| Description |
Introduction: Changes are inevitable. No matter where one works, it is an expected reality that change is part of the job. This is especially true within the field of healthcare. Medical and technological advances are constant, as well as procedure processes. The medical world is forever improving, and as healthcare professionals, it is essential to be able to adapt to these changes to ensure the safety and success of the patients who are treated. However, how often are these change processes successful? According to Mahar, Gustafson, and Evans, the National Health Service in the United Kingdom found that upon a one-year evaluation of quality improvement projects, 33% of these projects were not sustained (as cited in Silver et al., 2016). Unfortunately, early statistics show the failing of about 70% change initiatives (Beer & Nohria, 2000, p. 88). In a field where change is abundant and executed frequently, it is surprising to find that it is not as effective as it should be. Sirkin, Keenan, and Jackson (2005) state, "studies show that in most organizations, two out of three transformation initiatives fail. The more things change, the more they stay the same" (p. 99). Not only is this a problem in healthcare, but this issue plagues occupations across the map. This leads to the question, what makes change so hard and why is it so difficult to sustain? Some factors that affect sustainability may be obvious, while others are unclear. Often there is misjudgment on what it takes to make an effective change (Bouzidi, Sayeed, Serenata, Suarez, & Zigirumugable, 2004, p. 2). One factor that impacts sustainability is ownership. If the participants of change have low psychological ownership and resist the change taking place, the implementation can easily fail (Lorenzi & Riley, 2000). Time is also a factor in maintaining sustainability. Although it is hoped that with time, engagement and understanding will improve, unfortunately the rates of understanding and application of implementations are prone to falling over time (Doyle, et al., 2013). Something that often impacts the nurses on the Cancer/Transplant unit is their feeling of change constantly being thrown at them all the time and they can not express their opinions about it. Bowers (2011) expresses that nurses often feel as though these changes did not involve their consideration or opinions and are imposed on them. Without proper evaluation, it can be even more difficult to assess the rate of sustainability. It is crucial to properly evaluate after the change has taken place to ensure that those implementing the change are following through. According to Gesme and Wiseman (2010), "even groups that seek change may be complacent and not committed to follow through". Proper evaluation can describe the interventions, check the exposures to the interventions, and assess the experiences of those exposed to the implementation (Hulscher, Laurant, & Grol, 2003, p. 40). Evaluation is going to be a factor that will be discussed and explored further in this project. |
