Expert answer:Kurt Lewin’s change theory
Expert answer:Review Chapter 8 in the course text. Focus on Kurt Lewin’s change theory, and contrast it with other classic change models and strategies.Reflect on problems, inefficiencies, and critical issues within a specific department, unit, or area in your organization or one with which you are familiar. Select one issue as a focal point for this assignment, and consider a change that could be made to address the issue.Think about how the change would align with the organization’s mission, vision, and values as well as relevant professional standards.Using one of the change models or strategies discussed in Chapter 8, begin formulating a plan for implementing the change within the department/unit. Outline the steps that you and/or others should follow to facilitate the change effort. Align these steps to the change model or strategy you selected.Determine who should be involved in initiating and managing the change. Consider the skills and characteristics that are necessary to facilitate this change effort.To complete:By Day 7Write a 3- to 5-page paper (page count does not include title and reference page) that addresses the following:Identify a problem, inefficiency, or issue within a specific department/unit.Describe a specific, realistic change that could be made to address the issue.Summarize how the change would align with the organization’s mission, vision, and values as well as relevant professional standards.Identify a change model or strategy to guide your planning for implementing the change. Provide a rationale for your selection.Outline the steps that you and/or others would follow to facilitate the change. Align these steps to your selected change model or strategy.Explain who would be involved in initiating and managing this change. Describe the skills and characteristics that would be necessary to facilitate the change effort.
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Running head: Hospital Readmission Proposed Solution
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Hospital Readmission Proposed Solution
Maribel Sanchez
Walden University
Interprofessional Organization & System Leadership
NURS – 6053N
Dr. ELAINE TOWNSLEY
December 17, 2017
Hospital Readmission Proposed Solution
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Hospital Readmission Proposed Solution
The problem that will be discussed and the need for change is hospital readmission
problem. The organization that I am currently employed with is a managed care organization
Molina healthcare Inc. that insures over 4.2 million across the United States and Puerto Rico.
One of the problems that case managers have seen is the need to implement a plan to help
patients stay home and not be readmitted to the hospital. Hospital readmissions is a problem in
the United States and until organizations come out with a solution it will continue to see patients
readmitted and cost for health care will continue to rise. Hospitals spent $41.3 billion in the year
2011 from patients that were readmitted within 30 days of discharge this was according to the
Agency for Healthcare Research and Quality (AHRQ) (Shinkman, 2014). The top medical
conditions with Medicare insurance: Congestive heart failure, with 1.35 million readmission with
a cost of $1.7 billion. Septicemia was in second place, with 92,000 readmission rate, costing $1.4
billion, and then PNX was third with 88,000 readmissions that cost $1.1 billion in additional
costs (Shinkman, 2014). Medicaid patients’ readmission patients suffered from mood disorders
and serious mental illnesses like schizophrenia; schizophrenia patients had 77,400 readmissions
and cost $588 million. Diabetes led to 23,700 readmissions and cost $251 million in cost.
Molina Health Care, mission is to provide health services to financially vulnerable
families and individuals; vision statement to provide quality care and accessible services in a
caring manner and lastly core values to be an exemplary organization, care for the people being
served and advocate on their behalf (Molina HealthCare, 2017). To implement a change, it is
important to always have the organizations mission statement when making a plan, helping the
most vulnerable to prevent readmission to hospital is fundamental in following with the Molina
Healthcare Mission statement. Following the Lewin’s change theory will help prevent
Hospital Readmission Proposed Solution
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readmissions to hospitals and keep patients home and well taken care for. Lewin identified three
phases through which change agent must proceed before planning a change this includes:
unfreezing, movement, and refreezing (Marquis & Huston, 2017). Unfreezing occurs when the
agent has convinced members of the organization to change because of a concern or problem
within the organization (Marquis & Huston, 2017). Movement the change agent starts with a
plan and starts appropriate strategies, ensuring that driving forces exceed restraining forces
(Marquis & Huston, 2017). Lastly in Lewin’s theory is refreezing, this is when the agent helps in
stabilizing the system change so that it becomes integrated into the status quo (Marquis &
Huston, 2017).
Lewin’s theory first stage unfreezing: bring together supervisors, managers, and case
managers to a meeting to gather all the statistics on hospital readmissions and the cost to the
company and the hospital (Marquis & Huston, 2017). The meeting will provide information on
how hospital readmission is costing the company money but also that the patient is not getting
better, how can the organization decrease the number of readmissions. Second stage would be to
introduce the plan to the supervisors, this would begin in the hospitals the case managers can
work with the hospital discharge planners to have appropriate discharge plans. The discharge
plans would be reviewed by the nurse case manager making sure the patient has a good support
system at home, be knowledgeable with medications, follow up appointment with PCP/specialist
have been scheduled but also that the patient understands and has transportation, have physicians
order for home health services to have medication management at home and registered nurse to
follow home after discharge. The last stage would be the unfreezing, by having all the data and
what should be implemented to case managers and hospitals attempt convincing the organization
to start this program for one year to see how this new strategy could help reduce hospital
Hospital Readmission Proposed Solution
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readmissions. The organization would assign a nurse case manager to visit the hospital when a
patient is admitted to the hospital, to work with the patient and the discharge planner on what the
patient would most benefit from, for example home health services, therapy, nursing staff, home
meal delivery services; whatever the need, working together with the hospital staff to have all
resources available for the patient will help patient from a relapse to disease.
Successful leader-managers are well grounded in change theories are able to apply the
theory appropriately (Marquis & Huston, 2017). The leader plans the change and will have the
knowledge and skills to bring about change (Marquis & Huston, 2017). As leaders bring about
change it is important to know that change is never easy, regardless of the type of change, when
making a change in policy, protocols, etc. will bring positive feelings but also lots of stress
(Marquis & Huston, 2017). It is important for the leader to use developmental, political, and
relational expertise to ensure that needed change is not sabotaged (Marquis & Huston, 2017).
In conclusion hospital readmission will at times be unavoidable but as nurses it is
important to help the patient to the fullest to prevent hospital readmissions. It is the nurses’ duty
in any department to educate the patient and family on how to manage diseases to prevent
exacerbation of diseases. Patients need to be heard and if the patient needs additional resources
from community then the discharge planner as stated in plan, to connect the dots to help patients
stay home.
Hospital Readmission Proposed Solution
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References
Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in
nursing: Theory and application (9th ed.). Philadelphia, PA: Wolters Kluwer.
Molina HealthCare. (2017). Retrieved from
http://www.molinahealthcare.com/providers/oh/medicaid/manual/PDF/Provider_Orientat
ion.pdf
Shinkman, R. (2014). Readmissions lead to $41.3B in additional hospital costs.
FierceHealthcare. Retrieved from
https://www.fiercehealthcare.com/finance/readmissions-lead-to-41-3b-additionalhospital-costs
…
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