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Regional Medical Center: Changes and Negotiations Plan


The selected practicum problem is reducing respiratory complications in patients undergoing interventional radiological procedures under conscious sedation at Kendall Regional Medical Center. The change and negotiation plan at hand describe the key aspects of the proposed change implementation process putting a particular emphasis on the need for effective communication tactics and strategies. Hence, it is proposed that one of the major drivers of a smooth change flow is a negotiation that relies on establishing a shared vision of the change value, eliminating employee resistance, and encouraging their inclusion through such methods as continual communication, storytelling, and discourse, to name but a few. The paper likewise elucidates the theoretical basis of the change proposal and the underpinning change theory, i.e. Lewin’s Change Management Model that advances the idea of eliminating resistance through “unfreezing” employees’ emotional reinforcement.


The proposed change is reducing respiratory complications in patients undergoing interventional radiological procedures under conscious sedation at Kendall Regional Medical Center. The change implementation plan is based on the principle of Lewin’s Change Management Model that prioritizes the elimination of employee barriers through consistent communication (McCalman & Potter, 2015).

As a result, a particular aspect is put on negotiations as one of the major tools that can ensure a smooth transition to new operation patterns. The paper at hand targets to elucidate the main change objectives, the associated processes, and the involved stakeholders. It likewise focuses on the target communication tactics and strategies that are expected to impede the change progress.

Analysis of the Practicum Problem

In the framework of this practicum, it is proposed to address the problem of respiratory complications in patients undergoing interventional radiological procedures under conscious sedation at Kendall Regional Medical Center. In medical practice, conscious sedation is considered to be the safest type of sedation that implies minimal risks of adverse health outcomes (Amornyotin, 2013).

In the meantime, according to the latest studies, this procedure exhibits a high incidence of respiratory complications including hypoxia and hypoventilation. The described complications hurt the recovery process impeding it significantly and lowering the beneficial effect of the prescribed interventions. As a result, the length of hospital stay increases as well as the possibility of repeated hospitalization (Blayney, 2012). Therefore, it is considered critical to address this problem promptly to reduce the incidence of respiratory complications and improve patient outcomes.

Description of the Chosen Change Theory

The chosen change theory is Lewin’s Change Management Model. Hence, this model suggests that employee resistance to change can be eliminated in a series of simple steps. First and foremost, it is essential to perform the so-called “unfreezing” procedure that implies making employees more flexible and tolerant by challenging their beliefs and prejudices. As soon as the employees show their emotional readiness, they should be advised on the change essentials and prepared for its implementation. To help them overcome the psychological resistance, it is necessary to ensure that the change goals and outcomes are clearly outlined, and the potential benefits are explained in detail. Unless the shared vision of the change is established, employees will remain unconfident, and their resistance will grow, impeding the implementation progress (McCalman & Potter, 2015). This strategy is considered to be effective as it provides distinct guidelines for eliminating resistance and establishing an environment favorable for smooth transformations.

Proposed Changes, Strategies, and the Importance of Each

The proposed changes are to be carried out within three dimensions: communication, education, and collaboration. Hence, the first strategy aims to ensure that the change value is properly communicated to employees so that the latter has a shared vision of the expected outcomes. This strategy is important as it is supposed to ensure employee motivation and enhanced inclusion in the implementation process. The second strategy relies on the principle of continual improvement and suggests that the employees should receive the essential training to be able to assist in the change implementation. This strategy is likewise critical since it is expected to eliminate the skill barrier and lower employee resistance. The last strategy provides for enhancing common unity and ensuring a consistent collaboration between the stakeholder groups. This strategy plays a significant role in the change implementation since it helps to eliminate typical operation flaws that tend to impede the progress (Persily, 2013).

The Various Stakeholders and Their Roles within the Change

The proposed change will essentially involve a series of stakeholders. First, it is the Registered Nurses at the Intensive Care Unit that will play an important role in the change implementation. These stakeholders are responsible for improving general patient outcomes (Blegen, Vaughn, & Vojir, 2011). Thus, their evaluation of the change success will be particularly valuable. The second group of stakeholders is Interventional Radiology Nurses and Interventional Radiologists. These change actors have a clear understanding of the radiology impact on respiratory outcomes so that their expert opinion will be imperative while pointing out potential interventions.

The next group of stakeholders is patients and their families. The involvement of this group is critical as patients are the main target of the proposed change. In the meantime, opposite to other stakeholders, this group has low awareness of the radiology impact on respiratory complications so that the need for change should be communicated particularly effectively to them. The last stakeholder is the Nurse Director. The role of this change actor cannot be underestimated as they are supposed to ensure consistent and coordinated activity of all the other stakeholders.

Explanation of the Proposed Change Process

In the frame of this change project, it is proposed to establish improved nurse-patient relations to reduce respiratory complications in patients undergoing interventional radiological procedures under conscious sedation. The finite goal of the proposed change, therefore, resides in enhancing patient outcomes. It is assumed that the improvement of nurse-patient relationships can be reached through developing effective communication patterns that imply a positive attitude, information clarity, and consistent collaboration between the associated specialists.

