Exam 18: Leading Change

The home health agency hired an expert in financial management to evaluate and propose a plan for reversing a growth in expenses and a decrease in revenues.The expert is well respected,both personally and professionally,by members living in this small community.To be effective,staff will need to perceive this change agent as

Elizabeth,a registered nurse (RN)with approximately 15 years of service on your unit,walks away from one of the learning sessions on intravenous care,and you overhear her telling a colleague that she thought the session was a waste of time because "the unit has been using heparin for years and there has never been any adverse effect." According to Havelock (1973),this comment may originate from failure in which phase of the six phases of planned change?

To effectively achieve a change goal/outcome in a change situation,the wound care specialist will

As the unit manager,you spend a day performing direct patient care and work with a new system that is designed to capture patient documentation at the patient's bedside.During discussions with staff while giving care,you discover that the number of screens that need to be opened during documentation makes charting more complex and time consuming than traditional manual charting approaches.On the basis of this feedback,you

The nurse manager frequently interacts with staff and other hospice facility employees.Communication was purposeful because the manager assessed current issues,such as specific satisfactions and dissatisfactions with the newly implemented computerized documentation system.Informally,the manager gathered available staff members to address similar learning needs.Many times,staff members were found coaching other staff about improving use of the new system.According to Senge (1990),the activities demonstrated in this example are

An example of one strategy used to improve participation in the change process by staff members for whom the behavioural descriptions of innovators and early adopters fit is to

The clinical coordinator expects the position description of the new wound care specialist to change nurses' responsibilities in caring for patients with skin integrity problems.Which of the following is the best approach to address this need for change and yet to have the best outcomes for patients,staff nurses,and the organization?

The oncology clinic manager and the educational coordinator asked nursing staff to complete a brief written survey to assess their attitudes and knowledge related to having used the new infusion equipment for 6 weeks.The stage of change in this situation is

A few days after you speak with Elizabeth,you discover that she is now fine with the change but is concerned that other areas of the organization might resist the change because of perceptions related to patient safety and cost.She suggests that it is important to involve pharmacy staff because they have had previous concerns about the use of heparin.This type of campaign is best described as

To engage your staff in awareness of their current practice and how it is affirmed or not by evidence,you plan a short series of learning presentations on evidence and use of heparin and saline to maintain intravenous patency.You meet with the educator to plan the goals for each session with the overall purpose of increasing knowledge and assess which staff members are ready to begin to question current intravenous practice.This learning approach is an example of which change management approach?

Complex change situations require that the change leader promote ongoing envisioning among staff members.One strategy is to

As the unit manager on the unit that is leading changes to heparin locks,you find one staff nurse whose observations about other units and knowledge of organizational processes are very valuable in discussion of the new procedure with other staff members.This nurse might be considered an

The situation in Question 22 is best captured in which theory of change?

When goals/outcomes are somewhat unclear in early preparation for a complex change,the manager and the change management team develop several acceptable goals/outcomes.This change in management approach is termed

You follow up with Elizabeth and discover that she is quite angry about the information sessions because she believes that you are implying that what she has been doing all these years means that she is incompetent and does not care about her patients.Your response to her should indicate that

Which of the following are examples of application of the Leadership Rounding Tool (Studer,2009)?

In Question 12,staff nurses who obtain information on current intravenous therapy practices are engaging in which phase of Rogers's (1995)decision-making process?

On the basis of Elizabeth's insights and suggestions,you involve pharmacy staff,only to discover that the change in practice involves practice committees,a medical practice committee,and concerns from administration about potential costs and safety of the proposed change to the intravenous protocols.The change process at this point is

Resistance is most likely to occur when change

An example of one strategy to improve participation in the change process by staff members for whom the behavioural descriptions of laggards,early majority,late majority,and rejectors fit is to