and individuals must use to adapt from their current state to the new process. The techniques used in this event make sure that they are comprehensive, pertinent to the master strategy, and truly implementable.

Change Event: Most people are familiar with the Change Curve that describes the inevitable emotional reactions people experience before they finally accept and embrace a change. But how to straighten it? Or how to compress it? Whatever analogy you use, the techniques used here help people move through the Change Curve as quickly as possible. This accelerates the benefit of the implementation

Communication Plan: A well executed communication plan is critical to the success of a new project. These techniques help you identify what must be communicated, how, the audience and the best methods.

Executive Coaching: One of our central competencies is Executive Coaching. It covers CEO’s and all other executive levels. What sets our method apart is its focus on rapid results. Senior executives do not have time for multiple-year codependent therapy-like coaching relationships. The market environment rewards or punishes quarterly. Our method is attuned to this requirement for speed.

The above examples are illustrative of some of our Leadership Implementation services. They can be used singly, such as Executive Coaching, or in combination for a full-fledged implementation of a new process, project, program or corporate culture change. Our Facilitators are experienced, trained and sensitive to the dynamics of group meetings. Their participation in your implementation will help you achieve optimum results – fast. Implement your project by contacting us at the phone, e-mail or address below.

Creating a leadership strategy:

Strategic leadership provides the vision, direction, the purpose for growth, and context for the success of the corporation. It also initiates “outside-the-box” thinking to generate future growth. Strategic leadership is not about micromanaging business strategies. Rather, it provides the umbrella under which businesses devise appropriate strategies and create value.

Review the business strategy

Leaders play a critical role during change implementation, the period from the announcement of change through the installation of the change. During this middle period the organization is the most unstable, characterized by confusion, fear, loss of direction, reduced productivity, and lack of clarity about direction and mandate. It can be a period of emotionalism, with employees grieving for what is lost, and initially unable to look to the future.

In addition to forecast and amiability, the characteristics that leader must have are ability to recognize employees’ talents, the know-how to make teams work and an open mind.

Leadership does vary to some extent as per the positions i.e. it may be slight different for manager and different for a union leader but the basic qualities of leadership does not change.

1. Good communication skill

Communication is the key to be a great leader. The reason for this is simple: if he possesses the other nine leadership qualities but if he fails to communicate well, he will never be great leader.

What he can do is communicate with others in the organization about what IT can do to move the company forward. In other words, good communication is the key for developing good business relationships. If he can’t establish a good business working communicate how IT can add long-term value to the company. The modern leaders must therefore be equipped with good communication skill and use new ways to do effective communication.

2. Honesty

The most valuable asset of a leader is honesty. He must be honest with both his employees and the management committee. Another part of his features is integrity. Once a leader compromises his or her integrity, it is lost. That is perhaps the reason integrity is considered the most admirable trait. The leaders therefore must keep it “above all else.”

3. Visionary outlook

Leadership qualities are different for different position. For a CIO he must be thinking for stabilizing the current business and always looking for future scope of expansion. He has to be able to look beyond where we are today, know where the business is going, and be able to use that vision to move the company forward. Being able to do this is a rare skill indeed.

4. Selectingagoodteam

A good CIO although he possesses sound technical skills he assures that the team he selects is efficient enough to back up any skill he lacks. Choosing the best people for such team is a skill. A CIO after all is a human being and does not have answer for everything. But by working together he creates an atmosphere of mutual trust and respect; the team then always find the best solution.

5. Action speaks louder than words

Managers must be able to put aside their concerns to listen to (and appear to listen to) those around them. As a result, they come know what is going on, and know what is both said, and said between the lines. They have the knack of appearing to know what people need even if those needs are not expressed directly. However, knowing what is going on, and identifying the needs of those around them is not sufficient. The responsive manager also acts upon that knowledge, attempting to help fulfill the needs of employees, superiors, etc. Responsive managers wield influence to solve problems for those around them, often before even being asked.

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6. Ability to motivate people around

a good leader must always keep motivating his team mates for good work and should maintain healthy environment. He must give first priority to safety of workers and see that they are not exploited by superiors.

7. Consistency

Leadership effectiveness is impossible without consistency. Every leader has an approach that is unique to them. Don’t change your personal style radically after all; it got you in a leadership position. Modify the rough spots but take care not to confound your staff by displaying inconsistency. Your expectations, though subject to modification based on ever-changing business needs, should remain as constant as possible. The business world is confusing enough without you adding unwelcome surprises into the mix. Keep things simple and consistent.

