Lewin's change management theory has been widely applied to enhance understanding human behavior concerning change and patterns or resistance to change (Suc, Prokosch, & Ganslandt, 2009). Resistance to change is one of the barriers facing implementation of evidence-based practice to facilitate the better patient outcome. This model is also referred to as Lewins Force Field Analysis, and it involves three distinct phases namely the unfreezing, moving and freezing (Suc, Prokosch, & Ganslandt, 2009). Application of this model facilitates identification of factors that may obstruct from occurring; static forces that oppose change, and driving forces that promote change. The healthcare organization team identifies and fully understands the behaviors that oppose or drive change, then focus on strengthening the positive driving forces to ensure change occurs successfully. In the first unfreezing stage the management gets involved in the understanding of the barriers concerning the problem and then develops strategies to strengthen the driving forces and mitigate the restraining forces (Suc, Prokosch, & Ganslandt, 2009). The second, moving stage involves an actual change in practice after equalizing of the opposing forces to allow the driving forces to implement the change. During the last, refreezing stage, it is used to ensure the stability of the change and inclusive effectiveness within the practice (Suc, Prokosch, & Ganslandt, 2009).
Application of the change management theory
In this project, the first approach is to identify the changing focus; specifically the use of long-acting medications to help improve medication adherence. The major aspects of this step involve educating nurses and patients the risk of non-adherence to medication. Additionally, discussions to identify barriers that may prevent this change such patient resistance to injections and driving forces such as financial investments into the project will be identified.
This is the actual change which involves planning and implementation stages. In this stage, it will involve implementing change through creating a more enabling environment of education, shared decision-making, and responsibility in managing illness regarding long-term illness such as Schizophrenia. Providers will switch to the prescription of long-acting injectable medications. The challenges in this stage include patient resistance to these prescriptions and financial expenses.
In this stage, to support the project, providers will be educated including patients and family regarding the benefits of long-acting injectables. Additionally, an evaluation will be carried out to locate available challenges and establish strategies to mitigate their impacts into practice.
Suc, J., Prokosch, H. U., & Ganslandt, T. (2009). Applicability of Lewin s change management model in a hospital setting. Methods of Information in Medicine, 48, 5, 419-28.Appendix I: Logic Model
-Readmission of Schizophrenic Patients in Mental Healthcare.
-Frequent readmission can lead to psychological trauma, deterioration of their condition, and lack of mental health services and network.
-Providers dont prescribe long-acting medications thus facilitating non-adherence to medication.
-Non-adherence to medication contributes to frequent readmission.
-Decreased prescription of oral antipsychotics
-Increased preference for long-acting injectables by patients
Nursing education: effectiveness of long-acting injectables-Patient education: Advantages of adherence to medication.
-Existing healthcare culture
Evidence-based educational programs on use of long-acting injectable antipsychotics.
-Decreased readmission of schizophrenic patients age 18 years or older
-Reduced treatment cost for schizophrenic patients
-Adherence to antipsychotics medication by schizophrenic patients age 18 years or older
-Improved patient outcome after discharge
-Decreased use of oral antipsychotics in treatment of schizophrenic patients age 18 years or older
-increased prescription of long-acting injectables antipsychotics
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