To establish a positive attitude, nurses will develop individual approaches and consider patients’ characteristics including the social and cultural background (McFarland, Mixer, Webhe-Alamah, & Burk, 2012). They will likewise perform continual training to have a clear understanding of the radiological interventions, the associated outcomes, and risks. The training is also necessary to provide them with the latest data regarding potential alternatives for preventing respiratory complications. An effective collaboration, in its turn, can be established through consistent interactions between the involved specialists, the reciprocity of their vision of the essential prescription, etc. (Persily, 2013).

There is a series of processes that are considered to be critical to ensure a successful change implementation. First and foremost, it is necessary to formulate a concise goal and vision value and communicate it to the stakeholders properly to ensure the common vision of the change prospects. Second, it is proposed to determine the key roots of the resistance to change and eliminate them, enhancing, meanwhile, employees’ inspiration for intensive inclusion in the change processes. Finally, it is vital to perform a consistent evaluation of the change outcomes emphasizing the positive aspects and considering the causes of the identified failures.

Description of the Proposed Communication Plan for the Change

It is considered critical that the proposed change is properly communicated to the key stakeholders. The tactics that compose the communication plan are mainly aimed at eliminating employee resistance and ensuring the establishment of a shared vision of the change value. To complete the former task, it is proposed to use continuing communication and the method of storytelling. Continuing communication will help to establish positive reinforcement in the employees and lower their discredit (Nordin, 2014). Storytelling, in its turn, will help to encourage employees through real-life examples (Gill, 2011).

To complete the latter task, i.e. to ensure the shared vision of the change value, it is proposed to use such techniques as segmented communication and tailored communication. In other words, leaders’ message should be shaped by the peculiarities of the target audience so that it can be slightly reorganized while being communicated to a particular stakeholder group. Additionally, the most critical data should be delivered in person via Internet and print notes so that every change actor is sure to possess the key facts and figures associated with the change plan (Agency for Healthcare Research and Quality, 2012).

Explanation of the Tactics, Styles, and Strategies That Will Be Used In the Negotiation Processes

One of the principal strategies that will be used in the negotiation process is discourse. According to Norman (2013), this strategy will help to complete some short-term goals such as eliminating employee resistance to change and raising their involvement in the implementation process. The strategy implies organizing common discussions during which the key stakeholders will be able to share their vision of the change and offer their recommendations regarding the course of implementation.

Another important tactic that will be used in the negotiation process is shared decision making. Hence, it is proposed that all the critical decisions associated with the change implementation are made involving the main change actors to ensure that the best practices and experience are incorporated into the change strategy. Jaafarpour and Khani (2011) likewise believe that these tactics help to establish consistent team unity and increased responsibility for potential outcomes.

It is assumed that both tactics will assist in enhancing employee involvement and raising their commitment to the common goal.


Hence, the proposed change targets the improvement of the patient outcome as its long-term objective. To reach the set goal, it is proposed to implement the change through consistent communication and collaboration between the key stakeholders. It is considered critical to ensure the common involvement and the elimination of potential employee resistance. Likewise, it is assumed critical to communicate the change value to the main actors so that the latter have a shared vision of the expected outcomes and benefits.

Reference List

Agency for Healthcare Research and Quality. (2012). Communication and dissemination strategies to facilitate the use of health-related evidence. Web.

Amornyotin, S. (2013). Sedation-related complications in gastrointestinal endoscopy. World Journal of Gastrointestinal Endoscopy, 5(11), 527-533.

Blayney, M. R. (2012). Procedural sedation for adult patients: an overview. Continuing Education in Anesthesia, Critical Care & Pain, 12(4), 176-180.

Blegen, M., Vaughn, T., & Vojir, C. (2011). Nurse staffing levels: impact of organizational characteristics and registered nurse supply. Health Services Research, 43(1), 154-173.

Farland, M. C., Mixer, S. J., Webhe-Alamah, H., & Burk, R. (2012). Ethnonursing: A qualitative research method for studying culturally competent care across disciplines. International Journal of Qualitative Methods July, 11(3), 259-279.

Gill, D. R. (2011). Using storytelling to maintain employee loyalty during change. International Journal of Business and Social Science, 2(15), 23-32.

Jaafarpour, M., & Khani, A. (2011). Nurses’ roles in health promotion practice: an integrative review. Journal of Clinical and Diagnostic Research, 5(1), 16-19.

McCalman, J., & Potter, D. (2015). Leading cultural change: The theory and practice of successful organizational transformation. Philadelphia, PA: Kogan Page Publishers.

Nordin, J. (2014). Communicating organizational change: Strategies for communicating change. Web.

Norman, I. (2013). The art and science of mental health nursing: Principles and practice. Berkshire, England: McGraw-Hill Education.

Persily, C. A. (2013). Team leadership and partnering in nursing and health care. New York, NY: Springer Publishing Company.

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