8. Ability to stand against critics

as the success rate increases your critics multiply and become louder. Come to peace with the fact that you will always have a camp of people who critique every decision you make. They are generally the ones who are excellent problem-identifiers rather than problem-solvers. Develop your skills of repelling such critics so that they do not diminish your confidence or enthusiasm.

It takes focus and confidence not to be adversely affected by criticism. Strong leaders learn the art of listening to critics, but ultimately making decisions for the good of the department, not to simply please the critics.

Identify the driver of strategy

Management should introduce different types of elements.

Focuses on customer.

More opportunity


Assess current leadership situation & compare to the desired future

In current leadership situation in Park way asking following quotations

What leadership skills and perspectives are critical for success now and in the future?

How strong are current leaders in these critical skills and perspectives?

How aligned is today’s leadership strength with what will be the most important skill and perspectives in the future?

Desire future in Parkway…

Change of environment

Strong leadership

Solution for staff


Recruitment and training



Recommended leadership style

There are many kind of leadership style ….some are as follows

Autocratic leadership

Bureaucratic leadership

Charismatic leadership

Democratic leadership or participative leadership

Laissez-faire leadership

People-oriented leadership or relations-oriented leadership

Servant leadership

Task-Oriented leadership

Transactional leadership

Transformational leadership

For Parkway recommended leadership style should be Charismatic leadership because Parkway having a serious problem with communication… Charismatic leadership style can seem similar to transformational leadership, because these leaders inspire lots of enthusiasm in their teams and are very energetic in driving others forward. However, charismatic leaders can tend to believe more in themselves than in their teams, and this creates a risk that a project, or even an entire organization, might collapse if the leader leaves. In the eyes of the followers, success is directly connected to the presence of the charismatic leader. As such, charismatic leadership carries great responsibility, and it needs a long-term commitment from the leader.

Leader behaviors of Home Directors

Behavioral theories focus on how leaders behave…..

Common Behaviors are:

(1) Creating a leadership platform;

(2) Becoming the principal-learner and principal-teacher about leadership

(3) Affirming and teaching the powerful roles of organizational beliefs, vision, and


(4) Leading and modeling reciprocity of accountability

(5) Building collegiality around problems of practice

(6) Emulating the actions of successful coaches

(7) Developing the cultural understanding and affirmation that leadership and growth bring discomfort.

(8) Developing a sense of professionalism throughout the organization consistent with professionalism as demonstrated in and expected of other learned professions.

Leadership behavior of supervisor:


Supervisors have a general legal duty to take every precaution reasonable in the circumstances to protect workers.

In addition, they have the following specific duties outlined in the Act and regulations.

Supervisors must be familiar with the provisions of the Occupational Health and Safety.

Supervisors must be knowledgeable about potential or actual health and safety hazards in the workplace and advice workers about these hazards.

Supervisors must ensure that equipment; materials and protective devices required by regulation are provided to workers and maintained in good condition.

Supervisors must ensure that workers follow workplace procedures and use protective equipment required by the University or by any applicable regulations.

Supervisors must provide information, instruction and supervision to a worker to protect the health or safety of the worker.

Supervisors must ensure that subordinate supervisors have or acquire knowledge of the Supervisors must ensure that an up-to-date inventory is maintained of all designated substances, hazardous materials and hazardous physical agents present in the workplace.

Supervisors must ensure that all hazardous materials present in the workplace are identified and labeled. Supervisors must ensure that material safety data sheets are readily available for all hazardous materials present in the workplace.

Supervisors must ensure that workers exposed to a hazardous material or hazardous physical agent receive and participate in prescribed instruction and training.

Supervisors must ensure hazardous materials present in the workplace are disposed of in the manner prescribed by University procedures and applicable regulations.

In the case of a workplace injury, supervisors must ensure that prompt medical attention is provided and must report the circumstances of the injury to the Office of Environmental Health and Safety within 24 hours.

Job Stress in Parkway:

Workplace stress is the harmful physical and emotional response that occurs when there is a poor match between job demands and the capabilities, resources, or needs of the worker. … arly Warning Signs that coping with workplace stress is becoming difficult for an employee are –


Upset stomach,

Sleep problems,

Irritability and short temper,

Difficulty in concentrating,

Job dissatisfaction,

Low morale, etc

Source of Stress

Job stress comes in many different forms and affects your body in various ways. Minor sources of stress may include equipment that won’t work or phones that won’t quit ringing. Major stress comes from having too much work, not having enough work, doing work that is unfulfilling, fearing a job layoff, or not getting along with your boss.

