DNP 840 Using the nursing theory and the change management theory you selected, describe how you will formulate a strategy for leading, managing, stewarding, and collaborating within the context of your DPI Project

To facilitate leading, managing, good stewardship and collaboration, I consider Virgnia Henderson’s theory of need. One of the most contentious and enduring problems in nursing is the poor clinical observation and least integration of theoretical concepts into clinical practice. Change models make change happen via an overall structured process, and much like any industry, leaders need to implement change in healthcare systems. But achieving shifts in healthcare is more complex than in any other industry. With this in mind we must also consider a change theory. The ADKAR theory was created with nursing in mind. One of these reasons is that despite private healthcare funding much of the care, US healthcare organizations such as hospitals and clinics are considered part of the public sector.  A significant challenge for nursing leaders was how to prepare for the anticipated surge in patients, particularly for those requiring critical care if there was a mismatch of supply and demand of nursing staff. To address this issue, a team of nurse leaders at the faith-based, 25-hospital Texas Health Resources health care system utilized the ADKAR change models to guide a change in the staffing model from primary nursing to team nursing. These models allowed nurses to be safely deployed and practice within the systems hospitals from areas that had services closed or significantly decreased.

Community coalitions have the potential to catalyze important changes in the health and well-being of populations.Community coalitions are mechanisms that are increasingly utilized to address complex health issues at the local level. As collaborative partnerships of diverse members who work toward a common goal, coalitions afford communities the opportunity to combine and leverage resources from multiple and diverse sources. These collaborations enable greater breadth of scope and depth of responses to intractable problems that impact the health of communities. In addition to leveraging and increasing access to resources, coalitions offer many other advantages that make collaboration an asset for individuals, organizations, and communities. The increasing prioritization of healthcare quality across the six domains of efficiency, safety, patient-centredness, effectiveness, timeliness and accessibility has given rise to accelerated change both in the uptake of initiatives and the realization of their outcomes to meet external targets. Whilst a multitude of change management methodologies exist, their application in complex healthcare contexts remains unclear.

Balluck, J., Asturi, E., & Brockman, V. (2020). Use of the ADKAR® and CLARC ® Change Models to Navigate Staffing Model Changes During the COVID-19 Pandemic. Nurse leader, 18(6), 539–546. https://doi.org/10.1016/j.mnl.2020.08.006

Harrison, R., Fischer, S., Walpola, R. L., Chauhan, A., Babalola, T., Mears, S., & Le-Dao, H. (2021). Where Do Models for Change Management, Improvement and Implementation Meet? A Systematic Review of the Applications of Change Management Models in Healthcare. Journal of healthcare leadership, 13, 85–108. https://doi.org/10.2147/JHL.S289176