Term Paper on "Organizational Change Project Analysis"

Term Paper 6 pages (2505 words) Sources: 1+

[EXCERPT] . . . .

Nursing

Organizational Change Project Analysis

This two part report aims to create a plan for an organizational change. The associated change analysis will require some mandatory overtime for nursing professionals in both the hospital and long-term care settings. The proposal is to incorporate the nursing staff into our own in-house facility hospice program. This combining of responsibility is an idea that will gain a great deal of momentum on a national basis in the not so distant future because the comprehensive project not only helps to improve the final days for fatally ill patients, families and friends, it also provides a social service to the immediate community and will raise the level of respect and confidence in our facility as well as create a new source of revenue. This service therefore is an important part of our organization's future standing in the community and may even be a potential for academic and educational offerings that we could provide for other facilities looking to follow in our footsteps. The program will require some mandatory overtime for the nursing staff so as to train, provide service and support for the patients, family members and friends. It is important to note that this change will affect all key stakeholders which include the facilities, administration, patients, families and friends, the overall community and of course the nursing team.

Description Of The Organization

The United States healthcare system has been growing by leaps and bounds. Obviously the system entails more than our nursing staff - it includes health plans, physicians, hospitals, clinics, consumers, and public health programs as well as hospice organizations. "Governmental initiatives and not-for-profit foundation funding bolstered the spread of hospices here. In 1978, the National Cancer Institute awarded grants to three hospices as demonstration projects to investigate the costs associated with care and to describe the actual manner in which care was provided to patients. Shortly thereafter, the Health Care Financing Administration (HCFA) was charged by Congress and the Carter Administration to initiate a research and demonstration study to examine the costs, benefits, and feasibility of having Medicare pay for hospice care. Existing hospice programs were invited to apply." (Hospice Benefits and Utilization in the Large Employer Market)

The media has explained our aging population dilemma. Consider that the current median age throughout America is on the rise and more Americans will require hospice services. Our facility currently provides these services through external Hospice organizations.

External Hospice organizations are very short handed in their endeavors. Hospice programs do not have an objective of curing fatal diseases -- the program's goals are more in the line of providing help with inherent pressures related to the care of terminally-ill patients usually in the last stages of life. In addition, Hospice programs also assist patients that have confirmed life-threatening diseases or infections, thus providing an acceptable quality of life for terminal patients or keeping them as comfortable or pain free as possible is what is expected. "Nurses need to identify patients' strengths so they can use those strengths to help overcome the problems" Rubenfeld and Scheffer (1995, p. 100)

Description Of The Change

Since the late 1970's, Hospice services were performed in a patient's personal residence. "In 1977, the National Hospice Organization (NHO) was formed in the United States." (Hospice Benefits and Utilization in the Large Employer Market) However, more hospice organizations have been required to attend healthcare facilities such as free clinics, hospitals and nursing homes. This aspect of the service will only increase as more Americans come to that point in life where Hospice services will be required.

But, just as there are major shortage of quality nursing professionals in all aspects of the healthcare system, hospice programs have begun had to seek additional assistance from other avenues. Thus, our facility proposes to train the existing nursing professionals so as to prepare them to be able to administer the needed nursing care for potential and existing hospice recipients.

Proposed Change And Compatibility With The Organizational Culture

The mission, structure, and current community position of this facility will not change greatly with this proposed change. Our organization will continue to provide excellent patient care. The mandatory overtime required by our nurses will be divided as evenly as possible so as not to put any undue strain on the various professionals on the existing nursing staff. The objective will be to instill the hospice philosophy to the nursing staff with a thorough training that would be provided by already experienced Hospice nursing trainers. The goal will be explain and teach the completely holistic, family and home centered approach to death and dying.

The main reason for the mandatory overtime is because a Hospice approach requires more social and psychological training and theory as opposed to more hands implementation skills. The nurses will be trained to focus on the patient and not the illness which has been the foundation of the many globally renowned hospice organizations already providing an excellent service in a cost-effective manner.

Mandatory overtime will be used to help create the individualized care plans fatally ill patients and their families require. Our nursing staff will therefore be prepared to work as a part of the multidisciplinary team used to care for the terminally ill. Our staff will be given a required to gather a full understanding of the process so they can function with physicians, homecare aides, social workers and the other various counselors and volunteers. The nurses will also be taught to coordinate with the patients to provide the direct nursing care and provide the patients and families required education and support.

Rationale for selection of the proposed change is described

Since more patients will require hospice services within this and other facilities in the future, these responsibilities should be easily incorporated into our existing care processes. Hospice patients often require in many circumstances nursing care of eight to 24 hours per day. In addition, the relief sought through temporary respite care for family members often has terminally ill patients in our facility.

We want to assure the family that we are fully prepared and trained in order to provide the needed relief or rest for the patient's family. Our nursing staff is already proficient at administering the necessary medications often required for the medical or biological patient needs. Our nurses in additional to our physicians will also become more acclimated in providing the bereavement support once death occurs.

Conclusion

In conclusion, our healthcare system includes many systems and processes which include the health plans, physicians, hospitals, clinics, consumers, and public health programs. However, the system often overlooks an important aspect in the hospice organizations. Our nursing staffs will be trained to aid these programs as more Americans will soon require these types of services in house as opposed to the personal patient homes. The problem is that the Hospice process is an often long period where long hours of direct nursing care are required which will put additional strain on our existing staff. To make sure that we meet the potential needs of the Hospice program as well as properly train the nursing professionals, we will incorporate a mandatory overtime program that will help assure our staffing needs.

Introduction

Part two of this report provides insights into the theory that could be used to guide the change process of mandatory overtime for nurses due to the new Hospice requirement. This section of the report will focus on the strategies for implementing, monitoring and evaluating the proposed change as well as to present the resources needed to implement the change.

Support for proposed

From the various marketing aspects of this proposed change including various market analysis, economic projections, and financial analysis, the facility will benefit with the institution of an in-house Hospice prepared nursing staff working mandatory overtime shifts. Consider that the hospice program provides almost guaranteed patient eligibility. Because of legal and social support, Hospice is one section of the healthcare system that has not associated a great deal of emphasis to the financial area of illness. Our facility will offset the cost of overtime through the fact that to qualify for hospice there is only the single credential of the patient being fatally ill.

This translates into all terminally ill patients who can be classified as their being in a final phase of life becomes eligible to receive hospice care and the facility to receive mandated financial reimbursement. The perspective new market resource also includes individuals in a progressive stage of any life-threatening illness. Basically, hospice eligibility is not a finically discriminate process. For the facility, the key aspect is that all ages whether insured or uninsured are covered by a combined system of Medicare, Medicaid, and the majority of external private insurers such as the various Health Management Organizations (HMO's). Thus, the mandatory overtime will be a covered hospice related cost.

When Congress accepted hospice as a fully Medicare accepted program it noted that all working individuals usually have some lifetime limit of around two hundred days of coverage.… READ MORE

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