Implementation of a competency assessment tool for agency nurses working in an acute paediatric setting

Abstract

The ongoing success of the initiative, from a nurse manager's perspective, relies on structured communication with the agency provider before employing competent agency nurses. Sustainability of the change will depend on nurse managers' persistence in attending the concerns of those resisting the change while simultaneously supporting those championing the change. These key communication and supporting roles highlight the pivotal role held by nurse managers, as gate keepers, in safe-guarding children while in hospital. Leadership qualities of nurse managers will also be challenged in continuing to manage and drive the change where resistance might prevail.

Where Do Models for Change Management, Improvement and Implementation Meet? A Systematic Review of the Applications of Change Management Models in Healthcare

“…[29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47] Eight studies referenced their application of the Lewin 3-Stage Model of Change into a healthcare setting, [48][49][50][51][52][53][54][55] with three further studies that integrated the Lewin model with a concern-based change management approach, McKinsey 7S Model of Change, and Roger's Diffusion of Innovation Theory, respectively. [56][57][58] A further eight articles reported the use of six further models for managing and leading change: Influencer Change Model (1 study); 59 Prosci ADKAR (1 study); 60 Accelerated Implementation Methodology (AIM) (2 studies); 61,62 Advent Health Clinical Transformation Model (1 study); 63 Riches 4 stage model (1 study); 64 Youngs Nine Stage Framework (1 study), 65 and the CAP model (1 study). 66…”

“…43,47 Young's Nine Stage Framework was also used in a nurse-led local-level quality improvement project in an acute paediatric setting to introduce a competency assessment tool. 65 The authors described in detail the models, issues and actions arising through the stages of pre-change, stimulus, consideration, validate need, preparation, commit, do-check-act, results and into the new normal. 65 The application of the model enabled a considered change process which analysed organisational and systems influences impacting the change proposed, leading to full uptake of the assessment tool at 18-24 months.…”

“…65 The authors described in detail the models, issues and actions arising through the stages of pre-change, stimulus, consideration, validate need, preparation, commit, do-check-act, results and into the new normal. 65 The application of the model enabled a considered change process which analysed organisational and systems influences impacting the change proposed, leading to full uptake of the assessment tool at 18-24 months. 65 The Kotter model was also applied in a quality improvement program in head and neck surgery in a Canadian surgical department, with authors concluding the model provided a guiding principle to support the change process.…”

“…65 The application of the model enabled a considered change process which analysed organisational and systems influences impacting the change proposed, leading to full uptake of the assessment tool at 18-24 months. 65 The Kotter model was also applied in a quality improvement program in head and neck surgery in a Canadian surgical department, with authors concluding the model provided a guiding principle to support the change process. 36 In a further leadership-focused change program, the Comprehensive Unit-Based Safety Program (CUSP) model within the Division of General Surgery applied the Kotter 8-step and five principles of dualoperating systems to the development and implementation of surgical quality improvement initiatives.…”

Teacher Fellow accreditation – a madrigal of voices! But is it the right tune? Tensions of standardisation, engagement and neoliberalism

“…However, staff perception of manager commitment to and value of such frameworks also play a critical role in gaining staff buy-in (Shaw, 2018); if participation is only at a superficial level, then it is unlikely to influence organisational culture (de Lancer and Holzer, 2001) or it may even have adverse effects. In HE, local managers are critical in championing professional culture (Broadnax and Conway, 2001;Kaslow et al, 2004;Hennerby and Joyce, 2011) shaping an ethos that encourages flexibility, adaptability and readiness (Quinn and Rohrbaugh, 1981;Pandey et al, 2007) builds commitment, involvement and job satisfaction (Pandey and Stazyk, 2008) and engenders an open and collaborative environment to foster good pedological practice (Yang and Hsieh, 2006).…”