NR 528 Module 5 Discussion_Implementing Change..

2 ramifications to the hospital organization on the macro level. At the meso level, the NP is part of the interdisciplinary team that manages the personnel underneath her. The NP needs to sit down and initiate a conversation to get the perspective of the medical assistant, find out what her side of the situation was, and determine if this has occurred with any other patients. • What changes do you recommend to prevent further episodes of the problem behavior? What coaching and feedback skills can be used to discuss the event with the medical assistant? In the role of an advanced practice provider, it is essential to approach the conversation using the skills gained from transformational leader problem- solving and setting an environment of safety for an open, challenging conversation. I recommend reviewing the job description for the medical assistant role and duties. Also, an action plan should be established with protocol instructions when patients call for prescription refills. The coaching, which must take place, is a direct conversation with transparent communication of policies and the seriousness of patient harm that could have occurred. Stress the organization's financial and legal ramifications that could have occurred due to her malpractice actions. It is crucial to provide an opportunity to listen to the medical assistant's view on what they thought when the decision was made to fill the prescription. To fix the problem, the facts surrounding the error must be heard so as not to repeat the same mistake. • Which change model would you use to implement the identified change and why: Lewin’s Theory of Planned Change, Plan-Do-Study-Act (PDSA), or Kotter’s 8-Step Process for Leading Change? In this scenario, a quick investigation and change process must take place. Therefore, I would use Kurt Lewin’s 3-step Theory of Planned Change: 1. Unfreezing – Research feedback to seek input from all team members on how medication or refill requests are received and processed. 2. Freezing—A nurse or advanced practice provider must handle any phone calls regarding medication refills. 3. Refreezing—Once a new process has been trialed, pause to see whether it is effective for handling medication or refill orders. Endrejat & Burnes (2022) describe Lewin's theory as beneficial to managerial thinking. They detail three steps to applying the change theory to staff process change: using basic language to describe the problem, using visual pictures or pictographs to explain the change, and focusing on the exceptions instead of rules to receive buy-in for the necessary change. 4 (Tsai et al., 2023) References Endrejat, P. C., & Burnes, B. (2022). Draw it, check it, change it: Reviving lewin's topology to facilitate organizational change theory and practice. The Journal of Applied Behavioral Science, 60(1), 87–112. https://doi.org/10.1177/00218863221122875 Gagnon, J., Breton, M., & Gaboury, I. (2024). Decision-maker roles in healthcare quality improvement projects: A scoping review. BMJ Open Quality, 13(1), e002522. https://doi.org/10.1136/bmjoq-2023-002522 Tsai, S.-F., Wu, C.-L., Ho, Y.-Y., Lin, P.-Y., Yao, A.-C., Yah, Y.-H., Hsiao, C.-M., You, Y., Yeh, T.-F., & Chen, C.-H. (2023). Medical malpractice in hospitals—how