Melnyk et al. (2012) note that barriers to change do prevail as a result of resistance from managers, nurse leaders, and colleagues among other stakeholders within the healthcare environment. The following are detailed barriers to change as applied to the LOS or excess days. Firstly, nursing managers may feel threatened by the idea of change within the organization. Their sense of leadership implies that they could be satisfied with the status quo. Given the LOS project, the management may be unable to see how the process would benefit the current hospital environment.
Secondly, there may exist a lack of clear understanding concerning the reasons for a change. Both the management and staff operate on the premise that there are not enough resources to incorporate the change and its associated outcomes. That is, such moves could be a sign that management does not consider the importance of reduced LOS/excess days (Scott et al., 2003).
Thirdly, there are mostly limited communication and trust in working environments. In the hospital setting, a culture that favors criticism as opposed to solutions would not be favorable to the LOS project. Given such situations, they would find it easier blaming the process as opposed to finding solutions to change-associated issues. Finally, both the management and staff could possess a fear of the unknown. From an LOS perspective, this fear comes from a worry of venturing into unfamiliar clinical practices. A huge percentage of this fear follows the lack of skills and clear communication (Bowers, 2011).
Overcoming such barriers will be all about bringing the entire facility on board with the change initiative. The change managers should, therefore, focus on creating a team and goals that align with the organizational culture. Theirs should be some form of planned change that involves a gradual transformation. As opposed to focusing on eliminating barriers, the change ambassadors should engage in an ambassadorial role that converts barriers into opportunities. The baseline should be that reduced LOS is increasingly critical as a contemporary concern in healthcare delivery (Al-Abri, 2007).
References
Al-Abri, R. (2007). Managing Change in Healthcare. Oman Medical Journal, 22 (3), 9–10.
Bowers, B. (2011, August 14). Managing change by empowering staff. Retrieved from Nursing Times Web site: http://www.nursingtimes.net/roles/nurse-managers/managing-change-by-empowering-staff/5033731.fullarticle
Melnyk, B., Fineout-Overholt, E., Gallagher-Ford, L., & Kaplan, L. (2012). The state of evidence-based practice in US nurses: critical implications for nurse leaders and educators. The Journal of Nursing Administration, 42 (9), 410-417.
Scott, T., Mannion, R., Davies, H., & Marshall, M. (2003). Implementing culture change in health care: theory and practice. International Journal for Quality in Health Care, 15, (2), 111-118.