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Usually it is the major sources of stress that lead to burnout, causing people to become unhappy and less productive in their work. Job stress can affect your health and home life as well. Low levels of stress may not be noticeable; slightly higher levels can be positive and challenge you to act in creative and resourceful ways; and high levels can be harmful, contributing to chronic disease.

According to the NIOSH (National Institute for Occupational Safety and Health), these are job conditions that may lead to stress…..

The design of tasks. Heavy workload, infrequent rest breaks, long work hours and shift work; hectic and routine tasks that have little inherent meaning, do not utilize workers’ skills, and provide little sense of control.

Management style. Lack of participation by workers in decision-making, poor communication in the organization and lack of family-friendly policies.

Interpersonal relationships. Poor social environment and lack of support or help from coworkers or supervisors.

Work roles. Conflicting or uncertain job expectations, too much responsibility, too many “hats” to wear.

Career concerns. Job insecurity and lack of opportunity for growth, advancement, or promotion; rapid changes for which workers are unprepared.

Environmental conditions. Unpleasant or dangerous physical conditions such as crowding, noise, air pollution, or ergonomic problems.

Action Require:

Control: This factor is the most closely related to job stress. Studies show that workers who believe that they have a great deal of responsibility but little control or decision-making power in their jobs are at increased risk for cardiovascular disease and other stress-related illnesses.

Increased responsibilities. Giving on additional responsibilities to the staff job can be stressful. This can be worse if your staff have too much work to do and they are unable to say no to new tasks or projects.

Competence. Are your staffs concerned about their ability to perform well? Are they challenged enough, but not too much? Do your staff feel secure in their job? Job insecurity is a major source of stress for many people.

Clarity. Feeling uncertain about what their duties are, how they may be changing, or what your department’s or organization’s goals are can lead to stress.

Communication. Workplace tension often results from poor communication, which in turn increases job stress. An inability to express your concerns, frustrations, or other emotions can also lead to increased stress.

Support. Feeling unsupported by to your staff may make it harder to resolve other problems at work that are causing them stress.

Significance. If your staff don’t find their job meaningful or take pride in it, they may find it stressful.

Stress Management plan-

Emotional stress usually occurs in situations people consider difficult or challenging. Different people consider different situations to be stressful.

Physical stress refers to a physical reaction of the body to various triggers. The pain experienced after surgery is an example of physical stress. Physical stress often leads to emotional stress, and emotional stress often occurs as physical stress (e.g., stomach cramps).

About to reduce stress of staff Parkway should follow ….

Improve environment

Organize get to gather for staff



Time management

Some form of physical exercise

Sharing and connecting with your support network on a regular basis

Attention to good diet and healthy nutrition

Regular time set aside on a daily basis to unwind & relax

A repertoire of leisure activities

Regular sleep and rest

Some employers assume that stressful working conditions are a necessary evil-that companies must turn up the pressure on workers and set aside health concerns to remain productive and profitable in today’s economy. But research findings challenge this belief. Studies show that stressful working conditions are actually associated with increased absenteeism, tardiness, and intentions by workers to quit their jobs-all of which have negative effects on the bottom line.


A nurse is someone who basically takes care of the people. They are in charge of the welfare of their patients who are recovering from sickness and disease. They work with a health team which specializes on this matter. They are usually tasked to work with a doctor to ensure the proper medication and care is given to their patients.

Since nurses are a part of the medical team, they too can work in the research field. They can contribute to the existing knowledge about nursing. Of course, nursing is also a science and nurses just do not do what the doctor tells them to do. Research s something which should be done continuously, so working in the research field is always in demand.

Nurses are the workhorses of any hospital or health care facility. They are the ones who care for the patient – taking vital signs, recording symptoms, giving medicine, bathing and comforting, moving the patient from place to place, and making sure the patient is getting everything that is needed to help them get well. Some nurses can prescribe certain medications, just like doctors. Nowadays, you are more likely to receive medical care from a nurse than from a doctor, since nearly all doctor’s offices have nurse practitioners who can do almost anything the doctor would do.

Implicit rationing of nursing care is an important newly identified organizational variable reflecting processes in acute care nursing and appears to be directly linked to patient outcomes. Rationing offers promise as a measure of the impacts of staffing and the quality of the nurse practice environment on patient outcomes. As an indicator of the understudied processes of care affected by organizational conditions in hospitals, measures of rationing could assist in building theory in this area of outcomes research. Rationing levels, analyzed alongside other data, may help health systems and hospitals determine the minimum staffing and skill mix levels necessary to achieve desired patient outcomes and inform administrative decisions and policy.

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